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To assess how well radiologists visualize relevant features of lesions seen with automated breast volumetric scanning (ABVS) in comparison to hand-held breast ultrasound in women going to breast biopsy.Twenty-five subjects were recruited from women who were scheduled to undergo a breast biopsy for at least one Breast Imaging-Reporting and Data System four or five lesion identified in a diagnostic setting. In this institutional review board-approved study, the subjects underwent imaging of the breast(s) of concern using a dedicated system that allowed both hand-held breast ultrasound and ABVS. Five experienced breast radiologists reviewed the 30 lesions in 25 subjects in a reader study. Each reader was asked to specify the lesion type, size, imaging features, Breast Imaging-Reporting and Data System, and suspicion of malignancy and to compare the lesion characteristics of shape and margins between the two modalities.Seven (23.3%) masses were malignant and 23 (76.4%) were benign. Across all lesions regardless of size or final pathology, there was no significant difference in sensitivity or specificity (P.15) between the two modalities. For malignant lesions, the reader visualization confidence scores between the two ultrasound modalities were not significantly different (P.1). However, analysis for nonmalignant cases showed a statistically significant increase in reader visualization confidence in lesion shape and margins (P.001).Radiologists showed increased confidence in visualization of benign masses and equal confidence in suspicious masses with ABVS imaging. This information could help decrease the need for additional hand-held imaging after automated whole breast ultrasound.