Current imaging is able to detect microscopic lesions in the breast that may not be clinically palpable. It has been reported that 22% of palpation-negative breast calcifications at BI-RADS levels 3 and 4 are malignant lesions. Therefore, localization biopsy should be performed for calcified foci with negative palpation in high BI-RAD grades in order to improve the early diagnosis and treatment of breast cancer. Current localization biopsy techniques include: ① ultrasound-guided aspiration and surgical biopsy; ② preoperative X-ray localization and surgical biopsy; ③ stereotactic core-needle biopsy (CNB); ④ stereotactic fine-needle aspiration biopsy (FNAB); ⑤ stereotactic vacuum-assisted biopsy (MNA); and ⑤ stereotactic biopsy. The vacuum-assisted biopsy technique (Mammotome system), etc. Fine-needle aspiration biopsy can only provide qualitative diagnosis, and core needle biopsy or vacuum-assisted biopsy should be used for requests for more diagnostic information (e.g., receptor status, tumor grading, etc.). The underestimation rate of CNB for malignancy of microcalcifications has been reported to be 26.6%, and the accuracy of FNAB is lower than that of CNB; therefore, FNAB and CNB are more suitable for pretreatment biopsy of clinically palpable masses. Needle tract metastasis has been a concern for researchers performing puncture biopsies. Diaz LK et al. concluded that 32% of preoperative CNB punctures were performed and needle tract implants occurred, but the longer the time interval between puncture and surgical resection, the fewer tumor strains were implanted, and presumably needle tract implants do not readily form metastatic foci. Vacuum-assisted biopsy by ultrasound or molybdenum targeting is suitable for calcified foci or microscopic masses of the breast, and for some limited benign lesions, in addition to achieving the purpose of biopsy diagnosis, it also accomplishes the treatment at the same time, with the disadvantage of the possibility of forming local hematoma complications. The various puncture biopsy techniques mentioned above are increasingly widely used, but they have not completely replaced surgical biopsy. Traditional surgical biopsy is blind, removes more tissue and is more traumatic. The application of preoperative X-ray localization puncture and surgical biopsy technique is to perform preoperative metal wire localization of calcified foci by mammography and accurate and complete excision of calcified foci under its guidance, which avoids the problem of missed biopsy of microcalcified foci by the above techniques and enables comprehensive assessment of the lesions. In a study of 209 localized excisions of microcalcifications in the breast, complete excision of microcalcifications was obtained in all patients, with a positive predictive value of 27.0% and 81.6% for BI-RADs category 4 and 5 lesions, respectively, which should be aggressively biopsied by local excision.