To analyze the imaging features of ultrasound (US), mammography (MG), and magnetic resonance imaging (MRI) of solid (ML) and non-solid (NML) breast lesions, and to evaluate the value of US combined with MG and MRI in diagnosing ML and NML breast lesions.

A total of 231 female patients with 244 breast lesions diagosed at the Affiliated Hospital of Inner Mongolia Medical University from May 2021 to May 2025 were collected, all of whom underwent US, MG, and MRI examinations. The patients were divided into ML and NML groups based on US and MRI features, and then sub-grouped by benignity and malignancy. Using pathological results as the gold standard, differences in US, MG, and MRI features between benign and malignant ML and NML breast lesions were compared. By computing sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic (ROC) curve (AUC), the diagnostic efficacy of US, US+MG, US+MRI, and US+MG+MRI for ML and NML groups was evaluated.

Among the 244 breast lesions confirmed by pathology, 163 were malignant and 81 were benign. Compared with malignant ML lesions, malignant NML lesions showed statistically significant differences in menopausal status, palpability, internal echo, orientation, posterior echo, blood flow signal grade, fibroglandular content, T2WI signal, ADC values, and Ki-67 expression (P＜0.05). The diagnostic sensitivity, specificity, PPV, and NPV of US+MG+MRI for the ML lesion group were 94.8%, 89.1%, 94.5%, and 87.0%, respectively, with its AUC greater than that of US (0.947/0.778, P＜0.05). The diagnostic sensitivity, specificity, PPV, and NPV of US+MG+MRI for the NML lesion group were 93.6%, 84.6%, 91.7%, and 88.0%, respectively, with its AUC greater than that of US (0.940/0.712, P＜0.05).

US, MG, and MRI have significant diagnostic value for benign and malignant ML and NML breast lesions, and the combination of US, MG, and MRI can improve the diagnostic efficacy for benign and malignant ML and NML breast lesions.