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Interpreting Physician: Breast Ultrasound and Ultrasound-Guided Breast Biopsy (Revised 05-23-24)

Revision History


The physician performing or interpreting breast ultrasound exams or biopsies must:

  • Be a licensed medical practitioner

  • Have a thorough understanding of the indications for breast ultrasound examinations

  • Be familiar with the basic physical principles and limitations of the technology of ultrasound imaging

  • Be familiar with alternative and complementary imaging and diagnostic procedures

  • Be capable of correlating the results of mammographic and other procedures with the sonographic findings

  • Have a thorough understanding of ultrasound technology and instrumentation, ultrasound power output, equipment calibration, and safety

  • Be able to demonstrate familiarity with breast anatomy, physiology, and pathology

  • Be familiar with interpretation and documentation in accordance with the ACR Practice Parameter for Communication of Diagnostic Imaging Findings


In addition, all physicians supervising, performing, and/or interpreting breast ultrasound examinations at facilities accredited by the ACR in breast ultrasound must meet the following minimum criteria:


Initial Qualifications

Radiologist: Board-Certified

Other Physician

Both of these:

  • Certification in Radiology or Diagnostic Radiology by the American Board of Radiology (ABR), American Osteopathic Board of Radiology (AOBR), Royal College of Physicians and Surgeons of Canada (RCPSC) or College des Medecins du Quebec (CMQ). Radiologists graduating from residency after 6-30-14 must be Board-eligible as defined by the ABR.

  • Qualified to interpret mammograms under MQSA

All of these:

  • Completion of Accreditation Council for Graduate Medical Education (ACGME) - approved residency in specialty practice

  • 100 hours Cat 1 CME in breast ultrasound

  • Performance, interpretation, and reporting of 300 breast ultrasound exams in last 36 months, supervised by a Board and MQSA-Certified Radiologist

Radiologist: Non-Board-Certified

Breast Surgeons

All of these:

  • Completion of an Accreditation Council for Graduate Medical Education (ACGME) - approved diagnostic radiology residency program

  • Oversight and/or performance, interpretation, and reporting of 300 breast ultrasound examinations in the last 36 months

  • Qualified to interpret mammograms under MQSA

Full American Society of Breast Surgeons (ASBS) certification, including passing both written and clinical exams. Prerequisites of full ASBS certification include:

  • 100 breast ultrasound exams per year in last 36 months with authenticated reports

  • Must include a minimum of 80 diagnostic and 20 interventional ultrasound exams every 12 months

  • Documented completion of 15 Cat 1 CME in breast ultrasound. At least 7 credits must be within prior 18 months

Continuing Experience

Upon renewal, one of the following:

  • 200 breast ultrasound examinations in the prior 36 months (recommended)

  • Monitoring and evaluation indicating acceptable technical success, accuracy of interpretation and appropriateness of evaluation

Upon renewal, 200 breast ultrasound examinations in the prior 36 months

Additional information regarding continuing experience requirements is available here

Continuing Education

Upon renewal, one of the following:

  • Currently meets the ABR Maintenance of Certification (MOC) requirements

  • 150 hours CME (includes 75 hours of Cat 1) in the prior 36 months pertinent to the physician’s practice patterns (See ACR Parameter)

  • Completes 15 hours CME (half must be Cat 1) in the prior 36 months specific to the imaging modality or organ system

15 hours CME (half must be Cat 1) in the prior 36 months in breast ultrasound, including biopsy

Additional information regarding continuing education requirements is available here


All physicians performing and supervising ultrasound-guided biopsies must meet both the breast ultrasound interpretation criteria outlined above and the ultrasound-guided breast biopsy minimum criteria detailed here:


Initial Qualifications

Radiologist

Other Physician

Qualified to interpret mammograms under MQSA

All of these:

  • Review mammographic findings with a MQSA-qualified physician

  • Perform 3 ultrasound-guided breast biopsy procedures under the supervision of a qualified physician, OR complete a residency or fellowship that includes instruction in ultrasound-guided breast needle procedures by a Board- and MQSA- certified diagnostic radiologist

  • Have 3 hours of Category 1 CME didactic instruction in ultrasound-guided breast biopsy

Breast Surgeon:

  • Full certification by ASBrS, including passing both the written and clinical examinations. The prerequisites of full ASBrS certification include: 
    • 100 breast ultrasounds per year in the last 36 months with authenticated reports
    • Must include a minimum of 80 diagnostic and 20 interventional exams every 12 months
    • Documented completion of 15 AMA Category 1 CME in breast ultrasound. At least 7 credits must be within the prior 18 months. 

Continuing Experience

Upon renewal, 36 image-guided breast biopsies in the prior 36 months


In addition to meeting being fully certified by ASBS, all physicians must meet all other requirements of the accreditation program including compliance with the peer-review requirements and outcome data monitoring.


Only qualified physicians may independently perform ultrasound guided breast biopsy procedures at facilities accredited by the ACR. Physician Assistants or Radiologist's Assistants cannot perform without a qualified physician being in the room at the time of the biopsy procedure.


Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

04-30-20

Ultrasound-Guided Breast Biopsy

Incorporated FAQ regarding Physician Assistants or Radiologist Assistants
11-10-2023RadiologistClarification of MQSA qualifications requirements for breast ultrasound.
05-23-2024Biopsy Initial QualificationsClarification of Other Physician qualifications requirements for breast ultrasound-guided biopsy, specifically for breast surgeons.



Next: Sonographer/Technologist: Breast Ultrasound

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