Background and Aim: Breast cancer is the most common invasive cancer among women worldwide. In Iraq, the incidence of new breast cancer cases significantly increased from 52.00 per 100,000 in 2000 to 91.66 per 100,000 in 2019. The goal is to develop standardized reporting criteria for NMLs on ultrasound to improve patient management. Methods: A cross-sectional study at AL-Yarmouk Teaching Hospital in Baghdad included 55 female patients with NMLs. Participants underwent evaluations using ultrasound, with mammographic correlation when applicable. Lesion characteristics, such as size, location, echogenicity, and associated features, were documented according to BI-RADS lexicon. Tissue Core Biopsy (TCB) was performed to obtain samples for histopathological analysis. Ethical approval and informed consent were obtained, ensuring data confidentiality and participant privacy. Results: Among the 55 patients, 60% of NMLs were benign, 25.5% were malignant, and 14.5% had upgrade potential. Significant associations were found between ultrasound characteristics (e.g., distribution and echogenicity) and histopathological outcomes, with segmental distribution being more common in malignant lesions. Mammographic features such as calcifications and architectural distortion also strongly correlated with malignancy. Conclusion: The integration of advanced ultrasound technology has improved the detection of NMLs, crucial for early breast cancer detection. However, these lesions often mimic surrounding tissues, leading to potential false positives. Future research should focus on standardizing ultrasound interpretation of NMLs to enhance diagnostic accuracy and patient management.