Objective To explore the best cutoff point of the automated breast volume scanner (ABVS) by scoring method for differentiating malignant and benign breast lesions and to assess the diagnostic value using scoring in ABVS. Methods The ABVS images of 656 breast lesions (477 cases) proved by pathology were reviewed. 5 characteristics of the side, edge, burr, entanglement and calcification were used in scring. A receiver operating characteristic (ROC) curve was used to explore the best cutoff point. The area under the ROC curve (Az), sensitivity, specificity, accuracy, misdiagnosis rate and missed diagnosis rate were calculated. Results ABVS side, edge, burr, entanglement and calcification are all indicators of benign and malignant breast lesions. A comprehensive score was made on the 5 indicators and the ROC curve was plotted. The area under the curve was 0891. The critical point for ultrasound diagnosis of breast cancer was ≥2. The sensitivity, specificity, accuracy misdiagnosis rate and missed diagnosis rate were 0.891, 89.6%, 93.8%,93.0%,10.4% and 6.2%. Conclusion The scring in ABVS image is a useful quantitative index for differentiating breast malignant lesion from benign lesion.