A 21-year-old female from hilly area of Kashmir, presented with pus discharge of from two openings on the right breast for last 6 years. These aberrant openings on breast had often spontaneous pus discharge followed by cessation of discharge on its own. There were neither any constitutional symptoms nor any discharge or any abnormality of the nipple. She had already taken antitubercular therapy (ATT) thrice but was defaulter all times and reluctant for further antitubercular therapy (ATT) intake. Systemic examination was normal. Local examination showed no abnormality in left breast. A 1.5 centimeter opening was seen in inferior and outer quadrant breast, through which whitish pus was discharging along with a scar superior to discharging sinus which used to discharge pus 2 weeks before. (Figure 1). No swelling was palpable. Two firm tracts, inferior one with length of 4 cm, superior with 2.5 cm, were run posterior-superiorly ending on fifth rib. No axillary lymphadenopathy was evident. Erythrocyte sedimentation rate (ESR) was raised. Montoux test was positive (16x14 mm). X-ray chest showed an osteolytic lesion in anterior part of fifth rib. Computed tomography scan of chest could not reveal any foci of tuberculosis in lungs; only two sinus tracts in breast tissue and the necrosed rib were seen. Purulent aspirate was sterile for tubercle bacilli. Breast ultrasound showed ill-defined sinus tract and opening. Given the reluctance to antitubercular therapy (ATT) intake and recurrent disease coupled with apprehension of further followup, surgical intervention was done through fifth intercostal space. Excision of fibrous tract and resection of involved rib were carried out. (Figures 2 and 3) About 12 cm of rib containing pus and necrosed tissue were resected. Histopathology of specimen was chronic inflammatory cell infiltrate, with areas of caseous necrosis, giant cells (Figure 4). After proper counseling and understanding the nature of disease by patient and her parents the affected woman was motivated for antitubercular therapy (ATT) intake and with daily dose of 300 mg isoniazid, 600 mg rifampicin, 1500 mg pyrazinamide, ethambutol, and 10 mg pyridoxine for 9 months. She had regularly attended our followup clinics during last two years, with no recurrence of disease being recorded.