Abstract Objective To explore the application value of elastic heterogeneity analysis based on SWE technology in correcting BI-RADS category of breast leisions. Methods 132 female patients with 135 breast masses were enrolled in this study.All masses were assessed by conventional ultrasound and 2D SWE.The results of BI-RADS classiffication and elastic parameters of leisions were obtained,the Stiffness Gradient(SG) was caculated.Based on the pathological results,the diagnostic efficacy of BI-RADS classiffication and the BI-RADS classiffication adjusted by SG in identifying breast leisions were assessed according to ROC curves.Results In 135 breast masses,There were 75 benign cases and 60 malignant cases.The elastic parameters of malignant leisions were higher than those of benign leisions(P<0.001)，the SG has the largest area under the curve(0.925)compared with other elastic parameters.Using 120.2kPa as a threshold for SG,the diagnostic sensitivity,specificity and accuracy of SG in discriminating the benign and malignant breast leisions were 88.3%,96.0%,92.6%.Taking BI-RADS 4b as the diagnostic cut-off point,the AUC value, sensitivity,specificity and accuracy of BI-RADS category for breast assessment before and after correction by SG were 0.914,0.964;88.3%,90.0%;82.7%,92.0%; 85.2%, 91.1%, respectively.Conclusions The elastic heterogeneity quantitative analysis based on SWE technology is a valuable tool in distinguishing benign and malignant breast lesions.The BI-RADS classification adjusted by SG exhibit better discriminatory ability in differential diagnosis of breast leisions assessment than before,which can assist in reducing the unnecessary biopsies of breast leisions.