What a breast sonographer images, the exams they perform, the conditions those exams find, and the credentials and settings involved.
Breast sonography images the breast and the nearby lymph nodes, most often as a partner to mammography. It is frequently the test that answers a specific question — is a lump a harmless cyst or a solid mass that needs more work — and it guides procedures such as biopsies. Many breast sonographers come to the work from a mammography or radiologic-technology background.
What it images
Breast ultrasound images the breast tissue itself — the glandular tissue, the ducts, and the fat — and the axilla, the underarm area that holds the axillary lymph nodes (AIUM/ACR breast practice parameter).
The common studies
- Diagnostic breast ultrasound. Characterizing a lump that can be felt, or a finding seen on a mammogram or MRI — most importantly, telling a fluid-filled cyst from a solid mass (ACR/AIUM breast parameter).
- Targeted “second-look” ultrasound. A focused look after an abnormal mammogram or MRI.
- Whole-breast supplemental screening. Additional screening, for example for women with dense breast tissue (ACR whole-breast parameter).
- Procedure guidance. Breast sonographers assist with ultrasound-guided core-needle biopsy, fine-needle aspiration, cyst drainage, and localization; a physician performs the procedure.
Findings are reported using the BI-RADS ultrasound lexicon, a standard system for describing breast findings (AIUM/ACR breast parameter).
The conditions it helps find
Breast ultrasound distinguishes simple and complex cysts, benign solid masses such as fibroadenomas, and suspicious solid masses that may be cancer. It also evaluates enlarged axillary lymph nodes, abscess and infection (mastitis), and palpable lumps in dense, young, or pregnant breasts, where mammography is more limited (AIUM/ACR breast parameter).
The credentials
- RDMS — Registered Diagnostic Medical Sonographer, Breast specialty, issued by the American Registry for Diagnostic Medical Sonography (ARDMS). The path requires the Sonography Principles and Instrumentation (SPI) physics exam plus the Breast exam, within five years (ARDMS, 2024).
- Breast Sonography, issued by the American Registry of Radiologic Technologists (ARRT) as a post-primary credential designating R.T.(BS), most often earned by technologists who already hold a radiologic-technology credential (ARRT, 2024).
Because many breast sonographers are also mammographers, the path often runs through the ARRT rather than a primary ARDMS route. Licensing and Certification covers the bodies in full.
A note on standards
As of November 2013, the American Institute of Ultrasound in Medicine (AIUM) adopted the American College of Radiology (ACR) practice parameter for breast ultrasound in place of its own, so the governing breast-ultrasound standard is effectively the ACR’s (AIUM/ACR, 2013).
Where the work happens
Breast sonographers work in breast- and women’s-imaging centers, hospital radiology departments, outpatient diagnostic-imaging centers, and breast-surgery practices.
Pay and outlook
Breast work sits within the general diagnostic medical sonographers occupation (code 29-2032): a median wage of $89,340 and 13 percent projected growth from 2024 to 2034 (BLS, May 2024). The BLS notes breast sonographers assist with tumor tracking and treatment decisions but does not publish a separate breast-only wage.
Last verified: 2026-06-14. Credential requirements and standards change; confirm current details with ARDMS, ARRT, and the ACR. Salary figures are from the BLS and describe the occupation, not any individual job. This page is informational and does not recommend a specialty.