Objective To investigate the value of color Doppler ultrasonography in diagnosis and differential diagnosis of breast sclerosing adenosis (SA).Methods Preoperative sonography in 32 SA,99 invasive ductal carcinoma(IDC),51 ductal carcinoma in situ(DCIS) and 64 fibroadenoma(FA) confirmed by pathology were retrospectively analyzed.Results The average age of SA group was younger than IDC and DCIS groups',but older than FA group's (P <0.05).The focal maximum diameter of SA group was the smallest among all(P <0.05).All the SA sonograms showed solid hypoechoic lesions,with spiculate margin was less than IDC group and larger than DCIS and FA groups (P <0.05).Similar ultrasonic characteristics,such as irregular shape,unclear border,acoustic halos were seen in SA and DCIS groups (P >0.05),while IDC group showed the highest rate and FA group had the least(P <0.05).SA masses' uneven internal echo,calcification,posterior acoustic attenuation was higher than FA group(P <0.05),but less than IDC and DCIS groups(P >0.05).Meanwhile,A/T ratios(≥0.7) were higher than DCIS and FA groups,but less than IDC group(P >0.05).In addition,SA group had a similar detection rate of the internal blood flow with FA group(P >0.05),but less than the IDC and DCIS groups(P <0.05).Conelusions Ultrasonography has a significant clinical value in diagnosis and differential breast sclerosing adenosis. Key words: Ultrasonography, Doppler, color; Breast neoplasms; Fibrocystic breast disease