BACKGROUND: Currently, ultrasound is being considered as a first-line diagnostic tool for fatty liver disease. Ultrasound manifestations of fatty liver disease in the presence of chemotherapy and/or hormone therapy for breast cancer have not been sufficiently studied. AIM: To clarify the possibilities of complex ultrasound diagnostics in detecting signs of liver steatosis and its severity in patients with breast cancer on the background of chemotherapy and hormone therapy. METHODS: A total of 221 patients were examined, who underwent ultrasound examination of the liver in grayscale B-mode. In 35 cases, steatometry was additionally performed. The basis of the steatometry method is the assessment of the coefficient of linear attenuation of an ultrasonic wave, which makes it possible to quantify the degree of attenuation (in dB/cm/MHz) and assess its severity. A comparative assessment of the information content of the obtained data using grayscale B-mode and the steatometry method was performed. RESULTS: It has been established that the B-mode allows for the detection of steatosis of grades 2 and 3. According to our observations, steatometry, compared to the grayscale mode, increases the frequency of detection of fatty changes in the liver by 26.0% and the accuracy of determining their severity by 54.3%, especially when detecting steatosis of the liver of grades 1 and 3. CONCLUSION: A combined approach that combines both techniques (B-mode and steatometry) allows for more accurate diagnosis of liver steatosis and determination of its severity.