The Breast Specialty Examination is a comprehensive and wide-ranging examination developed by the American Registry for Diagnostic Medical Sonography for men and women who want to enter this exciting and rewarding field of health care. Those who take it must also pass the Sonography Principles and Instrumentation Examination in order to obtain the Registered Diagnostic Medical Sonographer credential.
The Breast Specialty Examination is three hours long and consists of 170 multiple-choice questions. It covers seven main content areas as follows:
- The section on breast instrumentation and technique (20 percent of the exam) covers system setup; transducers; grayscale; Doppler (color and power), including pressure and set up; and physical exams. This portion also includes questions regarding mammographic correlation, annotation, standoff pads, scan planes, compressibility, echo-palpation, artifacts, positioning, and indications.
- Normal anatomy (20 percent) addresses ducts (TDLU), fibrous planes, skin, superficial fascia, mammary zones, deep fascia, pectoralis, and ribs. This section also covers lymph nodes (LNs: internal mammary, axillary, and intramammary), mammography versus ultrasound appearance, pregnancy-induced changes, and involutional changes.
- The portion of the Breast Specialty Examination test on benign versus malignant features (25 percent) includes questions on the sharpness and contour of margins, border thickness and echogenicity, shape and orientation, echogenicity, heterogeneity, compressibility, vascularity, the effects on fibrous planes and ducts; calcifications, lymph nodes, and skin thickening.
- The section addressing specific lesions-benign (10 percent) covers cysts (simple, complex, debris, thick fluid, wall, through); transmission; sebaceous cysts; fibrocystic nodules; fibroadenoma; papilloma; lipoma; hamartoma; inflammation and infection (abscess, mastitis, and edema); traumatic changes (fat necrosis, seroma, and scarring); and gynecomastia.
- That on specific lesions-malignant (10 percent) reviews DCIS/LCIS; invasive lesions (ductal, lobular, colloid, medullary, and multifocal); phyllodes; lymphoma; and metastasis.
- Invasive procedures (5 percent) include localizations, core biopsy, FNA, mammotomy, abbi, and cyst aspiration.
- The miscellaneous portion of the test (10 percent) covers MRI appearance (implant leakage, cancer, and nodes); ductography; sentinel node procedure; histology; and implants.
The Breast Specialty Examination is given in a multiple-choice format, with four potential answers for each question. Some answer choices may be partially correct; it is the test taker’s job to select the best answer. The test is administered by computer in testing centers around the country.