Early detection of breast cancer is crucial, but most of the clinical findings are middle to late stage breast cancer. With the continuous development of diagnostic technology, clinical work often reveals some cases that cannot be palpated clinically but can be detected abnormally by ultrasonography, such as some hypoechoic or anechoic nodules, and sometimes more than one can be detected, which makes the patients very frightened and confuses the doctors. The appearance of the breast will also change after surgery, and simple follow-up may easily lead to misdiagnosis. How to deal with the detected lesions, which require surgical biopsy and which require continued follow-up, so that the detected malignant or precancerous lesions can be treated in a timely manner, while most benign lesions are spared unnecessary surgery and the surgical biopsy can be more targeted, is an urgent problem for clinicians to solve. Our experience is that it is particularly important for physicians to further master the characteristics of malignant lesions under ultrasound. Features such as irregular lesion borders, rich blood supply or attenuation of sound waves and calcification often suggest the possibility of malignant lesions and require further diagnosis and treatment. Preoperatively, a slim guidewire is left in the lesion area under ultrasound guidance, and intraoperatively, the mass is found in the direction of the guidewire guidance and enlarged for excision, which enhances the accuracy of the operation and reduces the extent of excision. The shape of the breast is not changed after careful suturing with good quality absorbable thread, which is welcomed and recognized by patients. Ultrasound-guided guidewire positioning does not require expensive equipment, is intuitive, allows timely adjustment of the needle direction, is non-radiological, is well tolerated by the patient, and has a high success rate. This is even more significant in dense breast and young female patients, and has advantages that are difficult to obtain with mammography. This technique is simple, easy to use, solves the patient’s worries, and can detect early cancer and precancerous lesions, which is a good method worth promoting.