Abstract Background: Automated Breast Ultrasound technology (ABUS) allows the radiologist to interpret ultrasonography images in a separate time after acquisition. Different interpre-tation times have been reported, ranging from 5 to 10min, probably according to differences in readers' experience and complexity of each case. Aim of Study: To detect the impact of ABUS technique's advantages, pearls and pitfalls combining with mammography compared with mammography alone, significantly improved detection of breast cancers in women with dense breast tissue without substantially affecting specificity. Patients and Methods: This cross-sectional study was conducted on of 20 women at Radiodiagnosis Department, Shoubra General Hospital referred from surgery clinic during a period of about one year. The study was limited to only females who were willingness to undergo additional investi-gations after being diagnosed as dense breast on mammo-graphy. Results: We found that cases with ABUS study shows sensitivity about (60%) which is more than that of mammogram (30%) but less than HHUS (80%); while ABUS (70%) was less specific than both mammogram (100%) and HHUS (90%). Accuracy of HHUS (85%) was more than that of both mam-mogram (65%) and ABUS (65%), with p-value (0.257) to both mammogram and ABUS, and (0.008) to HHUS. Conclusion: Adding automated breast ultrasound to mam-mography is of great value in detection of breast cancer in mammographically dense breasts. It increases the detection rate of breast lesions mostly cancer. It is important as screening tool to decrease doses of radiation that female exposed to while mammogram screening.