Objective To explore the clinical value of Doppler ultrasound and mammography when identifying benign and malignant breast lesions. Methods A total of 112 suspected breast cancer patients were included in this study, all of which were from Anyang Maternal and Child Health Hospital. The selection period was from October 2022 to October 2024. They were subjected to retrospective analysis and all received mammography and Doppler ultrasound examinations. Using pathological examination results as the gold standard, the examination results of mammography and Doppler ultrasound were analyzed, the missed diagnosis and misdiagnosis rates of the two examination methods, the diagnostic efficacy of the two examination methods on breast cancer were compared, and the imaging characteristics of the two examination methods were analyzed. Results The pathological examination results showed that the number of cases of malignant and benign breast lesions were 80 and 32 respectively. The results of mammography examination showed that the number of cases of malignant and benign breast lesions were 71 and 41 respectively. The results of Doppler ultrasound examination showed that the number of cases of malignant and benign breast lesions were 78 and 34 respectively. The missed diagnosis rate of breast cancer in Doppler ultrasound was lower than that of mammography examination (χ2=5.490, P<0.05); the sensitivity, accuracy and negative predictive value of Doppler ultrasound diagnosis of breast cancer were all higher than those of mammography (χ2=5.714, 6.694, 4.550, all P<0.05). Conclusion In the differential diagnosis of benign and malignant breast lesions, compared with mammography examination, Doppler ultrasound examination has a higher diagnostic effect, and can clearly reflect the imaging characteristics of various lesions, demonstrating high clinical value.