Abstract：Objective Investigating the value of angio planewave ultrasensitive imaging (AP), real-time shear wave elastography (SWE) and their combined application in the diagnosis of breast cancer. Methods 101 breast nodes with conventional ultrasound BI-RADS classification 3-5 were included, and AP imaging was performed on the nodes, and semi-quantitative blood flow grading and microvascular configuration typing were performed according to blood flow characteristics. Switch to SWE mode, obtain stable elastic images and then analyze to get SWE color typing and perform quantitative analysis to obtain Young's modulus values Emax, Emean. Using pathological findings as the gold standard, ROC curves of relevant parameters were plotted to analyze and compare the difference in efficacy of AP and SWE alone and in combination for the diagnosis of breast cancer. Results Emax, Emean, SWE typing, AP typing and AP grading were significantly higher in malignant breast lesions than in benign lesions (all P < 0.001). In the AP semi-quantitative blood flow grading, benign tumors are dominated by a lack of blood supply and malignant tumors are dominated by a rich blood supply. In microvascular configuration typing benign tumors are thought to be predominantly avascular, linear, and dendritic blood flow, while malignant tumors are predominantly stump and crab foot type. AP microvascular configuration typing method was superior to the semi-quantitative grading method of blood flow (P<0.05). The diagnostic efficacy of SWE quantitative analysis Emax was higher than that of Emean (P<0.05). SWE color typing is predominantly uniform blue or mostly blue for benign tumors, and restricted color changes at the edges or uneven color changes within and around malignant tumors. In the SWE color typing, benign tumors show predominantly uniform blue color or mostly blue color, and malignant tumors show predominantly restricted color changes at the edges or uneven color changes inside. The AUCs of AP typing, Emax and the combination of the two in diagnosing breast cancer were 0.898, 0.918 and 0.945. Conclusion Both AP and SWE have good differential diagnostic ability for breast tumors, and their combined application can significantly improve the diagnostic efficacy of breast cancer.