Cook macaroni according to package directions; drain. Place cooked macaroni in a lightly greased 2-quart baking dish.
Combine onion and next 9 ingredients; stir in almonds, if desired.
Cook milk in a small saucepan over low heat just until heated; stir into onion mixture (bread should dissolve). Pour over macaroni.
Bake casserole at 350° for 45 to 50 minutes.