Objective: To investigate the predictive value of quantitative parameters of contrast-enhanced ultrasound combined with carcinoembryonic antigen (CEA) and neutrophil/lymphocyte ratio (NLR) for recurrence and metastasis of breast cancer after modified radical mastectomy. Methods: 120 patients with breast cancer who underwent modified radical mastectomy in our hospital were selected from December 2020 to January 2022. All patients underwent breast CEUS to obtain contrast-enhanced images and quantitative CEUS parameters. Serum CEA levels and NLR were measured, and the incidence of recurrence and metastasis after surgery were statistically analyzed. The ROC curve of subjects was used to analyze the value of quantitative parameters of contrast-enhanced ultrasound combined with CEA and NLR in predicting the recurrence and metastasis of breast cancer after modified radical mastectomy. Results:Compared the preoperative sonographic features of the two groups, the recurrent metastasis group showed slightly higher enhancement intensity, most of which were hyperenhanced or globally enhanced, and the contrast agent distribution was not yet uniform. The results showed that 18 patients experienced postoperative recurrence and metastasis (in the recurrence and metastasis group). The peak intensity (PI) of the recurrence and metastasis group was higher than that of the non recurrence and metastasis group, and the serum CEA level and NLR were higher than those of the non recurrence and metastasis group. The time to peak (TTP) was lower than that of the non recurrence and metastasis group (P<0.05). The area under the curve (AUC) predicted by PI, TTP, CEA and NLR for recurrence and metastasis of breast cancer after modified radical mastectomy were 0.693, 0.764, 0.763 and 0.781, and the AUC predicted by PI, TTP, CEA and NLR for recurrence and metastasis of breast cancer after modified radical mastectomy was 0.909, which was greater than that predicted by each index alone. Conclusion: In patients with recurrence and metastasis of breast cancer after modified radical mastectomy, contrast-enhanced ultrasound parameters PI increased and TTP decreased, serum CEA and NLR increased. Combined detection of TTP, PI,CEA and NLR has a high predictive value in recurrence and metastasis of breast cancer after modified radical mastectomy. [ABSTRACT FROM AUTHOR]