In recent years, due to the increasing pressure of people’s work, life and interpersonal relationships, the incidence of female breast diseases has been increasing year by year. With the improvement of people’s living standard and self-care awareness, breast diseases have become more and more important to female patients, and the number of outpatient consultations has been increasing year by year. In this paper, we collected 511 cases of breast ultrasound examination from February 06 to December 08, focusing on the analysis of 2D and color Doppler flow imaging features to explore its diagnostic value in breast diseases. 1. Data and methods: All cases were inpatients and outpatients of our hospital, 511 cases in women and 2 cases in men, aged 3 to 85 years, with an average of 33 years. A total of 494 cases of various breast diseases were examined and the data were counted (see Figure 1). Instruments used:PHLIPS Envisor C color Doppler ultrasound diagnostic instrument with a probe frequency of 7-12 MHz.Detection method:Patients were examined in a combination of supine and lateral positions, with full exposure of the breast and bilateral breast comparison, with the nipple as the center and a radial overlapping sweep along the breast ducts, in the order of the outer upper, outer lower, inner upper and inner lower quadrants, and then in the order of top to bottom and left The order of examination is upper outer, lower outer, upper inner and lower inner quadrant, and then repeat the sweeping along the paint trajectory from top to bottom and from left to right to avoid missing. The lesion area was found and the local blood supply was observed. Finally, a comprehensive analysis was performed with the clinical history and other data, and ultrasound diagnosis was proposed. 2. Results: 2.1 A total of 379 cases of mammary gland hyperplasia were detected in this group, with a detection rate of 74.17%. The ultrasound images showed diverse manifestations: 2.1.1 Diffuse type: unilateral or bilateral breast tissue echogenicity is not uniform, and scattered small hypoechoic areas or anechoic areas are seen, which can range from several millimeters to several centimeters in diameter, and can be palpable in larger cases. 2.1.2 Ductal dilatation type: This is manifested by several dilated ductal echogenicity in the near areola area of the breast, with an inner diameter of about 2-3 mm. 2.1.3 Nodular type: This type is easily misdiagnosed as cancer. 1) Single or several substantial hypo-echoic or slightly hypo-echoic areas with clear borders, bright and neat, without envelope echogenicity, and partially lobulated in the breast. 2) Irregular substantial hypoechoic areas in the breast with poorly defined borders and no spherical appearance, often triangular or striped, with uneven or poorly uniform internal echogenicity, which can be deformed by pressure. 2.1.4 Mixed type: several types of lesions coexist in both breasts, with both fluid, parenchymal nodules or cystic mixed mass echogenicity. The CDFI manifestation of mastocytosis, most of the blood flow distribution is scattered and located in the peripheral part, and stellate blood flow is visible inside the substantial masses. 2.2 A total of 90 cases of various types of breast masses were detected in this group, with a detection rate of 17.54%. According to the nature of the masses, high-frequency ultrasound sonography has different characteristics: 2.2.1 Breast cysts: 10 cases were detected in this group. CDFI: no obvious blood flow signal in the periphery and inside. 2.2.2 Breast fibroids: 19 cases were detected in this group, among which 9 cases were confirmed by surgical pathology and 10 cases were still under regular follow-up observation. Sonographic features: mostly round or round-like hypoechoic nodules with specific lesions, uniform internal echogenicity, clear circumference, lateral acoustic shadowing, generally without calcification, and the anterior and posterior diameters can be reduced when the probe is locally pressurized. Spectral Doppler showed low resistance with a resistance index of <0.7. 2.2.3 Substantial nodules of unknown nature: A total of 57 cases were detected in this group, with no obvious clinical symptoms, which are difficult to characterize by ultrasonography alone. The ultrasound showed hypoechoic nodules in different quadrants of unilateral or bilateral breasts, and a small amount of blood flow (grade 0-1 blood flow) could be shown. 2.2.4 Four cases of breast cancer were detected and confirmed by surgery in this group, and all of them were accompanied by enlarged lymph nodes in one axilla. The sonograms showed that the tumor border was irregular, without obvious envelope, and the interior was hypoechoic with sound failure, and the colored blood flow was significantly increased, and the tubular blood flow extended into the lesion with bright color, RI: >0.7. The axillary enlarged lymph nodes were round or fused with each other and lost the medullary structure, showing hypoechoic or nearly anechoic nodules, and the larger ones could reach 2-3 cm, and the interior was visible with tubular or rod-like bright blood flow. The nodes may be 2-3 cm in size, and all have tubular or rod-like bright blood flow inside. 2.3 . Other breast diseases. A total of 2 cases of mastitis, 2 cases of early mammary gland development and 8 cases of axillary parametriosis were detected in this group. All of them were accompanied by clinical symptoms such as pain and lump feeling of different degrees. 3. Discussion: 3.1 High-frequency ultrasound can show the fine structures inside the breast, and ultrasound can show the skin, subcutaneous tissue, glands, pectoralis major muscle and rib cage. Therefore, which layer has lesions can be localized from ultrasound images. 3.2 Breast hyperplasia is a common disease, accounting for the majority of positive cases in this group. It has attracted great attention because many types of epithelial hyperplasia can develop into precancerous lesions. The cause of the disease is mainly due to the imbalance of estrogen and progesterone ratio, resulting in excessive hyperplasia and incomplete regeneration of the ducts and lobules of the breast during the menstrual cycle, which leads to the occurrence of mastoproliferative disease. Neuropsychiatric factors are also a major cause of hyperplasia. They manifest as breast swelling and pain before menstruation after childbirth and breastfeeding, and lumps can be palpated, and some lumps may also subside on their own with hormonal changes. The complexity of the pathological changes in mastocytosis leads to a diversity of sonograms. Through careful analysis and conclusion of different sonograms, the sonograms of mammary hyperplasia are characterized by diversity, diffuse, mixed type, and less blood flow, and at the same time, combined with the patient’s medical history and clinical manifestations, it is easy to make a clear diagnosis. Therefore, it is believed that: high-frequency ultrasound has a high detection rate and compliance rate for the diagnosis of mastoproliferative disease, is easy and non-invasive, and can also be used for regular follow-up or ultrasound-guided puncture biopsy for clear diagnosis in patients with suspected mastoproliferative disease. If the image changes or if malignant changes are highly suspected, clinical surgery can be prompted at any time. 3.3 This study concluded that the presence or absence of masses should be clearly identified first during the examination of breast diseases, which requires not only a good nature of ultrasound diagnostic instrument and high operational level, but more importantly, the examination must be careful and conscientious to avoid missing diagnosis and comprehensive analysis of the sonographic features of each type of mass to identify its benign and malignant nature. The application of color Doppler ultrasound to detect the blood supply of the mass is an indispensable method to identify benign and malignant masses.(4) In this study, it was shown that malignant masses have increased neovascularization and richer blood supply, while benign masses have relatively less blood supply. The features of enlarged lymph nodes under the axilla can help in the differential diagnosis of benign and malignant breast masses. 3.4 Mastitis is more common in first-time mothers during the postpartum lactation period. It is caused by infection with Staphylococcus aureus 3 to 4 weeks after delivery, with an increased white blood cell count, and can form abscesses if improperly treated or repeatedly infected. It shows indistinct borders of the mass, enhanced internal echogenicity but uneven distribution, probing plus pressure pain, and scattered punctate blood flow signals around and inside the mass as seen on ultrasound. If an abscess is formed, there is no or weak echogenicity, and the diagnosis is generally clear based on the medical history and sonographic features. In summary, high-frequency ultrasound is easy, painless, noninvasive, reproducible, effective and inexpensive for primary screening of breast diseases, and has important clinical value in identifying benign and malignant masses through color flow imaging, spectral analysis and ultrasound-guided puncture biopsy.