An image guided biopsy grid markable with marking medium for marking a subjects skin underlying the grid with a marking to identify a needle entry target. The grid includes a flexible substrate and a plurality of substrate pores extending therethrough. An adhesive layer on the underside of the substrate conformingly and removably attaches the substrate to the skin substantially without gapping therebetween. The adhesive layer defines a plurality of adhesive pores and/or adhesive free spaces that allow marking medium to flow through the adhesive layer and onto the skin to mark the skin and identify the needle entry target. The biopsy grid may be marked substantially anywhere along its upper surface and marking medium will pass therethrough and mark the skin.
