Breast (BR) Specialty Exam Prep

The ARDMS Breast (BR) specialty exam covers breast anatomy, the ACR BI-RADS lexicon, benign and malignant pathology patterns, image-guided procedures, and supplemental screening. The BI-RADS framework is the organizational backbone of the entire exam and must be understood at a category-by-category level.

What the BR Exam Covers

The Breast registration is a 150-question, 3-hour examination administered by the ARDMS. Work through every content domain in proportion to its published weight rather than reviewing only familiar topics.

Who This Exam Is For

The BR credential suits both sonography students sitting for their first registration and practicing sonographers adding a new specialty. The outline covers material that may not come up in every clinical setting. Mapping each study block to a specific domain helps you review the published scope.

Exam Facts

• Credential earned: RDMS
• Exam format: 150-question, 3-hour examination
• Passing score: 555/700

2025 Pass Rates

First-time candidates: 77%; repeat candidates: 49%; overall: 71%. This 28-percentage-point difference compares separate candidate groups; it does not measure changes in exam difficulty or the effectiveness of a study strategy.

Source: ARDMS/APCA Global Exam Performance Summary Report, 2025.

High-Yield Focus Areas

• Breast anatomy and tissue composition
• BI-RADS classification system
• Cystic vs. solid mass differentiation
• Breast pathology and sonographic characteristics
• Interventional breast procedures

Common Mistakes to Avoid

• Misclassifying BI-RADS categories based on lesion characteristics
• Confusing complicated cysts with solid masses
• Incorrectly assessing lesion margins and shape descriptors
• Overlooking posterior acoustic features as diagnostic clues
• Not understanding the role of elastography in lesion assessment

Study Tips

• Memorize the BI-RADS categories and their associated management recommendations
• Create a comparison chart of benign vs. malignant sonographic characteristics
• Study the ACR lexicon for breast ultrasound descriptors
• Practice correlating mammographic and sonographic findings
• Review interventional procedure indications and techniques

Sample Question Types

Illustrative prompts, not actual registry questions.

• Classify this breast lesion using the BI-RADS system
• What sonographic feature most suggests malignancy in a solid breast mass?
• A well-circumscribed, oval, parallel mass is most consistent with what diagnosis?
• What is the appropriate next step for a BI-RADS 4 lesion?

Key Topics

• Breast anatomy
• BI-RADS classification
• Cystic lesions
• Solid masses
• Fibroadenoma
• Breast carcinoma
• Ductal pathology
• Lymph node assessment
• Breast implant evaluation
• Interventional procedures
• Elastography
• Male breast pathology

How to Prepare

Take specialty quizzes or a timed exam and review missed concepts using domain-level analytics. Platform question-bank inventory and mock exams are separate from official exam-format facts.

Related Specialties & Resources

Explore these related specialties when planning another registration:

• Abdomen (AB) exam prep — BR vs AB comparison
• Obstetrics & Gynecology (OB/GYN) exam prep — BR vs OB/GYN comparison
• Vascular Technology (VT) exam prep — BR vs VT comparison

Browse the seven ARDMS specialties we cover, weigh your options on the specialty comparison hub, or read study guides on the Ultrasound Analytics blog.