Breast cancer is commonly diagnosed with mammography. Using image segmentation algorithms to separate lesion areas in mammography can facilitate diagnosis by doctors and reduce their workload, which has important clinical significance. Because large, accurately labeled medical image datasets are difficult to obtain, traditional clustering algorithms are widely used in medical image segmentation as an unsupervised model. Traditional unsupervised clustering algorithms have limited learning knowledge. Moreover, some semi-supervised fuzzy clustering algorithms cannot fully mine the information of labeled samples, which results in insufficient supervision. When faced with complex mammography images, the above algorithms cannot accurately segment lesion areas. To address this, a semi-supervised fuzzy clustering based on knowledge weighting and cluster center learning (WSFCM_V) is presented. According to prior knowledge, three learning modes are proposed: a knowledge weighting method for cluster centers, Euclidean distance weights for unlabeled samples, and learning from the cluster centers of labeled sample sets. These strategies improve the clustering performance. On real breast molybdenum target images, the WSFCM_V algorithm is compared with currently popular semi-supervised and unsupervised clustering algorithms. WSFCM_V has the best evaluation index values. Experimental results demonstrate that compared with the existing clustering algorithms, WSFCM_V has a higher segmentation accuracy than other clustering algorithms, both for larger lesion regions like tumor areas and for smaller lesion areas like calcification point areas.