In my daily work, I often have acquaintances who ask me to help them read their breast ultrasound reports, so today I will talk about how to read her. An ultrasound report is divided into three parts: the top column is the information of the person being examined; the middle column is what the ultrasonographer sees; and the last column is the ultrasound report, the main character we are going to talk about today. The first line of the report will tell you: youthful glands, lactating glands, degenerative glands, atrophic glands or multiple glands, few glands, mixed glands, etc. …… This actually tells you the ratio of glands to fat in your breast or which stage your breast belongs to, which is not very relevant to the diagnosis of disease. It has little to do with diagnosing disease. This is similar to saying whether you have a small skeleton or a large skeleton, which is not as relevant as judging your figure. Of course, to understand the ultrasound report, the most important thing is the BI-RADS classification, which is divided into 0-6 categories, commonly speaking, that is, how many nodules or masses in the breast are considered to be malignant breast tumors in the eyes of the ultrasonographer. Category 0 means that the sonographer thinks that ultrasound alone cannot determine the problem and other tests (e.g. mammogram, MRI) are needed. Category 1, indicating that the sonographer did not find any abnormality, no lump, no structural disorder, no skin thickening, no calcification, etc. This is a completely normal pair of breasts and routine screening is recommended (once a year). In category 2, the ultrasonographer considers it benign. In this case, neither puncture nor surgery is needed, and the possibility of breast malignancy is 0. Routine screening is sufficient. Usually, simple cysts in the breast, intra-mammary lymph nodes, fibroadenomas that do not change much after breast implantation and regular review by multiple ultrasounds belong to category 2. Category 3, which is the most commonly reported result, indicates that the ultrasonographer believes that the likelihood of breast malignancy is less than 2% and does not require puncture or surgery, and recommends 6-monthly review or continued monitoring. Usually fibroadenomas younger than 40 years old, single complex cysts, fat necrosis, and structural distortion due to postoperative scarring fall into category 3. Of course, if the doctor suspects malignancy through examination, he or she will still recommend a biopsy (puncture biopsy or excisional biopsy). Some women with breast lumps that are known to be benign but are particularly worried about falling into the small 2% probability or worried about cancer in the future and are under too much psychological pressure can choose minimally invasive rotational excision or mastectomy to get rid of the lesion quickly and easily. If the lesion is stable at 2-3 years of follow-up, it can be downgraded to category 2; if the lesion grows more than 20% in diameter at 6 months of follow-up or other suspicious changes appear, it needs to be upgraded to category 4. Category 4 is an important watershed. Reaching category 4 indicates the possibility of breast malignancy, and this possibility is 3%-95%. Category 4a indicates a 3%-10% likelihood of breast malignancy; category 4b indicates a 11-50% likelihood of breast malignancy; and category 4c indicates a 51-94% likelihood of breast malignancy. As long as it reaches category 4, it indicates that although it does not have typical malignant manifestations, it is suspicious enough to obtain histological evidence (that is, pathological diagnosis under the microscope) through biopsy (puncture biopsy or excisional biopsy) as much as possible, to clarify whether it is a malignant tumor of the breast or not. For category 5, the ultrasonographer thinks it is breast malignant tumor, so it is necessary to consult a breast specialist, and after the lesion is biopsied to clarify the pathological diagnosis, subsequent breast malignant tumor treatment, including surgery, chemotherapy, radiotherapy, endocrine therapy and molecular targeted therapy. Category 6, is a patient who has been diagnosed clearly as breast malignant tumor by pathology to undergo imaging examination again, will be affected by some previous biopsy or treatment, so report a different category 6 from category 5. Many times breast ultrasound examination usually also has the diagnosis of axillary lymph nodes, in fact, healthy people also have swollen lymph nodes, so when you see swollen lymph nodes, don’t be nervous, you need to continue to read: when the reported lymph portal structure is shifted, disappeared or destroyed, it means that there is something wrong with this lymph node, it is recommended to consult a breast specialist, and the doctor will give reasonable advice with medical history: regular review or biopsy to clarify Pathological diagnosis.