Preoperative staging of breast cancer based on breast imaging is mandatory. Breast imaging is a general term that encompasses mammography, breast sonography, and breast magnetic resonance tomography (MR-mammography, MRM). It is known that earlier diagnosis of breast cancer is more likely to result in a favourable oncological outcome. Use, limitations, and influences on surgical procedures of MR-mammography in diagnosis and staging of breast cancer have to be discussed. Different interventional procedures have been developed. The histological results of interventional procedures guided by ultrasound, stereotactic mammography or magnetic resonance have to be integrated in planning surgical resection margins in oncoplastic breast-conserving surgery. Image-guided wire markings are an important tool for planning these surgical margins. This review gives an overview regarding the influences of breast imaging, interventional procedures, and wire markings on breast-conserving therapy of breast cancer. Breast imaging and interventional procedures are the basis for a concept of targeted oncoplastic breast surgery.