A method is for monitoring a tissue removal taking place via an X-ray imaging system. The method includes acquiring first X-ray projection scan data, influenced by a contrast medium, of the breast tissue situated in an image field of the X-ray imaging system. The contrast medium-influenced first X-ray projection scan data is generated with X-ray photons having a photon energy above an absorption edge of the contrast medium used. A first image data set is then reconstructed based upon the acquired X-ray projection scan data. Finally, based upon the reconstructed first image data set, the method includes determining a current position of the lesion, in relation to a reference coordinate system.
