In a large pot over a medium-high heat, add ground beef, onions, garlic, salt, pepper, worcestershire sauce, and ketchup. Break up the beef to incorporate the seasonings and cook until browned, about 6-7 minutes.
Pour in the beef broth and one cup of water and bring to a simmer.
Add the pasta and simmer for 20 minutes or until the pasta is cooked throughout and the broth has cooked down, stirring occasionally.
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Pour in the milk and cheese. Stir until the cheese has melted.