Breast (BR)

APCA is currently accepting, processing and approving applications for this examination. Pearson VUE our test vendor is open and operating, however at limited capacity and locations. Please visit the APCA COVID-19 page for additional details.

​​​​​​​​​​​​​​​​If you are not a physician but are interested in applying for the ARDMS RDMS credential with a BR specialty, please visit the BR specialty page on the ARDMS website.

The Breast (BR) examination tests the requisite breast knowledge, skills and abilities essential to sonographer-level professionals.

As a physician, you are able to pursue many of the examinations offered by the APCA companion council, ARDMS. While ARDMS manages the BR examination and the associated Registered Diagnostic Medical Sonographer (RDMS) certification, APCA, its companion council created exclusively to serve physicians, will be your destination to apply, prepare for, schedule and maintain all your certifications. You will log into MY APCA for information regarding the examination and to apply online.

To earn the Registered Diagnostic Medical Sonographer (RDMS) credential with a BR specialty, you must pass the Sonography Principles & Instrumentation (SPI) examination and the BR examination within five years. After passing the SPI examination, you can earn additional ARDMS credentials without having to retake the SPI examination, provided you maintain active status.

You must wait 60 days before you can retake the BR examination if you do not pass it however, you are welcome to reapply after 3 days.

The BR examination assesses the knowledge, skills and abilities in the areas of normal breast as well as breast abnormalities that are found with screening or diagnostic mammography.

We periodically​​ conduct a BR Practice Analysis and update the BR examination to reflect the frequency and importance of BR tasks being performed by sonographer-level professionals.

The latest BR Practice Analysis was conducted in 2017. Click to view the 2017 BR Practice Analysis Results​​.

The Breast (BR) examination is three hours, including a five-minute survey, and contains approximately 170 multiple-choice questions, which include hotspot questions. The hotspot questions​ are Advanced Item Type questions​ ​that assess and measure your practical sonography skills.

To earn a Registered Diagnostic Medical Sonographer (RDMS)​ certification from ARDMS with a BR specialty, you must pass the Sonography Principles & Instrumentation (SPI) examination and the BR examination within five years.

After passing the SPI examination, you can earn additional certifications without having to retake the SPI examination, provided you maintain active status.

ARDMS functions under policies intended to demonstrate impartiality, high ethical standards and validity of its certification assessments.

ARDMS does not restrict Applicants, Candidates or becoming a Registrant/Certificant based on limiting conditions, such as membership of an association or professional society of any organization. ARDMS will not unfairly impede or inhibit access to its certification to Applicants, Candidates or Registrants/Certificants who meet our stated policies regarding qualification requirements, renewal requirements and/or passing ARDMS’ psychometrically sound certification assessments.

Candidates must pass the Sonography Principles & Instrumentation (SPI) examination and the corresponding specialty examination within five years, regardless of sequence. Candidates who do not complete both examinations within five years must retake the examination previously passed.

Note: The five-year rule does not apply to Registrants seeking additional specialties under a certification already earned. For example, if you have the RDMS certfication with AB, the five-year rule is not applicable if you want to add another RDMS specialty (OB/GYN, BR, FE, PS). There is no time limit to add additional specialties to a certification already earned, provided you maintain Active status.

However, if you earned the RDMS with the old UPI physics examination and AB (or any other RDMS specialty), and then passed the SPI examination, you would need to pass one of the RDCS, RVT or RMSKS specialties to meet the five-year rule requirement for the SPI examination. In this situation, adding an additional RDMS specialty after passing the SPI examination (or vice versa) would not meet the five-year rule requirement since you would be adding a specialty to a certification already earned.

The five-year rule is based on the calendar year (January 1 through December 31). The five-year period begins the day the first examination is passed, and it includes any time that remains in that year plus the next five years. For example, a candidate who passed the first ARDMS examination on June 6, 2011, is required to pass the second examination by December 31, 2016.

New 2020 Prerequisite for Physicians Applying for ARDMS Examinations:
Physicians can now apply under the current physician prerequisites and the new physician prerequisite from January 1, 2020 through June 30, 2020. Learn more!

To sit for the BR examination and earn the RDMS certification, First-Time Applicants must select a prerequisite that best meets your education and clinical experience.

Click to view the SPI Requirement and General Prerequisites​​.

If you are a Re-applicant, visit the “Apply” tab and view the Re-applicant information.

When applying for the BR examination, if your prerequisite selection requires documentation of clinical experience, please note that application letter(s) must:

  • Be an official letter with the address and telephone number indicated
  • Include the current date (mm/dd/yyyy)
  • State actual dates of employment or program
  • Contain original signatures (stamped and/or computer generated signatures are not acceptable); letters cannot be signed by a relative of the applicant
  • Provide a physician’s medical license number or Certification (ARDMS or APCA) number
  • Employment letters must indicate full-time or part-time training/experience AND must include the total number of paid clinical hours.

Program completion letters must include the total number of hours in the program and state individually, the number of didactic and clinical hours in the program.

Provided are some sample letters that may correspond with your prerequisite requirements:

New 2020 ARDMS Physician Prerequisite Sample Letters – Effective January 6, 2020.

4A1, 4A2, 4B1, and 4B2 Prerequisite Sample Letters – Going away July 1, 2020.

Patient Log 

Standard Clinical Verification forms are intended for applicants residing in the U.S or Canada. International Clinical Verification forms are intended for applicants residing outside the U.S. or Canada. Please note that the home address on record at the time of application submission is the basis for determining which form to use.

Degrees earned internationally must be evaluated prior to selecting a prerequisite. We require a course by course evaluation. Click here​ for complete list of Evaluation Agencies for International Degrees.

If the applicant has taken and passed all three parts of and earned the Educational Commission for Foreign Medical Graduates (ECFMG®) certification, a copy of the ECFMG® certificate may be submitted with a copy of current, valid MD or DO license from the U.S. or Canada in lieu of the evaluation.​​

Based on your prerequisite or requirement selection​, the necessary supporting ​documentation must be received within 21 days of submitting your online application. ​

Note: We do not retain application documentation received prior to receipt and payment of the online application. Any documentation received prior to the completed online application will be discarded.​​​

As a physician, once you are ready to apply for an ARDMS examination, follow the steps below:

  • Log in to MY APCA and choose the “Apply Online” option.
  • Complete the online application form and submit payment. If you are a first-time applicant, you are required to choose a prerequisite under which to apply.
  • Gather the required supporting documentation.
  • Submit your supporting documentation for receipt within 21 days of applying online. Review of your application can take up to five business days from receipt of documentation in the office. Please note, due to the increased volume during November, December and January the review of your application can take up to ten business days from receipt of documentation in the office.

For more details, please visit the RDMS, RDCS, RVT, and RMSKS How to Apply Guide​​.​

Once we have reviewed your information, we will email you with either an Examination Confirmation Letter (ECL) or a request for additional documentation. When you receive the ECL, you may contact Pearson VUE to schedule an examination appointment during your 90-day eligibility period. ​

If you are found ineligible to take the examination, your application will be partially refunded (less the $100 USD processing fee per examination) and your documentation will be mailed back to you.

The BR examination fee is $250 USD, which includes a $100 USD non-refundable processing fee.  If you take an ARDMS examination at an international test center (outside the U.S., Canada and Mexico), you will be charged an additional non-refundable $50 USD fee when you schedule your examination. This fee is subject to change without notice.

Reimbursement Information for U.S. Armed Forces Veterans: 

Learn more about the GI Reimbursement Program for United States Armed Forces Veterans. ​

The application checklist is a helpful, online tool that lets you track the status of your submitted application. To view it, log into MY APCA and visit the “Application Checklist” from the “Application Center” drop down menu.

Once we have reviewed your documentation, you can find out what documentation we accepted and what additional documentation we may still need by selecting “View Checklist.”

If “View Checklist” is not available, it simply means we have not yet reviewed your documentation.

​If you are found eligible to take an examination, we will email you an Examination Confirmation Letter (ECL) within one to two days of application approval and you will be able to schedule your appointment at that time. The ECL will also be posted to your MY APCA account and will include your eligibility period to schedule and take your examination.

You will be considered a Re-applicant for the BR examination:

  • If you were previously approved to sit for any of the following
    Sonographer-level specialty examinations:

    1. Abdomen (AB)
    2. Obstetrics and Gynecology (OB/GYN)
    3. Breast (BR)
    4. Fetal Echocardiography (FE)
    5. Pediatric Sonography (PS)
    6. Adult Echocardiography (AE)
    7. Pediatric Echocardiography (PE)
    8. Vascular Technology (VT)​
  • If you were previously approved to sit for the SPI examination
    under a prerequisite (excludes approval of the SPI
    examination under the SPI Examination Requirement)

To apply as a Re-applicant:

  • If you have a current BR Clinical Verification (CV) Form on file, you will need to submit the application and examination fee only. The application will automatically be approved and you will be able to schedule within a day.
  • If you do not have a current BR CV Form on file, you will need to submit the application, the examination fee and a current BR CV Form. To access your active CV Forms, please log into MY APCA​ and click on “Clinical Verification Form” under “Application Center.”​

If you need special accommodations, please select “Yes” for “Special Accommodations” in the application and submit the following along with your completed application:

  • An original copy of a letter dated within the past five years and typed on official letterhead from a qualified physician or health care provider who specializes in the disability. This letter must document the disability and its severity, describe the applicant’s limitation due to the disability and state exactly what accommodations are recommended. The letter must contain an original signature and the physician’s or provider’s credentials.
  • An original copy of a comprehensive medical evaluation/report of the diagnosed disability from the physician or health care provider, dated within the past five years.
  • A completed Americans with Disabilities Act (A​DA) Special Accommodations Questionnaire​​​,​ which must be submitted each time you apply for an examination.

For more information, visit Americans with Disabilities Act.​

Once your BR application has been approved, an Examination Confirmation Letter (ECL) will be emailed to you to schedule an examination with Pearson VUE – ARDMS’ official testing vendor. You will have 90 days to schedule and take your examination.

If you have not done so already, visit Pearson VUE to:

  • Create a Pearson VUE account
  • Search for seat availability
  • Locate a test center
  • Schedule an examination
  • Contact Pearson VUE Customer Service

If you are taking the examination at an international test center (outside the U.S., Canada and Mexico), a $100 USD non-refundable fee and Value Added Tax (VAT) will be charged by Pearson VUE. All international scheduling fees and associated VAT will be charged at the time the examination is scheduled. The fees and associated VAT are subject to change without notice, and they are non-refundable.

To reschedule the date and time of your examination during your eligibility period, you must contact Pearson VUE (1-877-258-9220) at least 96 hours prior to the scheduled examination date and time.

To cancel an examination appointment, you must contact Pearson VUE (1-877-258-9220) and cancel the scheduled appointment no later than 96 hours prior to the scheduled examination appointment time. You will receive a cancellation email from Pearson VUE.

To request a partial refund, you must wait 24 hours after canceling the appointment with Pearson VUE and then submit a cancellation/partial refund request no later than 96 hours prior to the last date of the eligibility period.

To submit this request:

  • Log in to your MY APCA account.
  • Visit “My Examination/Application Status” under “Application Center.”
  • Select the examination you wish to request a partial refund for. ​
  • Complete and submit the form.

We will refund your examination fee, less the $100 USD processing fee per examination, unless we receive your request too late, you never schedule your examination or you do not keep your scheduled examination appointment. Then, the entire examination and processing fees are forfeited.

If you need more time and cannot schedule your examination within the 90-day eligibility period, you can request a one-time 60-day extension for the examination. You must request this extension at least 96 hours prior to the last date of the eligibility period.

To request an extension:

  1. Log in to your MY APCA account.
  2. Visit “My Examination/Application Status” under “Application Center.”
  3. Select the examination you wish to extend.
  4. Complete and submit the form.

If you have a scheduled examination appointment, you must contact Pearson VUE (1-877-258-9220) at least 96 hours prior to the scheduled examination, and notify them that you are cancelling your scheduled appointment before you complete the steps above to request an extension.

The entire examination fee is forfeited if we receive your request too late, you never schedule your examination or you do not keep your scheduled examination appointment.

When you arrive at a test center, be prepared to:

  • Check in with a Test Center Administrator
  • Present one valid photo identification (ID); see Test Center Identification Requirements
  • Provide a digital signature
  • Have your palm vein scanned
  • Take a test-day photograph

Note: The only thing that you can bring into the testing room is you. The test centers have lockers you can use to store personal belongings. Study materials as well as food and drink are prohibited in the test center. No visitors, guests, pets or children are allowed.

Important: Review ARDMS’s Examination Admission Compli​ance​ policies to ensure you are not refused admission at the test center and do not conduct unauthorized examination behavior.

Test centers will provide white boards for notes during the examination upon request.

If you need special accommodations, please select “Yes” for “Special Accommodations” in the application when you apply.

Taking a practice test or two is a great way to prepare for your actual examination. We offer a Breast (BR) Practice Test that simulates the computer interface used in the actual test center environment. The BR practice test review is comprised of 30 sample questions and is 30 minutes long.

After you complete a practice test, you will be emailed a report that shows the number of questions you answered correctly. While the report is an indication of your knowledge, the practice tests results should not be used to predict how well you will perform on the actual test at the test center.

See FAQs​ for additional information.

Each practice test costs $35 USD.

You can now register for a BR practice test by signing into your MY APCA​​ account and clicking the Sign Up/View Practice Test option in the Application Center tab. You can also view the computer system requirements in your MY APCA portal. For any general questions or technical problems regarding the practice tests, please call APCA at (800) 943-1709 or email

Before your session begins, you should review the test tutorial. Please note you will not get a chance to review the test tutorial during the actual practice test, so please prepare accordingly. Once your session begins, you have 30 minutes to complete the practice test.

Register for a BR practice test by signing in your MY APCA account.

The BR examination covers the following content areas. All percentages are an approximate distribution of the questions across the content areas.

BR Content Outline (Please click on “BR Content Outline” for the detailed Content Outline in PDF-Printable format)

Anatomy and Physiology [15%]

  • Normal anatomy and physiology

Pathology [34%]

  • Abnormal perfusion and function
  • Benign vs. suspicious findings

Integration of Data [19%]

  • Incorporation of outside data

Protocols [13%]

  • Clinical standards and guidelines
  • Measurement techniques

Ultrasound Physics [12%]

  • Artifacts
  • Hemodynamics
  • Imaging instruments

Emerging Technology and Treatment [7%]

  • New technologies
  • Interventional procedures​

Please note: All percentages are approximate.

Your score report will display and include performance feedback for these content areas.​

After all of your diligent preparation and hours spent studying, here are a few valuable tips to help make your examination day a success:

  • Double check that you know where the test center is before examination day and give yourself plenty of time to get there. Remember, you MUST arrive and register at least 30 minutes before the examination begins.
  • Get a good night’s sleep before you take your examination. Being well rested and relaxed when you take your examination will help you concentrate.
  • Bring one form of current and valid identification that complies with the test center identification requirements​​.
  • Travel light. The only thing you can bring into the testing room is you. You can store your personal belongings — your car keys, watch, smartphone, purse, backpack, etc. — in lockers at the test center. The following items are not allowed in test centers: study materials, food, drink, visitors/guests, pets and children.
  • Request a white board if you plan to jot down notes during the examination. Test centers are using white boards (rather than paper) in an effort to “go green.”

Good luck!

Even though we offer practice examinations and sample questions, we do not offer study materials for our examinations – but our sister organizations do. You can find materials at:

The BR examination features Advanced Item Type questions​​, which assess and measure your practical sonography skills. They include hotspot questions in which you will receive questions about individual images; you will use the cursor to mark the correct answer directly on the image.

Watch the video presented by APCA’s companion organization for sonographers, ARDMS: How to Answer a Hotspot Question.​

The BR examination evaluates mammography knowledge and skills you must demonstrate as a Sonography Professional. The primary test result is a PASS or FAIL decision. In addition, you will receive a scaled score, ranging from 300 to 700. A scaled score of 555 is required to pass all ARDMS examinations.

The scaled score is not a percentage of correct answers, nor is it built on a “curve” where a certain percentage of scores would pass and a certain percentage would fail. To learn more, visit Notification of Results and Scoring​​.​​

You can receive a score report at the test center once you complete the examination. The Pass or Fail results will then be posted to your secure MY APCA account within the next week.

Candidates receiving a confirmed passing score on all required examinations and meeting all other requirements will be awarded a certification, effective the date the final examination was taken. For information on the ARDMS’ scoring methods, visit Notification of Results and Scoring​​.

Candidates who do not pass are invited to re-apply.

You can request a score verification for a $35 USD fee, payable by check, money order or credit card. Score verification ensures that the computer counted the correct and incorrect answers appropriately, but it does not review the questions and answers.

You must submit the completed Exam Score Verification Form​  within 30 days of having taken the examination in question​. The Exam Score Verification Form will be returned if incomplete, unsigned or unpaid.

When deciding whether to have your score verified, please consider that examinations are scored electronically with a high degree of accuracy, and it is unlikely that verification will alter your original score.

Below are the pass rates for the BR examination for the past three years. As this is a sonographer-level examination, this pass rates are reflective of all examinees (both sonographers and physicians).

First-time takers: 79%
Overall: 76%​​

First-time takers: 81%
Overall: 77%​​

First-time takers: 80%
Overall: 77%​

First-time takers: 80%
Overall: 77%

First-time takers: 79%
Overall: 75%

First-time takers: 76%
Overall: 73%