Abstract: Based on remote breast ultrasound consultation cases from the Remote Ultrasound Diagnosis Center of Jiading District Central Hospital in Shanghai—and in comparison with the corresponding ultrasound and pathological findings from higher-level hospitals—this study evaluated the application value of regional remote ultrasound in breast cancer screening at primary hospitals. A total of 323 breast ultrasound examinations uploaded to the remote ultrasound platform were retrospectively enrolled as study subjects. Pathological diagnoses from surgical resection specimens or image-guided biopsies served as the “gold standard” for assessing the diagnostic performance of both remote breast ultrasound and conventional breast ultrasound performed at higher-level hospitals. The description of intratumoral blood flow by ultrasound was significantly more detailed and accurate in higher-level hospitals than in remote ultrasound assessments (P < 0.001). Regarding diagnostic performance, the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of remote ultrasound–based BI-RADS classification for diagnosing breast cancer were 75.5%, 77.6%, 72.9%, 78.9%, and 71.3%, respectively; the corresponding values for higher-level hospitals were 79.9%, 77.6%, 82.9%, 85.5%, and 73.9%, respectively. Remote ultrasound technology supports precise triage management of breast nodules and demonstrates high practical value and reliability in breast cancer diagnosis.