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· Breast MRI is an essential part of breast imaging. · The recommendations for performing breast MRI have been updated. · A table provides a compact and quick overview. More detailed comments supplement the table.. · The "classic" breast MRI can be performed based on the recommendations. Tips for special clinical questions, such as implant rupture, mammary duct pathology or local lymph node status, are included.. CITATION FORMAT: · Wenkel E, Wunderlich P, Fallenberg E et al. Aktualisierung der Empfehlungen der AG Mammadiagnostik der Deutschen Röntgengesellschaft zur Durchführung der Mamma-MRT. Fortschr Röntgenstr 2024; 196: 939 - 944., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Axillary lymphadenopathy (LA) after COVID-19 vaccination is now known to be a common side effect. In these cases, malignancy cannot always be excluded on the basis of morphological imaging criteria.Narrative review for decision-making regarding control and follow-up intervals for axillary LA according to currently published research. This article provides a practical overview of the management of vaccine-associated LA using image examples and a flowchart and provides recommendations for follow-up intervals. A particular focus is on patients presenting for diagnostic breast imaging. The diagnostic criteria for pathological lymph nodes (LN) are explained.Axillary LA is a common adverse effect after COVID-19 vaccination (0.3-53%). The average duration of LA is more than 100 days. LA is also known to occur after other vaccinations, such as the seasonal influenza vaccine. Systematic studies on this topic are missing. Other causes of LA after vaccination (infections, autoimmune diseases, malignancies) should be considered for the differential diagnosis. If the LA persists for more than 3 months after COVID-19 vaccination, a primarily sonographic follow-up examination is recommended after another 3 months. A minimally invasive biopsy of the LA is recommended if a clinically suspicious LN persists or progresses. In the case of histologically confirmed breast cancer, a core biopsy without a follow-up interval is recommended regardless of the vaccination, as treatment appropriate to the stage should not be influenced by follow-up intervals. For follow-up after breast cancer, the procedure depends on the duration of the LA and the woman's individual risk of recurrence.Vaccination history should be well documented and taken into account when evaluating suspicious LN. Biopsy of abnormal, persistent, or progressive LNs is recommended. Preoperative staging of breast cancer should not be delayed by follow-up. The risk of false-positive findings is accepted, and the suspicious LNs are histologically examined in a minimally invasive procedure. · The vaccination history must be documented (vaccine, date, place of application).. · If axillary LA persists for more than 3 months after vaccination, a sonographic follow-up examination is recommended after 3 months.. · Enlarged LNs that are persistent, progressive in size, or are suspicious on control sonography should be biopsied.. · Suspicious LNs should be clarified before starting oncological therapy, irrespective of the vaccination status, according to the guidelines and without delaying therapy.. · Wilpert C, Wenkel E, Baltzer PA et al. Vaccine-associated axillary lymphadenopathy with a focus on COVID-19 vaccines. Fortschr Röntgenstr 2024; DOI 10.1055/a-2328-7536., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Purpose: Breast imaging represents an integral part of radiology and is subject to strict quality controls. Regarding this, precise diagnostics including multimodal assessment by mammography, sonography, and MRI, including image-guided biopsy and localization procedures, is often decisive and must be performed by experts with profound knowledge and skills in all of these procedures.However, due to numerous restructurings, breast imaging has been shifted more and more towards large, specialized centers, resulting in less patient exposition and training opportunities for radiologists in smaller sites. The following whitepaper summarizes the current circumstances and discusses opinions of the participating societies., Materials: Under the leadership of the German Roentgen Society (DRG) and with the participation of the DRG's AG Mammadiagnostik, the CAFRAD (Chefarztforum Radiologie), the KLR (Konferenz der Lehrstuhlinhaber für Radiologie e. V.), the DRG's Forum Junge Radiologie (FJR) and the Berufsverband der Deutschen Radiologen e. V. (BDR), possible solutions were discussed and consented for a structured training in breast radiology in the future., Results: In addition to the teaching provided at the primary workplace, qualified training should be ensured through flexible, multi-institutional, interdisciplinary, and cross-sectoral collaboration. Furthermore, the integration of online case collections and close cooperation with certified breast cancer centers and mammography screening units is recommended. It is indispensible that online courses and case collections adhere to the standards of the national societies and include a maximum of one third of the required cases., Conclusion: In order to provide training in breast radiology at a high professional level, a paradigm shift with closer cooperation of all participants is necessary. This includes close collaboration of the breast imaging societies with the federal medical associations to establish new teaching concepts like e-learning in the training schedule of radiologists., Key Points: · Breast diagnostics is an integral part of radiology training.. · Due to recent restructurings, smaller training centers have difficulties in meeting the case numbers demanded by the Specialist Training Regulations (WBO). Improved integration of the new structures and their adaptation to the needs of education are necessary to guarantee standardized high-quality training of young radiologists.. · The integration of certified case collections enables quality-assured training, even across regions in online-based formats. In accordance with the "blended learning principle", up to one-third of the required number of patient studies can be substituted with cases from a certified case collection.. · Legally secured short- and medium-term internships may complement training in radiology.., Citation Format: · Sauer ST, Bley TA, Wenkel E et al. Whitepaper: Training in Diagnostic and Interventional Breast Radiology. Fortschr Röntgenstr 2023; 195: 699 - 706., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose  The aim was to evaluate a minimum echo time (minTE) protocol for breast magnetic resonance imaging (MRI) in patients with breast lesions compared to a standard TE (nTE) time protocol. Methods  Breasts of 144 women were examined with a 1.5 Tesla MRI scanner. Additionally to the standard gradient-echo sequence with nTE (4.8 ms), a variant with minimum TE (1.2 ms) was used in an interleaved fashion which leads to a better temporal resolution and should reduce the scan time by approximately 50 %. Lesion sizes were measured and the signal-to-noise ratio (SNR) as well as the contrast-to-noise ratio (CNR) were calculated. Subjective confidence was evaluated using a 3-point scale before looking at the nTE sequences (1 = very sure that I can identify a lesion and classify it, 2 = quite sure that I can identify a lesion and classify it, 3 = definitely want to see nTE for final assessment) and the subjective image quality of all examinations was evaluated using a four-grade scale (1 = sharp, 2 = slight blur, 3 = moderate blur and 4 = severe blur/not evaluable) for lesion and skin sharpness. Lesion morphology and contrast enhancement were also evaluated. Results  With minTE sequences, no lesion was rated with "definitely want to see nTE sequences for final assessment". The difference of the longitudinal and transverse diameter did not differ significantly (p > 0.05). With minTE, lesions and skin were rated to be significantly more blurry (p < 0.01 for lesions and p < 0.05 for skin). There was no difference between both sequences with respect to SNR, CNR, lesion morphology, contrast enhancement and detection of multifocal disease. Conclusion  Dynamic breast MRI with a minTE protocol is feasible without a major loss of information (SNR, CNR, lesion morphology, contrast enhancement and lesion sizes) and the temporal resolution can be increased by a factor of 2 using minTE sequences. Key points   · Increase of temporal resolution for a better in-flow curve.. · Dynamic breast MRI with a shorter TE time is possible without relevant loss of information.. · Possible decrease of the overall scan time.. Citation Format · Wenkel E, Janka R, Geppert C et al. Breast MRI at Very Short TE (minTE): Image Analysis of minTE Sequences on Non-Fat-Saturated, Subtracted T1-Weighted Images. Fortschr Röntgenstr 2017; 189: 137 - 145., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: The presented study aimed at optimizing a patient table design for breast CT (BCT) systems with respect to breast tissue coverage and patient comfort. Additionally, the benefits and acceptance of an immobilization device for BCT using underpressure were evaluated., Materials and Methods: Three different study parts were carried out. In a positioning study women were investigated on an MRI tabletop with exchangeable inserts (flat and cone-shaped with different opening diameters) to evaluate their influence on breast coverage and patient comfort in various positioning alternatives. Breast length and volume were calculated to compare positioning modalities including various opening diameters and forms. In the second study part, an underpressure system was tested for its functionality and comfort on a stereotactic biopsy table mimicking a future CT scanner table. In the last study part, this system was tested regarding breast tissue coverage., Results: Best results for breast tissue coverage were shown for cone-shaped table inserts with an opening of 180 mm. Flat inserts did not provide complete coverage of breast tissue. The underpressure system showed robust function and tended to pull more breast tissue into the field of view. Patient comfort was rated good for all table inserts, with highest ratings for cone-shaped inserts., Conclusion: Cone-shaped tabletops appeared to be adequate for BCT systems and to allow imaging of almost the complete breast. An underpressure system proved promising for the fixation of the breast during imaging and increased coverage. Patient comfort appears to be adequate., Key Points: Tissue coverage in breast CT is highly dependent on patient table design. An underpressure fixation system shows potential to increase breast coverage. The proposed breast CT patient table design combines good coverage and patient comfort., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: The presented study aimed at optimizing a patient table design for breast CT (BCT) systems with respect to breast tissue coverage and patient comfort. Additionally, the benefits and acceptance of an immobilization device for BCT using underpressure were evaluated., Materials and Methods: Three different study parts were carried out. In a positioning study women were investigated on an MRI tabletop with exchangeable inserts (flat and cone-shaped with different opening diameters) to evaluate their influence on breast coverage and patient comfort in various positioning alternatives. Breast length and volume were calculated to compare positioning modalities including various opening diameters and forms. In the second study part, an underpressure system was tested for its functionality and comfort on a stereotactic biopsy table mimicking a future CT scanner table. In the last study part, this system was tested regarding breast tissue coverage., Results: Best results for breast tissue coverage were shown for cone-shaped table inserts with an opening of 180 mm. Flat inserts did not provide complete coverage of breast tissue. The underpressure system showed robust function and tended to pull more breast tissue into the field of view. Patient comfort was rated good for all table inserts, with highest ratings for cone-shaped inserts., Conclusion: Cone-shaped tabletops appeared to be adequate for BCT systems and to allow imaging of almost the complete breast. An underpressure system proved promising for the fixation of the breast during imaging and increased coverage. Patient comfort appears to be adequate., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: Many publications describe the use of diffusion-weighted imaging (DWI) in breast MRI. This article addresses the question of when to apply the DWI sequence in the course of the scan protocol. The effect of T1-shortening contrast media (CM) on the ADC values of breast lesions is investigated., Materials and Methods: Data were acquired on a 1.5 T scanner. 60 patients with 79 lesions (20 benign, 59 malignant) were included. The DWI sequence (4 mm slice thickness, b-values: 50, 400, 800) was applied before and after CM administration. Before calculating the ADC map, the b50, b400 and b800 series were analyzed concerning lesion displacement. ADC values before and after CM application were compared., Results: The mean lesion size was 1.5 ± 0.8 cm. On the basis of the b50 and b400 measurements, the mean ADC value of benign lesions was 1.89 ± 0.30 × 10-3 mm2/s before and 1.85 ± 0.28 ×10-3 mm2/s after CM administration. The consecutive values for two pure mucinous carcinomas were 1.88 × 10-3 mm2/s and 1.81 × 103 mm2/s and for the remaining malignant lesions 1.00 ± 0.18 × 10-3 mm2/s and 0.88 ± 0.21 × 10-3 mm2. On the basis of the b50, b400 and b800 measurements, the mean ADC value of benign lesions was 1.99 ± 0.37 × 10-3 mm2/s before and 1.97 ± 0.30 × 10-3 mm2/s after CM application, whereas the mean ADC value of the malignant lesions was 0.90 ± 0.14 × 10-3 mm2/s before and 0.80 ± 0.14 × 10-3 mm2/s after CM application. While there was no significant change for benign lesions, the ADC value decrease in post-contrast malignant lesions was highly significant., Conclusion: DWI after CM is possible and even leads to slightly better lesion discrimination between benign and malignant. However, further studies need to be performed to verify this. Citation Format: • Janka R, Hammon M, Geppert C et al. Diffusion-Weighted MR Imaging of Benign and Malignant Breast Lesions Before and After Contrast Enhancement. Fortschr Röntgenstr 2014; 186: 130 - 135., (© Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: Evaluation of an automated breast ultrasound system (ABUS) regarding the detection and classification of breast lesions according to BI-RADS., Materials and Methods: Women were selected for the study who had unclear findings in breast diagnosis performed elsewhere (palpation, sonography or mammography) and who were referred for further work-up. All patients received a hand-held ultrasonography (HHUS) with a 13 MHz transducer, clinical examination and mammography of both breasts. Additionally, the affected breast received the ABUS (SomoVuTM, U-Systems, Inc., San Jose, CA, USA; EC Representative: Siemens, Erlangen, Germany) which was performed with an 8 MHz transducer. Five radiologists independently evaluated the ABUS images regarding lesion detectability. All detected lesions were classified according to BI-RADS assessment. The examiners had no knowledge of the patients' clinical examination or of the result of the mammography or the HHUS. Results of the ABUS were compared to HHUS., Results: 35 women were included in the study. 25 BI-RADS 4 or 5 lesions had further histological (n = 23) or cytological (n = 2) work-up which revealed 13 malignant and 12 benign findings. The size of all lesions ranged from 6 to 32 mm (median 14 mm). With the ABUS all examiners detected 29 to 30 lesions while HHUS revealed 30 lesions. One suspicious area in HHUS was not reported by any of the five examiners with the ABUS. Histology of this area revealed mastopathic disease. No benign lesion was classified as BI-RADS 5 with the ABUS or HHUS. All breast cancers were found with the ABUS by all examiners and correctly classified as BI-RADS 4 or 5. There was good agreement regarding BI-RADS classification of HHUS and ABUS for the five different examiners with Kappa values between 0.83 and 0.87., Conclusion: These preliminary results show that the ABUS allows detection of solid and cystic lesions and their BI-RADS classification with a high reliability in a selected patient group.

Purpose: Evaluation of the diagnostic value of breast specimen imaging with a digital mammographic system using a detector system with changeable pixel size compared to standard mode imaging in different monitor display modes., Materials and Methods: Using the digital mammographic system SenoScan (Fischer Imaging, Denver, USA), 50 diagnostic breast specimens with microcalcifications were visualized in both standard mode (pixel size 54 microm) and high resolution mode (pixel size 27 microm). The resulting radiographs were displayed 1:1 on a monitor. Standard mode images (pixel size 54 microm) were additionally displayed in a 2:1 mode. A total of 5 readers with different mammographic experience analyzed the type of the microcalcifications on the basis of the different display modes. The images were presented randomly. The findings were subsequently compared to the histology., Results: The high resolution mode yielded slightly but not significantly better results than the standard mode on average for all 5 readers. Compared to a sensitivity of 80 % and a specificity of 72 % (PPV = 74 %, NPV = 78 %) in the standard mode, the high resolution mode provided a sensitivity of 86 % and a specificity of 74 % (PPV = 77 %, NPV = 83 %). The standard mode images on a 2:1 monitor display yielded 84 % and 74 % (PPV = 76 %, NPV = 82 %)., Conclusion: The high resolution mode did not significantly increase the sensitivity and specificity of the microcalcification reading. A similar improvement was achieved by the 2:1 display mode, i. e. digital monitor zooming. For the clinical situation this means that there is no diagnostic advantage from using a high resolution target view with this mammographic system.

Purpose: Reduction of radiation exposure at an adequate image quality by optimizing the radiation quality for a new system of full-field digital mammography using a digital detector (a-Se)., Materials and Methods: The investigations were performed using a digital mammography system Novation (Siemens, Erlangen). The system was constructed with a bimetal anode (molybdenum and tungsten) and the possibility of changing the filter (molybdenum/rhodium). The test object was the Wisconsin Mammography Random Phantom Model 152 A (Radiation Measurements Inc.) of which images were acquired using the digital technique with the tungsten anode and rhodium filter at different tube voltages (26-35 kV) and tube loads (40-100 mAs) and compared to images in the molybdan/molybdan molybdenum/molybdenum technique. To quantify the image quality, we used the detection rate of the simulated lesions in the phantom., Results: Increasing the tube voltage significantly decreases the average glandular dose when using AEC (Automatic Exposure Control), i. e., constant detector dose. At the same time, the image quality decreases significantly with respect to the detection rate (26 kV, 1 mGy, 95.1 %; 35 kV, 0.7 mGy, 82.7 %). As a good compromise between the necessary diagnostic image quality and the lowest dose exposition, 28 kV and 60 mAs were selected for imaging with the tungsten/rhodium anode/filter combination. A further change to the tube load did not make sense because a decrease of 10 % resulted in a significant decrease in the detection rate while only a 2 % increase in detection rate was achieved for a 65 % increase in radiation exposure., Conclusion: The results of this phantom study demonstrate that the routine use of the tungsten anode in combination with a rhodium filter for full-field digital mammography with an a-Se detector in contrast to a molybdan/molybdan molybdenum/molybdenum anode/filter combination results in a reduction of the average glandular dose of up to 30 % without loss of diagnostic image quality.

Purpose: To compare the sensitivity of conventional two-dimensional (2D) projection imaging with tomosynthesis with respect to the detectability of mammographic phantom lesions., Materials and Methods: Using a breast tomosynthesis prototype based on a commercial FFDM system (Siemens MAMMOMAT Novation), but modified for a wide angle tube motion and equipped with a fast read-out amorphous selenium detector, we acquired standard 2D images and tomosynthesis series of projection views. We used the Wisconsin mammographic random phantom, model RMI 152A. The anode filter combinations Mo/Mo and W/Rh at two different doses were used as typical radiographic techniques. Slice images through the phantom parallel to the detector were reconstructed with a distance of 1 mm employing a filtered back-projection algorithm. The image data sets were read by five radiologists and evaluated with respect to the detectability of the phantom details., Results: For all studied radiographic techniques, the detection rate in the tomosynthesis mode was 100 %, i. e. 75 true positive findings out of 75 possible hits. In contrast, the conventional projection mode yielded a detection rate between 80 and 93 % (corresponding to 60 and 70 detected details) depending on the dose and X-ray spectrum., Conclusion: Tomosynthesis has the potential to increase the sensitivity of digital mammography. Overlapping structures from out-of-plane tissue can be removed in the tomosynthesis reconstruction process, thereby enhancing the diagnostic accuracy.

Purpose: To determine the diagnostic accuracy of microcalcifications and focal lesions in a retrospective clinical-histological study using high-resolution digital phosphor storage plates (hard copy) and full-field digital mammography (hard copy)., Materials and Methods: From May 2003 to September 2003, 102 patients underwent digital storage plate mammography (CR), using a mammography unit (Mammomat 3000 N, Siemens) in combination with a high resolution (9 lp/mm) digital storage phosphor plate system (pixel size 50 microm) (Fuji/Siemens). After diagnosis and preoperative wire localization, full-field digital mammography (CCD) (DR) was performed with the same exposure parameters. The full-field digital mammography used a CCD-detector (SenoScan) (Fisher Imaging) with a resolution of 10 Ip/mm and a pixel size of 50 microm. Five investigators determined the diagnosis (BI-RADS I - V) retrospectively after the operation from randomly distributed mediolateral views (hard copy reading). These results were correlated with the final histology., Results: The diagnostic accuracy of digital storage plate mammography (CR) and full-field digital mammography (CCD) (DR) was 73 % and 71 % for all findings (n = 102), 73 % and 71 % for microcalcifications (n = 51), and 72 % and 70 % for focal lesions (n = 51). The overall results showed no difference., Conclusion: Our findings indicate the equivalence of high-resolution digital phosphor storage plate mammography (CR) and full-field digital mammography (CCD) (DR).

Purpose: Experimental phantom study for the detection of simulated lesions with five different digital and one conventional screen-film mammography system., Materials and Methods: Three radiographs were obtained at various configurations of the phantom with one conventional screen-film system (Mammomat 3000 N) (Siemens), five digital systems (high resolution computed radiography system [Fuji/Siemens], one a-Si detector [GE Medical Systems], two a-Se detectors [Siemens; Hologic / Lorad] and one CCD detector [Fischer Imaging]), applying the same exposure parameters. The Wisconsin Mammographic Random Phantom, Model 152 A, was used. Five investigators with different experience in mammography (3 months to more than 4 years) evaluated the 18 randomly selected radiographs., Results: No significant differences were found in the detection rate of simulated breast lesions for conventional screen-film mammography (84.9 %), high resolution computed radiography (86.7 %) and digital mammography with an a-Si detector (89.8 %). Highly significantly better results (p < 0.001) were found with the two a-Se systems (97.3 %) and the CCD system (100 %)., Conclusion: Conventional screen-film mammography can be replaced by high resolution computed radiography and digital mammography with a-Si-, a-Se- and CCD-detectors. This has to be confirmed in further clinical studies.

Purpose: Experimental investigations of a new digital mammography system., Materials and Methods: The digital mammography system SenoScan (Fischer Imaging) is based on 4 charged coupled devices (CCD) (slot detector). The pixel size is 50 micro m, field of view 21 x 29 cm (2), effective quantum efficiency (DQE) (0) 50 %, spatial resolution 10 lp/mm, and memory depth 12 bit. The object of investigation was the Wisconsin Mammographic Random Phantom, Model 152 A (Radiation Measurements Inc., Wisconsin). The radiograms were acquired using the digital mammography system., Results: The digital mammography detected 225 of 225 possible details. The surface dose was 6.95 mGy., Conclusions: These experimental results support the use of the digital mammography in practice. This has to be confirmed in further clinical trials.

Purpose: A retrospective clinical-histological study to determine the diagnostic accuracy of mammography using conventional screen-film cassettes (hard copy), high-resolution digital phosphor storage plates (hard copy) and monitor display (soft copy) for microcalcifications and focal lesions (BI-RADS (TM) category 4 or 5)., Materials and Methods: From April to November 2001, 76 patients underwent conventional film-screen mammography and, after diagnosis and preoperative wire localization, digital mammography with the same exposure parameters. Five investigators retrospectively determined the diagnosis after the operation from randomly distributed mediolateral views (hard-copy reading) and from the monitor display (soft-copy reading). These results were correlated with the final histology., Results: The accuracy of conventional screen-film mammography, digital mammography and monitor-displayed mammography was 67%, 65% and 68% for all findings, (n = 76), 59%, 59% and 68% for microcalcifications (n = 44) and 75%, 72% and 63% for focal lesions (n = 32). The overall results showed no difference., Conclusion: Our findings indicate equivalence of conventional screen-film mammography, high-resolution digital phosphor storage plate mammography and monitor-displayed mammography.

Purpose: Determination of image quality of a new digital mammography system with an a-Se-detector., Material and Method: Radiograms of the Wisconsin Mammographic Random Phantom, Modell 152 A (Radiation Measurements Inc., Wisconsin) were acquired using a conventional film screen and a digital system., Results: With the conventional film screen system there were detected 191/a 38.2 and with the digital mammography 219/a 43.8 of 225 possible details., Conclusion: Based on these results there is the possibility to replace the conventional film screen system by the digital mammography with a-Se-detector--this has to be confirmed in further clinical trials.

Purpose: We wanted to determine if tissue marker clips after sonographically or stereotactically guided breast biopsy improve the follow-up of small breast lesions classified BI-RADS 4/5 and the localisation of breast cancer (TNM stage 2 or 3) after neoadjuvant chemotherapy., Material and Methods: Prospective analysis was performed of 108 breast lesions 1 cm or smaller mammographically classified as BI-RADS 4/5 and 14 breast lesions larger than 2 cm mammographically classified as BI-RADS 5. 33 of the 108 breast lesions 1 cm or smaller underwent sonographic core cut breast biopsy (group 1) and 75 stereotactic vacuum-assisted breast biopsy (group 2). All 14 lesions greater than 2 cm were stereotactically vacuum-assisted breast biopsied (group 3). The centre of the lesion was marked by a clip after the biopsy. Mammographies were performed in all patients of group 1 and 2 with a histologically benign finding (n = 31, n = 69, respectively) and in all patients of group 3 directly after clip placement and after 6 and 12 months. Clip localisation and possible divergence from the original position were verified by a grid., Results: Two patients of group 1 and 6 patients of group 2 had breast conservative surgery (BET) because of the histological diagnosis of a ductal carcinoma in situ or invasive breast cancer. The tissue marker clips of the remaining 31 patients of group 1 and 69 patients of group 2 diverged with a mean value of 0.4 cm (standard deviation +/- 0.23 cm; range 0.1 cm to 0.9 cm) from their placement position after 6 months. After 12 months the marker clips deviated with a mean value of 0.4 cm (standard deviation +/- 0.21 cm; range 0.1 cm to 0.9 cm) in 94 patients and 0.8 cm (standard deviation +/- 0.25 cm; range 0.1 cm to 0.9 cm) in 6 patients from their original location. No tumour progression of the benign lesions in group 1 and 2 was diagnosed in follow-up mammograms. In all patients of group 3 the tissue marker clips were the only possibility to localize the tumour after neoadjuvant chemotherapy as all other diagnostic methods showed inconsistent results., Conclusion: Positioning a tissue marker clip in the tumour centre seems to be reasonable after interventional biopsy of breast lesions of 1.0 cm or smaller and before neoadjuvant chemotherapy.