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Background: This study aimed to evaluate the diagnostic efficiency of coronal ultrasonic characteristics by automated breast volume scanning (ABVS) in differentiating benign from malignant breast lesions, and further compare the differential diagnostic values of handheld ultrasound (HHUS), ABVS, HUUS combined with ABVS, and molybdenum target X-ray (MTXR) in benign and malignant lesions. Materials and Methods: This study was retrospectively performed in 84 patients with 87 breast lesions. All breast lesions were diagnosed by ABVS, HHUS, and MTXR, then confirmed using histopathologic examination. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated, as well as receiver operating characteristic (ROC) curve with the area under the curve (AUC) was analyzed to predict the diagnostic values of coronal ultrasonic characteristics by ABVS as well as HHUS, ABVS, HHUS combined with ABVS, and MTXR in breast benign and malignant lesions. Results: Convergence sign and lotus root sign of malignant lesions and the weeping willow sign of benign lesions could be observed in ABVS coronal image. Mass margin and surrounding halo also had high sensitivity, specificity, accuracy, PPV, and NPV. In addition, HHUS combined with ABVS, HHUS, ABVS, and MTXR had similar sensitivity, specificity, accuracy, PPV, NPV, and AUC in differentiating benign from malignant breast lesions. Conclusions: ABVS coronal image have high application value in differential diagnosis of benign and malignant breast lesions. In addition, HHUS combined with ABVS, HHUS, ABVS or MTXR have similar diagnostic efficiencies in differentiating benign and malignant lesions. [ABSTRACT FROM AUTHOR]