Among the machine learning models generated, the best predictive model achieved area under the ROC curve values of 0.893 (95% confidence interval [CI], 0.860-0.920) in the training and validation dataset and 0.854 (95% CI, 0.775-0.927) in the external validation dataset.<h4>Conclusion</h4>Machine learning models based on ultrasound radiomics features have potential clinical value for predicting HER2-positive status in BC. The gene discussed is ERBB2; the disease is breast cancer.