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The manifestations of tuberculosis (TB) are myriad and can affect any organ. Involvement of breast by TB is rare and the condition is often mistaken with breast cancer or pyogenic breast abscess. We report the case of a 75-year-old woman with long standing type 2 diabetes mellitus who presented with a swelling in the left breast. Core biopsy of the swelling showed necrotizing epithelioid granulomas with acid-fast bacilli. The patient responded well to short-course anti-TB treatment. The present case documents the uncommon isolated occurrence of TB of the breast in a patient with long standing type 2 diabetes mellitus.