Highlights 1. Ultrasonographic features of HHUS are significant for differentiating benign and malignant breast NMLs. 2. ABUS evaluation was associated with the highest sensitivity, specificity, PPV, NPV, and accuracy in the diagnosis and evaluating the risk of NML. 3. MG was superior to HHUS in specificity in diagnosis and evaluating the risk of NML. 4. Internal flow (HHUS), calcification (MG), and coronal plan feature (ABUS) may be risk factors for malignant or precursor lesions. The lexicon of ACR BI-RADS can also be used in the evaluation of NML.