Objective: To evaluate the value of shear wave elastography (SWE) in the identification of benign and malignant breast tumors and the correlation between breast cancer peripherals and axillary lymph node metastasis (ALNM). Methods: 159 patients with breast mass who underwent SWE and conventional ultrasonography before surgery were analyzed and selected. A retrospective analysis was performed on 155 lumps. Q-box trace irregular tracing method was used to obtain the elastic modulus of lumps. The elastic modulus of maximum value (Emax), minimum value (Emin), mean value (Emean), and standard deviation (Esd) of each lump and its peripheral area (Shell 1.0, 2.0, 3.0 mm) were measured and recorded. To compare the difference of elastic modulus between benign and malignant masses and their peripheral tissues. Taking pathological diagnosis as the gold standard, receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) of each elastic modulus was compared to obtain the elastic modulus with the greatest diagnostic value. Finally, Spearman correlation analysis was used to evaluate the relationship between ALNM and the elastic modulus of malignant mass and its periphery. Results: There was no significant difference in age, maximum diameter of mass and Emin of elastic modulus inside and around mass between benign and malignant groups (p > 0.05). The Emax, Emean and Esd in the malignant group were higher than those in the benign group, and the difference was statistically significant (p < 0.05). The ROC of the elastic modulus (Emax, Emean, Esd) of each group showed that E2max had the highest diagnostic efficiency, the diagnostic cut-off value was > 126.31kPa, the diagnostic sensitivity was 84.1.0%, the specificity was 91.9%, and the accuracy was 89.23%. Correlation analysis showed that E3max was positively correlated with ALNM (P <0.05). ROC curve results showed that the AUC value of E3max was 0.874, the diagnostic cut-off value was > 178.36kPa, the diagnostic sensitivity was 75.0%, the specificity was 88.9%, and the accuracy was 72%. Conclusion: SWE quantitative parameters of breast mass and its peripheral tissue can effectively distinguish benign and malignant tumors, and are closely related to ALNM, which can provide a valuable reference for the selection of preoperative breast cancer staging and treatment.