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To compare and analysis the accuracy of mammography and ultrasound in the clinical diagnosis of breast cancer. From August 2018 to January 2021, 110 cases of patients with breast tumors who were diagnosed and treated in our hospital were selected as the research objects. All patients were given mammography and ultrasound examination, and the imaging characteristics were recorded and the diagnostic value were judged. There were 76 patients were pathologically diagnosed as benign breast tumors and 34 patients were breast cancerin the 110 cases. The proportions of lobular sign, calcification, big angle sign, and burr sign of the malignant group were higher than those of the benign group, and the size of the lesion were also higher than that of the benign group (P<0.05). The proportion of ultrasound irregularities, uneven edges, hyperechoic halo, echo attenuation, and microcalcification in the malignant group were higher than that in the benign group (P<0.05). Mammogram breast imaging report and data system(BI-RADS) judged 72 cases of breast benign tumors and 38 cases of breast cancer; ultrasound BI-RADS judged 75 cases of breast benign tumors and 35 cases of breast cancer. The sensitivity of mammography in differential diagnosis of breast cancer were 93.4%, the specificity were 97.1%, and the accuracy were 94.5%; the sensitivity of ultrasound in differential diagnosis of breast cancer were 98.7%, the specificity were 100.0%, and the accuracy were 99.1%. Multivariate logistic regression analysis showed that lesion size, lobular sign, echo attenuation, and glitch sign were important factors leaded to misdiagnosis (P<0.05). Breast cancer have obvious signs and characteristics in mammography and ultrasound. The accuracy of ultrasound diagnosis are higher. The size of the lesion, the lobular sign, the echo attenuation, and the burr sign are very important factors that affect the diagnosis. [ABSTRACT FROM AUTHOR]