Estrogen receptor(ER) is a vital biomarker in the development and development of breast cancer, and its status has great clinical value in clinical treatment strategy, endocrine therapy efficacy prediction, and breast cancer prognosis. By specifically combining 18 F-FES with ER, 18 F-FES PET/CT imaging uses standard uptake value(SUV) to semi-quantitatively reflect the distribution of ER and its biological activity in patients, and assesses the expression of ER in breast cancer patients about primary and metastases before or after treatment, to provide a basis for personalized treatment of breast cancer. In this review, we will review the imaging principles of a new ER detection method 18 F-FES PET/CT, and the research progress in the clinical application of breast cancer, and compare its diagnostic and treatment value with non-specific tumor imaging 18 F-FDG PET/CT in breast cancer.