To evaluate the value of automated breast volume scanner (ABVS) and conventional ultrasound in differentiation of benign and malignant breast imaging reporting and data system (BI-RADS) 4 breast lesions.

Totally 239 breast lesions from 217 patients, with diagnosing of BI-RADS 4 by conventional ultrasound and automatically breast volume imaging, were analyzed retrospectively, using postoperative pathology as golden standard. The sensitivity, specificity, accuracy and area under the curve of ABVS and conventional ultrasound were calculated separately.

There were 154 benign breast lesions, 83 malignant lesions and 2 borderline lesions. The statistical analysis results of ABVS and conventional ultrasound were 96.10% and 91.80% in sensitivity, 84.30% and 80.20% in specificity, 89.30% and 84.10% in accuracy, and 0.952 and 0.833 in area under the curve. Therefore, ABVS was superior to the conventional ultrasound.

Compared with conventional ultrasound, ABVS could improve the diagnostic efficacy for BI-RADS 4 breast lesions in the aspects of sensitivity, specificity, accuracy, which was useful in detection of small and atypical breast cancer and could be used as a noninvasive and reliable complement for conventional ultrasound.