BACKGROUND: The concept of personalized medicine is becoming increasingly important. The possibilities of diagnostics include not only genetic and molecular tumor profiles, but also the use of precise and individual imaging techniques. OBJECTIVES: The development and implementation of suitable diagnostic procedures with high sensitivity and specificity, which are at the same time tailored to the individual risk factors and biological characteristics of the patient, remain a challenge. MATERIALS AND METHODS: To enable personalized profiling, comprehensive diagnostics must be established that take into account all parameters such as imaging, molecular and genetic markers as well as real-world data and the use of artificial intelligence. This article sheds light on different approaches to personalized diagnostics in breast cancer and highlights the current clinical standard, innovative areas of research and the resulting challenges. CONCLUSION: The highest hurdles for newer imaging techniques are the standardization of image analysis and the validation of these techniques in large clinical trials. The use of artificial intelligence requires not only appropriate technical and medical expertise, but also a sensitive approach to issues such as data protection and patient privacy. Real-world registries offer insights into real world treatment situations and are therefore of great importance.