Automated sonomammography and xeromammography were compared in a group of 293 patients referred for a variety of symptomatic and asymptomatic conditions. Twenty of the 293 patients had mammographic evidence of carcinoma that was confirmed pathologically. Seventeen of these patients had sonomammographic evidence of a solid mass; 11 of these demonstrated signs of malignancy, such as irregular border, and desmoplastic reaction manifested by thickening of Cooper's ligaments, skin retraction, periductal fibrosis or disruption of architecture. Statistical analysis of the results reveals that a high degree of sensitivity and specificity in the diagnosis of malignant breast disease can be accomplished with automated sonomammography.