Background: Breast cancer is one of the most serious diseases threatening womenâs health. Early screening based on ultrasound can help to detect and treat tumors in early stage. However, due to the lack of radiologists with professional skills, ultrasound based breast cancer screening has not been widely used in rural area. Computer-aided diagnosis (CAD) technology can eïŹectively alleviates this problem. Since Breast Ultrasound (BUS) images have low resolution and speckle noise, lesion segmentation, which is an important step in CAD system, is challenging.Results: Two datasets were used for evaluation. Dataset A comprises 500 BUS images from local hospitals, while dataset B comprises 205 BUS images from open source. The experimental results show that the proposed method outperformed its related classic segmentation methods and the state-of-the-art deep learning model, RDAUâNET. And itsâ Accuracy(Acc), Dice eïŹcient(DSC) and Jaccard Index(JI) reached 96.25%, 78.4% and 65.34% on dataset A, and ACC, DC and Sen reached 97.96%, 86.25% and 88.79% on dataset B.Conclusions: We proposed an adaptive morphology snake based on marked watershed(AMSMW) algorithm for BUS images segmentation. It was proven to be robust, eïŹcient and eïŹective. In addition, it was found to be more sensitive to malignant lesions than benign lesions. Whatâs more, since the Rectangular Region of Interest(RROI) in the proposed method is drawn manually, we will consider adding deep learning network to automatically identify RROI, and completely liberate the hands of radiologists.Methods: The proposed method consists of two main steps. In the ïŹrst step, we used Contrast Limited Adaptive Histogram Equalization(CLAHE) and Side Window Filter(SWF) to preprocess BUS images. Therefore, lesion contours can be eïŹectively highlighted and the inïŹuence of noise can be eliminated to a great extent. In the second step, we proposed adaptative morphology snake(AMS) as an embedded segmentation function of AMSMW. It can adjust working parameters adaptively, according to diïŹerent lesionsâ size. By combining segmentation results of AMS with marker region obtained by morphological method, we got the marker region of marked watershed (MW). Finally, we obtained candidate contours by MW. And the best lesion contour was chosen by maximum Average Radial Derivative(ARD).