Objective To investigate the application of ultrasound-guided vacuum-assisted biopsy for breast masses in primary hospital and the degree of patients' cognition.Methods A retrospective analysis of 1691 female patients in the department of breast diseaseofHuidongwomen and children hospital from September 2012 to September 2014 undergoing biopsy, 1004 casesofultrasound-guided vacuum-assisted biopsy with 1325 masses, and 687 Cases of open surgery with 712 masses, all confirmed by pathological examination after operation.Results In 1325 masses in 7 breast cancercases accounted for 0.7％.Twenty-one (2.1％)cases of postoperative subcutaneous ecchymosis, hematoma in 10(1％) cases.Operation takes 2-26 min.Average hospitalization expenses of unilateral lesions was 6490 yuan.712 masesby open surgery in 9 infiltrating ductal carcinoma accounts for 3.8％ , 8(1.2％) postoperative cases of subcutaneous ecchymosis, 0 case withhematoma, operationtakes 35 to 74 minutes.Average hospitalization expenses of unilateral lesions was 3805 yuan.The follow-up of 3 to 27 months.Recurrenceof 5 fibroadenoma by vacuum-assisted biopsy and 3 by open surgery, there was no difference between its (P ＞ 0.05).Survey was found 97.4％ good cosmetic effectby vacuum-assisted biopsy, significantly higher than open surgery (P ＜ 0.05).There were mild pain after two kinds of operations, no difference (P ＞ 0.05).The cost of vacuum-assisted biopsy was higher than 2485 vuan of open operation.Grade 4a in 993cases with ultrasonic diagnosis found 2 cases of breast cancer (0.2％) in two groups of patients, and grade 4b in 132 cases found 10 cases of breast cancer (7.6％) and 2 cases in grade 5 was breast cancer (100％), and nobreast cancer in 2-3 grade was found.Conclusions Ultrasound-guided vacuum-assisted biopsy is not only fast and accurate diagnosis of early breast cancer, but also be further one-step surgical biopsy of benign tumor in primary hospital, and is safe, simple and convenient operation with high postoperative satisfaction.Strictly select a case can reduce hematoma complications.The ultrasonic BIRADS grade has good guidance for breast masses of diagnosis and treatment, and can reduce the missed diagnosis of breast cancer.Ultrasound-guided vacuum-assisted biopsyand BIRADS grade of breast massesare appropriate technology for diagnosis and treatment in the primary hospitals.