Objective Based on multiple ultrasound techniques, ultrasound images of breast cancer patients with or without axillary lymph node metastasis were compared.

Methods A total of 105 patients with breast cancer diagnosed pathologically after surgery in Shanghai Pudong Gongli Hospital from January 2019 to December 2022 were selected. According to the pathological results, the patients were divided into a group with metastasis (n＝51) and a group without metastasis (n＝54). The image characteristics and differences of conventional ultrasound, shear-wave elastic imaging and contrast-enhanced ultrasound were analyzed and compared between the two groups.

Results There were significant differences in tumor morphology, size, orientation, margin, burr sign, lobular state, average value of shear wave velocity, peak time and peak intensity between the two groups (allP < 0.05). There were no significant differences in age, tumor location, internal echo, calcification, hyperechoic halo, posterior echo and blood flow between the two groups.

Conclusions Breast cancer in the group with axillary lymph node metastasis was more likely to be characterized by large tumors, non-parallel growth, irregular morphology, uneven edges, and lobule and burr sign. The average value of Shear wave velocity (SWV) was higher than that in the group without axillary lymph node metastasis. The results of CEUS showed uneven high/isoenhancement, the peak time was earlier than that of the group without axillary lymph node metastasis, and the peak intensity was higher than that of the group without axillary lymph node metastasis.