Breast cancer ultrasound BI-RADS classification of category 4B (grade) suggests that the nodule has some possibility of malignancy, and the probability of malignancy is less than 50% but greater than 10%. category 4B breast nodules require puncture pathology to finally clarify the benign or malignant nature, which is relatively cumbersome. For partially well defined, partially infiltrated (unclear borders) masses, puncture findings of fibroadenoma or fat necrosis are acceptable with relatively low severity, but require short-term follow-up examinations every 3 to 6 months. The detection of progressive enlargement and other signs of deterioration require intervention such as surgery. For nodules with atypical hyperplasia on puncture pathology, further biopsy is needed to confirm malignancy or malignancy on puncture pathology, and timely intervention such as surgical resection is needed. It is recommended that the patient go to a regular hospital for consultation, and the clinician will synthesize the patient’s situation to formulate the next treatment plan.