Breast biopsies are mandated before surgery to confirm the diagnosis and to plan a sentinel node biopsy. Ultrasound or stereotactic breast biopsies are commonly performed, nevertheless, when the lesion is not visible on mammogram or ultrasound, some alternative biopsy techniques are necessary. Breast biopsy can be guided by CT or MRI also. CT guided breast biopsy is useful when the lesion is visible on CT, and when access to MRI biopsy is not possible. CT guidance is less precise as MR guidance due to the absence of dedicated compression device on CT. MRI breast biopsy should be preferred today for suspicious occult lesions on mammogram or US. MR biopsy is precise but the procedure is long and more difficult compare to CT breast biopsy. Once the lesion has been localized, signal of the lesion should be totally removed in order to reduce the number of false negative. A mark should be placed in the biopsy area, if a further surgery will be performed. Alternative breast biopsies should be known from the clinicians and discussed with the radiologist for an adequate treatment of the patient, especially for high risk women.