Cook the ground beef, onion and garlic in a skillet with a lid over medium heat. The ground beef should be browned and broken down. Drain.
Stir the Worcestershire sauce and tomato paste into the ground beef.
Mix the beef broth with uncooked elbow pasta. Mix well and bring to boil.
After the pan has boiled, cover it with a lid and turn down the heat to medium-low.
Let the pasta cook for about 15 minutes, or until the liquid has evaporated.
Mix in the cream, shredded cheese, and sour milk. Stir until combined.
Serve immediately
You can keep leftovers in a Tupperware container for several days. In the microwave.