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Objectives: To explain the difficulties in diagnosing Breast tuberculosis (BT), especially in the absence of other specific clinical signs, and to emphasize the efficacy of anti-tuberculosis (TB) therapy. Methodology: We report nine cases of BT retrieved from the files of the TB patients in Khuzestan a province located in the south west of Iran during 5 years period of time (2005-2009). Data of fine needle aspiration (FNA) cytology, Ziel-Nelson stains, microbiological analysis, routine fungal and culture for tuberculosis were reviewed. Results: Age range was 25 to 51 years with a mean of 34.1 years. Two patients were lactating, and one patient was pregnant. Seven patients had a lump in the breast and four of these patients had a discharging sinus in association with the lump. Another two patients had multiple sinuses. Two patients had breast abscess. Cytology of the patients presented with breast lump or abscess showed granulomatus reaction with or without caseous. Culture was negative for M.tuberculosis in all cases. Conclusion: Cases with breast mass despite clinical suspicion of cancer, histologically presented with granulomatous mastitis even with culture negative results for TB are appropriate candidates for anti TB therapy. [ABSTRACT FROM AUTHOR]