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Simple Summary: Shear wave elastography (SWE) is a new diagnostic method allowing for a non-invasive differential diagnosis between benign and malignant mammary tumors. Mammary tumors in dogs are often hormone-dependent, and a surgical approach is currently the most recommended method for the treatment of mammary neoplasia. However, preoperative, pharmacological therapy eliminating hormonal stimulation can sometimes be indicated to reduce the size of the tumor and facilitate subsequent surgery. The aim of this study was to evaluate the influence of the reduction in the benign tumor size observed after treatment with the use of aglepristone on the shear wave elastography results, obtained before and after therapy. We noticed that a fast and significant reduction in tumor size, as a consequence of preoperative pharmacological treatment, did not influence the diagnosis performed using the SWE technique. These results seem to indicate the accuracy and usefulness of this new diagnostic method, and confirm the hypothesis that tumor tissue density is a valuable parameter when determining the benignancy of mammary tumors in dogs. Shear wave elastography (SWE) can be useful to discriminate between malignant and benign mammary tumors. In dogs with elevated progesterone levels compared to the baseline and fast-growing tumors, treatment with the use of aglepristone allows for tumor size reduction, which facilitates surgery. This study aimed to evaluate the influence of the preoperative treatment of benign mammary tumors (BMTs), performed with the use of aglepristone, on the density of the tumor tissue measured by SWE. Twelve female dogs with diagnosed BMTs and increased levels of progesterone were treated with aglepristone (Alizine, Virbac, France) at 10 mg/kg s.c. (Subcutaneous injection). twice, with a 24 h interval. The density of the tumor was evaluated by SWE before and after the treatment. The type of tumor was evaluated by fine needle aspiration cytology before treatment, and a histopathological examination was made after surgical removal, performed after the aglepristone treatment. In all the cases, a significant reduction in the mammary tumor's size was observed following treatment, with no influence on the density of the tumor's tissue measured by SWE. Similar studies on malignant mammary tumors are warranted to verify if in these cases, density will also be a constant parameter that is not dependent on the tumor size. [ABSTRACT FROM AUTHOR]