Background: Breast cancer is the most common malignancy among women in Zambia. Ultrasound can be a useful tool for early diagnosis of breast cancer based on the breast lesions’ features. However, an overlap in the ultrasound features of malignant and benign breast tumours has been noticed together with a paucity of information on the ultrasound features that are more suggestive of breast cancer. Objective: The purpose of this study was to identify ultrasound features of suspected breast cancer lesions which may assist in ascertaining a high breast cancer or benign breast disease suspicion index, that may be used to prioritise patients requiring further and urgent management for breast cancer. Methods: Systematic random sampling was used for the selection of participants in this study. The selected patients first underwent an ultrasound scan in the Ultrasound department to obtain the breast lesion ultrasound features. The histology results for the same patients were then obtained from the University Teaching Hospital (UTH) histology laboratory or the histology report filed in the patient’s medical file. Results: Irregular shape of breast lesions, vertical orientation of breast lesions, hypoechogenicity of breast lesions, complex echo pattern of breast lesions, irregular or spiculated margin contours of breast lesions, compression of breast lesion surrounding tissue, absence of hyperechogenic spots in breast lesions and a breast lesion boundary with neither a hyperechoic halo nor thin capsule (None) were found to be associated with breast cancer. No breast lesion showed less than 3 ultrasound features suspicious for breast cancer. Hyperechoic spots in breast lesions were found to be associated with non-cancerous breast lesions. Conclusion: Low-resource countries, such as Zambia, where access to imaging diagnostic equipment such as Mammography and Magnetic Resonance Imaging machines (MRI), and histology examinations are scarce, the preceding ultrasound findings .......