The usefulness of breast ultrasound could be extended by improving the detection of microcalcifications by being able to detect and enhance microcalcifications while simultaneously eliminating hyperechoic spots (e.g., speckle noise and fibrocystic changes) that can be mistaken for microcalcifications (i.e., false microcalcifications). This study investigated the use of a strain-compounding technique with speckle factor (SF) imaging to analyze the degree of scatterer redistributions in breast tissues under strain conditions for identifying microcalcifications and false microcalcifications. The efficacy of the proposed method was tested by collecting raw data of ultrasound backscattered signals from 26 lesions at BI-RADS category 4 or 5 with suspicious microcalcifications. The different strain conditions were created by applying manual compression to deform the breast lesion. For each region in which microcalcifications were suspected, estimates of the SNR of the strain-compounding B-scan images and estimates of the mean SF (SFavg) in the strain-compounding SF images were calculated. Compared with microcalcifications, the severity of speckle of the false microcalcifications would be easily degraded under compressive strain conditions. The results demonstrated that the SNR estimates in the strain-compounding B-scan images for microcalcifications and false microcalcifications were 5.22 ± 1.04 (mean ± standard deviation) and 4.62 ± 1.09, respectively; the corresponding SFavg estimates in the strain-compounding SF images were 0.47 ± 0.10 and 0.22 ± 0.10 (p < 0.01). The mean area under the receiver operating characteristic curve using the SNR estimate was 0.71, whereas that using the SFavg estimate was 0.94. These findings indicate that the strain-compounding SF imaging method is more effective at discriminating between microcalcifications and false microcalcifications.