Figure 2: 57-year-old female with biopsy proven invasive ductal carcinoma in the lower outer left breast with a biopsy proven metastatic intramammary lymph node marked with a ribbon clip. Both the lymph node and the clip were sonographically occult after 5 months of neoadjuvant therapy. (a) Initial computed tomography axial slice identifies the radiodense clip in the far posterior left metastatic intramammary lymph node (arrow) which itself is no longer visible on computed tomography. (b) Axial computed tomography shows a 25-gauge local anesthesia needle confirming the trajectory for needle-directed seed localization. (c) Axial computed tomography confirms the 18-gauge coaxial localization needle tip (arrow) immediately adjacent to the clip, and a single radioactive I-125 seed is deployed. (d) Axial computed tomography after seed deployment confirms the seed (arrow) positioned immediately adjacent to the biopsy clip marking the site of malignancy. (e) Specimen radiograph from lumpectomy shows successful resection of both the radioactive seed and the ribbon shaped clip.