BS exam guide
About the Breast Sonography (BS) exam
The ARRT Breast Sonography examination emphasizes optimized ultrasound image production and the sonographic evaluation of breast anatomy, pathology, procedures, and multimodality findings. Preparation should connect equipment choices and scanning technique to lesion characterization, documentation, clinical history, mammography, MRI, and pathology.
MedPorium is an independent education platform and is not affiliated with or endorsed by The American Registry of Radiologic Technologists (ARRT). Exam details can change; confirm them with the official source before applying.
BS exam format at a glance
- Questions
- 225
- 185 scored; 40 unscored
- Time
- 225 minutes of test time within a 245-minute appointment
- Delivery
- Computer-based testing at Pearson VUE test centers
Knowledge to review for the BS exam
These foundations support the practical tasks in the official examination matrix.
Patient and breast-care context
- History, symptoms, risk factors, consent, communication, privacy, positioning, infection control, and procedural care
- Breast anatomy, physiology, lymphatics, pregnancy and lactation, postoperative change, and multimodality correlation
Ultrasound image production
- Acoustic principles, transducers, focusing, frequency, gain, dynamic range, harmonics, compounding, Doppler, and optimization
- Artifacts, quality assurance, equipment care, ergonomics, image labeling, measurements, and complete documentation
Findings and procedures
- Cysts, benign and high-risk lesions, malignancy, inflammation, implants, male breast, axilla, and BI-RADS terminology
- Needle localization, aspiration, biopsy, specimen handling, post-procedure care, complications, and pathology concordance
BS examination matrix
The percentages below are the approximate exam-score weights published by The American Registry of Radiologic Technologists (ARRT). Use them to allocate study time, then adjust for your own weak areas.
8.6%
Patient Care
Prepare and protect the patient, obtain focused history, and support diagnostic and interventional encounters.
- Verify identity, indication, symptoms, risk, prior imaging, pregnancy or lactation status, and consent
- Position and communicate with the patient while protecting privacy and applying infection control
- Assist with procedure preparation, monitoring, aftercare, and complication recognition
56.8%
Image Production
The largest area applies ultrasound physics, instrumentation, optimization, Doppler, artifacts, quality, and documentation to breast imaging.
- Select the transducer and optimize frequency, focus, depth, gain, dynamic range, harmonics, and compounding
- Acquire orthogonal, radial and antiradial, Doppler, elastography, axillary, implant, and procedure images as indicated
- Recognize artifacts, maintain quality assurance and ergonomics, and label, measure, and document reproducibly
34.6%
Procedures
Evaluate anatomy and pathology, correlate modalities, characterize findings, and support image-guided procedures.
- Differentiate normal anatomy, developmental or physiologic change, benign disease, high-risk lesions, and malignancy
- Use accepted descriptors and assess lesion shape, orientation, margins, echo pattern, posterior features, vascularity, and associated findings
- Correlate ultrasound with mammography, MRI, history, surgery, and pathology and support aspiration, biopsy, and localization
How to use this BS diagnostic
The diagnostic follows the September 2026 specification. Image Production is now the dominant scored area, so review every item through both a clinical and technical lens: transducer choice, settings, Doppler, artifact, anatomy, lesion descriptors, correlation, documentation, or procedure support.
High-yield BS study priorities
Priority 1
Lead with image optimization
For every case, explain why the transducer, frequency, focus, gain, depth, harmonics, Doppler settings, and scan plane are appropriate.
Priority 2
Use a consistent lesion vocabulary
Practise complete morphology descriptions before choosing an assessment or differential.
Priority 3
Correlate across modalities
Match sonographic location and appearance with mammography, MRI, examination, operative history, and pathology.
Priority 4
Rehearse procedure safety
Review sterile setup, local anesthetic context, device visualization, sampling, specimen handling, hemostasis, aftercare, and complications.
BS exam FAQ
How many questions are on the ARRT Breast Sonography examination?
The current examination format contains 225 questions: 185 scored questions and 40 unscored pilot questions. Pilot questions are mixed into the examination and are not identified.
How long is the Breast Sonography examination?
225 minutes of test time within a 245-minute appointment. ARRT's appointment time also includes the tutorial, nondisclosure agreement, and survey where applicable.
How is the content outline weighted?
The currently effective specification is approximately Patient Care 8.6%, Image Production 56.8%, Procedures 34.6%. These percentages are calculated from ARRT's scored-item counts, so rounding may prevent the displayed values from totaling exactly 100%.
What should I prioritize for Breast Sonography?
Image Production is the largest scored content area at approximately 56.8%. Give it the largest share of practice, but continue sampling every area because the examination blueprint is broad.
What score is required to pass an ARRT examination?
ARRT reports examination results on a scaled score from 1 to 99, and a scaled score of 75 is required to pass. A 75 scaled score is not the same as answering 75% of questions correctly.
Does this diagnostic predict whether I will pass?
No. A 15-question diagnostic is a low-confidence baseline, not a validated pass prediction. Review every rationale and use larger mixed and content-specific sets to build a more stable readiness estimate.
Is MedPorium affiliated with ARRT?
No. MedPorium is an independent education platform and is not affiliated with or endorsed by The American Registry of Radiologic Technologists.
Review and official source
Clinical reviewer: P. P. Lemon
Exam format and matrix information were checked against the ARRT Breast Sonography credential page and examination content specifications. Source reviewed October 15, 2026.
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