Abstract: Objective To compare the value of ultrasound-guided needle biopsy(UGCNB)versus routine ultrasound(US)in diagnosis of breast cancer. Methods The clinical data of 82 patients with probable breast cancer diagnosed in our hospital was retrospectively analyzed. All patients underwent US and UGBNB examinations, and the differences in ultrasound findings between benign and malignant breast lesions were observed. The surgical pathology results were taken as gold standards to evaluate the sensitivity(SE), specificity(SP), accuracy(AC), positive predictive value(PPV)and negative predictive value(NPV)of UGCNB and US in diagnosis of breast cancer, and the diagnostic value of two methods was compared. Results Of the 82 patients, 58 cases were diagnosed as breast cancer and 24 cases as benign breast lesions. Ultrasound images of breast cancer were mainly characterized by irregular shape, unclear boundary, coarse and heterogeneous internal echo, posterior echo attenuation, common microcalcification, non-smooth capsule and most blood flow signals of grade Ⅱ~Ⅲ, which showed significant differences when compared to the ultrasound findings of benign breast lesions(P<0.01). The SE, SP, AC, PPV and NPV of UGCNB in the diagnosis of breast cancer were higher than those of US(P<0.05 or P<0.01). Compared with postoperative pathology results, UGCNB showed a higher Kappa value than US. There were statistically significant differences - in the relevance and superiority between US and UGWNB in the diagnosis of breast cancer(P<0.05). Conclusion There are significant differences in ultrasound findings between benign and malignant breast lesions. UGCNB has better diagnostic efficacy than US in the diagnosis of breast cancer, and it is of great significance in improving the diagnostic accuracy of breast cancer.