PurposeThis study aims to explore the diagnostic efficiency of the Demetics for breast lesions and assessment of Ki‐67 status.MaterialThis retrospective study included 291 patients. Three combined methods (method 1: upgraded BI‐RADS when Demetics classified the breast lesion as malignant; method 2: downgraded BI‐RADS when Demetics classified the breast lesion as benign; method 3: BI‐RADS was upgraded or downgraded according to Demetrics' diagnosis) were used to compare the diagnostic efficiency of two radiologists with different seniority before and after using Demetics. The correlation between the visual heatmap by Demetics and the Ki‐67 expression level of breast cancer was explored.ResultsThe sensitivity, specificity, and area under curve (AUC) of diagnosis by Demetics, junior radiologist and senior radiologist were 89.5%, 83.1%, 0.863; 76.9%, 82.4%, 0.797 and 81.1%, 89.9%, 0.855, respectively. Method 1 was the best for senior radiologist, which increased AUC from 0.855 to 0.884. For junior radiologist, Method 3 was the best method, improving sensitivity (88.8% vs. 76.9%) and specificity (87.2% vs. 82.4%). Demetics paid more attention to the peripheral area of breast cancer with high expression of Ki‐67.ConclusionDemetics has shown good diagnostic efficiency in the assisted diagnosis of breast lesions and is expected to further distinguish Ki‐67 status of breast cancer.