To determine whether colour overlay features can be quantified by the standard deviation (SD) of the elasticity measured in shear-wave elastography (SWE) and to evaluate the diagnostic performance for breast masses.One hundred thirty-three breast lesions in 119 consecutive women who underwent SWE before US-guided core needle biopsy or surgical excision were analysed. SWE colour overlay features were assessed using two different colour overlay pattern classifications. Quantitative SD of the elasticity value was measured with the region of interest including the whole breast lesion.For the four-colour overlay pattern, the area under the ROC curve (Az) was 0.947; with a cutoff point between pattern 2 and 3, sensitivity and specificity were 94.4 % and 81.4 %. According to the homogeneity of the elasticity, the Az was 0.887; with a cutoff point between reasonably homogeneous and heterogeneous, sensitivity and specificity were 86.1 % and 82.5 %. For the SD of the elasticity, the Az was 0.944; with a cutoff point of 12.1, sensitivity and specificity were 88.9 % and 89.7 %. The colour overlay features showed significant correlations with the quantitative SD of the elasticity (P < 0.001).The colour overlay features and the SD of the elasticity in SWE showed excellent diagnostic performance and showed good correlations between them.