The coexistence of breast cancer and tuberculosis has been described in over 100 cases; however its coexistence in the axillary lymph node is rare with only a handful cases have been reported in the literature. We report a case of infiltrating ductal carcinoma of the left breast, metastatic to ipsilateral axillary lymph nodes harbouring tuberculous lymphadenitis without primary mammary or pulmonary tuberculosis. The case is presented for its rarity and illustrates that the simultaneous occurrence of tuberculosis and carcinoma can create a dilemma in the diagnosis and treatment, so surgeons and pathologists should keep such a combination on the back of their mind, especially in endemic areas.