Synchronous breast carcinoma with ipsilateral axillary tuberculosis, posing a diagnostic dilemma.

This case report describes a 63-year-old postmenopausal diabetic female with synchronous primary invasive ductal carcinoma of the right breast and tuberculosis (TB) of the ipsilateral axillary lymph nodes. Presenting with a palpable right breast lump and axillary lymphadenopathy, the patient underwent imaging, revealing BIRADS V classification and suspicious lymph nodes. Core needle biopsy confirmed invasive carcinoma, while lymph node histology revealed caseating granulomatous inflammation consistent with TB. Managed with modified radical mastectomy, adjuvant chemotherapy, and antitubercular therapy, the patient showed complete disease resolution on follow-up. This rare coexistence underscores the necessity for histopathological confirmation and multidisciplinary management to optimize outcomes.