Coexistent carcinoma and tuberculosis in a breast is a rare entity. It poses problems right from the diagnosis and staging of carcinoma to treatment and patient compliance. Proper clinical examination and investigations should be performed in such cases as both carcinoma and tuberculosis are major diseases with no definite symptoms or signs to distinguish the two. Herein, we report the case of a 45-year-old female who presented with complaints of a lump and pain in left breast, weight loss and weakness for the past 4 months. Fine needle aspiration cytology from the breast lump showed clusters of malignant cells along with many loose clusters of epithelioid cells on a background showing caseous necrosis. A diagnosis of coexisting breast carcinoma and tuberculosis of the breast was made and antitubercular treatment was started. The patient was operated and histopathology confirmed the diagnosis.