Abstract Background: Breast cancer (BC) is one of the most com-mon cancers among the women population all over the world. It is also the one of the leading causes of death among that population. Advances in early diagnosis and BC treatment, a combination of surgery, chemotherapy, and radiation therapy, in the past decades have resulted in prolonged survival in patients with BC. However, the major problem for the BC management is still its local-regional recurrence and distant metastasis in BC patients who have previously undergone surgery. Aim of Study: To evaluate the diagnostic accuracy of postoperative surveillance by ultrasound and Doppler study in breast cancer patients correlated to pathology as golden reference. Patients and Methods: In this diagnostic accuracy study of 20 female patients with breast cancer subjected to surgical management within one year whether mastectomy or conserv-ative surgery, breast U/S done to the patient with colour Doppler study to characterised the lesion. Radiology depart-ment of Tikrit University Hospital under supervision of Diagnostic Radiology, Ain Shams University. Diagnostic Radiology, Ain Shams University. Study period: From May 2020 till January 2021. Results: Based on histopathology (biopsy), as the reference standard, we analyzed the capacity of US and Doppler study scan to identify the lesions. US (FAST) yielded two false negative results in the identification of traumatic injuries. The sensitivity of US was 88.24% and its specificity 100%; the positive and negative predictive values were 100% and 60%, respectively with accuracy 90%. These results show that US had high sensitivity and specificity in the detection of breast lesion and differentiate between benign & malignant lesions. US surveillance results according to final diagnosis, there were 17 US-positive findings in 15 malignant patients. In our study, there was no significant difference in the overall survival between patients with benign lesions only and patients with malignant lesions. Conclusion: The results of this study demonstrated that Post surveillance Ultrasound (PSU) can be used for detection of the malignant lesions in the breast regional area with BC. Postoperative US had a high sensitivity for the detection of malignant lesions in the breast and associated breast region, which can be a predictor of distant metastasis in mastectomy and breast conservation surgery patients.