The management of breast cancer involves a multidisciplinary team approach involving the surgeon, radiologist, pathologist, radiotherapist, and clinical oncologist. Radiology in the management of breast cancer patients allows for lesion detection and characterization, confirmation of diagnosis with image-guided biopsy, post-biopsy placement of clip marker, confirmation of patients’ eligibility for breast conservation surgery, image-guided localization, staging, evaluation of response to therapy before surgery, and follow-up after treatment for breast cancer. This narrative review is based on a case of a 35-year-old woman offered breast-conserving therapy for stage IIB breast cancer in a tertiary hospital in Southwest Nigeria. This case-based review highlights the radiologist’s vital role in breast conservation in the management of breast cancer, elaborating on the radiological management of this patient.