A breast X-ray imaging apparatus according to an embodiment includes processing circuitry. The processing circuitry collects three-dimensional image data of a breast of a subject. The processing circuitry detects a lesion from the three-dimensional image data. The processing circuitry derives a puncture path for inserting a puncture needle into the breast, by analyzing linearity in three-dimensional distribution of the lesion and based on an analysis result of the linearity.
