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Exam Review

Key Facts: BS Exam

225

Total Questions

185 scored + 40 unscored

$225

Application Fee

ARRT

75

Passing Scaled Score

ARRT

Sep 2026

New Content Specs

Updated effective Sep 1, 2026

ARRT BS (Breast Sonography) is a post-primary credential. 225 items (185 scored + 40 unscored), scaled passing 75. $225 fee. Prerequisite: ARRT certification in Radiography, Sonography, Nuclear Medicine, or Radiation Therapy. Master BI-RADS 5th Ed lesion descriptors, common pathology (fibroadenoma vs IDC), supplemental screening for dense breasts, and US-guided biopsy procedures. Updated content specs effective Sep 1, 2026.

Sample BS Practice Questions

Try these sample questions to review concepts for the BS exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 178+ question experience with AI tutoring.

1Before beginning a breast ultrasound exam, which patient identification practice is required?
A.Verify patient using two unique identifiers such as full name and date of birth
B.Confirm only the patient's first and last name verbally
C.Match the patient to the requisition by appointment time
D.Ask the patient to confirm the body part being imaged
Explanation: ARRT and Joint Commission standards require two patient identifiers (e.g., name and DOB) before any imaging procedure to prevent wrong-patient errors.
2A patient reports a palpable lump in the upper outer quadrant of the right breast. The most appropriate first action is to:
A.Mark the area with a radiopaque BB or palpation marker before scanning
B.Scan all four quadrants before addressing the lump
C.Document only the patient's verbal description
D.Refer the patient back to the ordering provider
Explanation: Marking the palpable area allows the sonographer to correlate sonographic findings with the patient's symptom and ensures the area is documented and scanned thoroughly.
3Which communication technique best supports a patient who becomes anxious upon learning a biopsy may be needed?
A.Use empathetic listening and clear, jargon-free explanations
B.Reassure the patient that the lesion is almost certainly benign
C.Postpone the discussion until the radiologist arrives
D.Limit information to reduce the patient's worry
Explanation: Empathetic, plain-language communication respects autonomy and reduces anxiety while remaining within the sonographer's scope.
4Which infection-control practice is required between breast ultrasound patients?
A.Disinfect the transducer with an EPA-registered low- or intermediate-level disinfectant per manufacturer guidance
B.Wipe the transducer with a dry paper towel only
C.Replace the transducer cover but reuse residual gel
D.Soak the transducer head in alcohol for one minute
Explanation: AIUM/ARRT guidelines require cleaning visible debris and disinfecting the probe with manufacturer-approved EPA-registered agents between patients.
5A patient with breast implants is scheduled for ultrasound. The sonographer should:
A.Use light transducer pressure and image around and over the implant carefully
B.Apply firm pressure to displace the implant out of the field of view
C.Refuse the exam due to risk of implant rupture
D.Image only the axilla to avoid the implant
Explanation: Light, controlled pressure prevents implant injury while allowing complete evaluation of breast tissue and the implant capsule.
6What is the sonographer's role regarding informed consent for an ultrasound-guided core needle biopsy?
A.Verify that the radiologist has obtained signed consent before the procedure begins
B.Obtain the patient's signed consent independently
C.Explain the procedural risks and complications to the patient
D.Determine whether consent is necessary based on lesion type
Explanation: The performing physician obtains informed consent. The sonographer verifies it is documented before assisting.
7Which patient position is standard for evaluating the upper outer quadrant of the right breast?
A.Left posterior oblique with the right arm raised above the head
B.Prone with both arms at the sides
C.Upright in a chair facing the sonographer
D.Trendelenburg with arms crossed over the chest
Explanation: A contralateral posterior oblique position with the ipsilateral arm raised flattens lateral breast tissue against the chest wall, optimizing visualization.
8A patient with limited English proficiency is scheduled for breast sonography. The most appropriate action is to:
A.Use a qualified medical interpreter or telephonic interpretation service
B.Ask a family member who is a minor to translate
C.Proceed using gestures and simple English
D.Reschedule until the patient brings someone fluent
Explanation: Federal patient-rights standards require qualified medical interpretation for limited-English-proficiency patients.
9Which finding is the sonographer ethically obligated to report to the interpreting physician immediately?
A.A suspicious mass with features of malignancy not noted on the requisition
B.An incidental skin nevus
C.A patient's request for the radiologist's name
D.Mild patient discomfort during scanning
Explanation: Significant findings, especially suspicious masses, should be communicated promptly so the physician can guide additional imaging or correlation.
10Per ALARA, which adjustment most directly minimizes ultrasound exposure during a diagnostic breast exam?
A.Use the lowest acoustic output and shortest scan time consistent with diagnostic image quality
B.Maximize transmit power to reduce gain
C.Always disable thermal index display
D.Use the highest frame rate available regardless of need
Explanation: ALARA mandates minimizing acoustic output and exposure time while maintaining diagnostic quality.

About the BS Exam

ARRT post-primary credential for breast ultrasound technologists. Validates expertise in breast anatomy/physiology/pathology, image production with high-frequency linear transducers, scanning procedures (radial/antiradial/orthogonal documentation), BI-RADS Atlas 5th Edition lesion characterization (shape, orientation, margin, echo pattern, posterior features), supplemental screening for dense breasts (BI-RADS C/D), automated whole-breast scanning (ABUS/AWBUS), and ultrasound-guided interventional procedures (core biopsy, vacuum-assisted, wire localization).

Exam sponsor: ARRT. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

225 questions

Time Limit

Per ARRT scheduling

Passing Score

Scaled 75

Exam / Certification Fees

$225

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

10%

Patient Care, Safety, Communication

Patient communication, infection control, dense-breast screening counseling

20%

Breast Anatomy, Physiology, Pathology

Cooper's ligaments, lobules, ducts, common pathology (cyst/fibroadenoma/IDC/ILC/DCIS/papilloma/abscess)

15%

Image Production & Quality

High-frequency linear transducer (12-15 MHz), gain/TGC/focal zones, harmonic imaging

25%

Procedures (Diagnostic, Screening, ABUS)

Scanning planes (radial/antiradial), clock-face documentation, ABUS/AWBUS workflow

20%

BI-RADS, Lesion Characterization, Reporting

BI-RADS Atlas 5th Ed: shape, orientation, margin, echo pattern, posterior features; categories 0-6

10%

Interventional (US-Guided Biopsy, Wire Loc, Aspiration)

Core biopsy, vacuum-assisted, wire localization, fine-needle aspiration

Preparing for the BS Exam

What You Need to Know

  • Passing score: Scaled 75
  • Exam length: 225 questions
  • Time limit: Per ARRT scheduling
  • Exam / certification fees: $225 Official sources

Using Our Practice Resources

  • Work through all 178 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

BS: Suggested Study Strategy

1Master BI-RADS lesion descriptors: shape, orientation (parallel = lower risk), margin, echo pattern, posterior features
2Memorize categories 0-6 with malignancy risk: 3 ≤2%, 4A 2-10%, 4B 10-50%, 4C 50-95%, 5 ≥95%
3Know fibroadenoma vs IDC: fibroadenoma = oval, parallel, circumscribed, hypoechoic; IDC = irregular, NOT-parallel, NON-circumscribed, hypoechoic + posterior shadowing
4Apply scanning documentation: radial vs antiradial planes; clock-face position; distance from nipple
5Understand supplemental screening: BI-RADS density C/D triggers shared decision-making for handheld US, ABUS, or MRI

Frequently Asked Questions

What are BI-RADS categories?

BI-RADS Atlas 5th Edition categories: 0 = incomplete (need additional imaging); 1 = negative; 2 = benign; 3 = probably benign (≤2% malignant — recommend 6-month FU); 4 = suspicious (subdivided 4A 2-10%, 4B 10-50%, 4C 50-95% — biopsy recommended); 5 = highly suggestive of malignancy (≥95% — biopsy required); 6 = known biopsy-proven malignancy.

What lesion features predict malignancy?

BI-RADS lesion descriptors associated with malignancy: NOT-parallel orientation (taller than wide); irregular shape; non-circumscribed margin (indistinct, angular, microlobulated, spiculated); marked hypoechogenicity; posterior shadowing; surrounding architectural distortion. BENIGN features: oval shape; parallel orientation (wider than tall); circumscribed margin; isoechoic/hyperechoic; posterior enhancement (cyst). Microcalcifications often seen on mammography but US can identify some.

What is supplemental screening for dense breasts?

Women with mammographic breast density Category C (heterogeneously dense) or D (extremely dense) per BI-RADS may benefit from supplemental screening due to reduced mammographic sensitivity. Options: hand-held screening US, automated whole-breast US (ABUS), MRI (highest sensitivity but high cost). Many states have density notification laws and ACR/SBI guidelines support supplemental screening per shared decision-making.

How should I study for ARRT BS?

Plan 60-100 hours over 8-12 weeks. Focus heaviest on Procedures (25%), Anatomy/Pathology (20%), and BI-RADS (20%) — together 65% of exam. Master BI-RADS Atlas 5th Ed lesion descriptors, the morphology of common pathology (fibroadenoma vs IDC), and US-guided biopsy procedures. Updated content specs effective Sep 1, 2026.