In breast cancer treatment it has become necessary to determine prognostic factors from small tissue specimens due to neoadjuvant Chemotherapies and small tumor size. This study compares the determination of the prognostic factors uPA (urokinase-type plasminogen activator) and PAI-1 (plasminogen activator inhibitor type 1) in surgical specimens and corresponding preoperative needle biopsies (n=163 Patients). Proteinlevels of uPA and PAI-1 below specified cut offs are associated with a significant lower risk of recurrence and better disease free survival. The prediction of the uPA-/PAI-1-Status by needle biopsy was correct with a sensitivity of 85-90% and a specifity of 69-89%. Due to positive predictive values of 88-96% the risk of an over-treatment by uPA/PAI-1-Determination in Biopsy-Tissue is very low. Negative predictive values of 67-74%, however, lead to a higher probability of under-treatment. Deviating protein levels were analyzed regarding clinical and pathological factors as well as intratumoral heterogeneity.