Objective To evaluate the clinical efficacy of ultrasonography combined with puncture biopsy for the diagnosis of anterior lymph nodes in breast cancer using Meta-analysis. Methods Systematic development of literature search methods and principles of literature screening, Chinese search subject terms for ultrasonography, breast puncture, puncture biopsy, puncture cytology examination, breast cancer, anterior lymph node metastasis in Chinese databases China Knowledge Network (CNKI), Wanfang, China Biomedical Literature Database (CBM), Vipers (VIP), Longyuan Journal, Medical Library, National Research Database; English search Subject terms were Contrast Ultrasound, Breast cancer, Needle biopsy, Sentinel lymph node metastasis, Sentinel Lymph node biopsy in foreign language databases PubMed, Embase, NEJM medical journal, Cochrane Library; literature related to puncture biopsy combined with ultrasonography for the diagnosis of anterior lymph node metastasis of breast cancer published before June 31, 2021 was selected and Meta-analysis was completed. Results A total of 6 Chinese literature and 6 English literature were retrieved and included according to the screening criteria, with a total of 1645 study subjects, which showed no significant pattern of SLN in breast cancer patients; the combined statistics were combined SEN=0.685 (95% CI: 0.55-0.80), combined SPE=1.000 (95% CI: 0.99-1.00), combined SCC= 0.903 (95% CI: 0.68 to 0.95), combined diagnostic ratio = 258.29 (95% CI: 97.82 to 721.58), combined positive predictive value = 1.000 (95% CI: 0.98 to 1.00), combined negative predictive value = 0.93 (95% CI: 0.87 to 0.98). Conclusion Patients with positive breast cancer by ultrasonography-guided mammocentesis can be treated directly with axillary lymph node dissection, while negative patients still need to be considered in combination with SLNB diagnosis to develop a treatment plan.