Percutaneous, image-guided breast interventional procedures have emerged as the standard for diagnosing both palpable and nonpalpable breast lesions and preoperative localization. These procedures, utilizing ultrasound, mammography, or MRI guidance, offer a minimally invasive, accurate, and cost-effective alternative to open surgical biopsies. They significantly reduce false-negative rates and facilitate precise targeting of lesions, minimizing sampling errors and complications. Preoperative localization techniques, including wire and nonwire methods, aid in surgical planning and ensure successful tumor removal. Compared to open surgical procedures, minimally invasive interventions result in reduced invasiveness, fewer complications, minimal scarring, and faster recovery times. Percutaneous interventions play a vital role in guiding surgical excision and improving diagnostic accuracy. Ongoing research aims to further enhance their efficacy and impact on patient management, particularly in assessing pathological responses and guiding surgical decisions.