Figure 8: 47-year-old female with biopsy-proven left breast invasive mammary carcinoma and metastatic left axillary lymphadenopathy. Known metastatic lymph node could not be seen under ultrasound at the time of surgery and underwent tomosynthesis guided localization. (a) Diagnostic mammogram mediolateral oblique view demonstrating an axillary lymph node with a biopsy clip (arrow) abutting it. This lymph node was targeted for digital localization using tomosynthesis guidance. The depth from the skin surface was calculated and a seed was placed at the correct depth. (b) Needle being advanced under tomosynthesis guidance perpendicular to the skin surface. The needle tip is seen immediately adjacent to the clip (arrow). A seed was subsequently deployed. (c) Postprocedure mammogram demonstrating both the seed (arrowhead) and the clip (arrow) adjacent to each other.