Breast Ultrasound Certification

The American Society of Breast Surgeons recognizes the leading role of surgeons as providers of clinical expertise in management of patients with breast abnormalities. A major goal of the Society's breast ultrasound certification program is to improve the quality of care for patients with breast disease by encouraging education and training to advance expertise and clinical competency for surgeons who use ultrasound and ultrasound-guided procedures in their practices.

Certification demonstrates a dedication to quality patient care and public safety through adherence to established standards for performance and training in breast ultrasound. The program will offer a means of recognition to individual surgeons who meet criteria in the areas of clinical experience, training, and quality assurance. The framework of the program is based on the principles for the proper performance and interpretation of diagnostic and interventional breast ultrasound, its appropriate clinical application, and use of interventions to guide further management as outlined in the Society’s Performance and Practice Guidelines for Breast Ultrasound.

There are two components to the breast ultrasound certification process: (1) a clinical application, and (2) a written examination. The examination and submission of the clinical application must occur within the same 12 month period. Applicants can choose which component to complete first.

Sample exam questions are available here.

You may order the clinical application or register for the examination by mail, phone, fax, or E-mail. A $50 non-refundable document fee is required. Check or credit card payment is accepted. An application on computer disk will be mailed to you. Click here for printable clinical application order form.

The Society has established the following minimum prerequisites for surgeons who may choose to undertake breast ultrasound certification:

Stereotactic Breast Procedure Certification

The American Society of Breast Surgeons goal in establishing certification is to improve the quality of care for patients with breast disease by encouraging education and training for surgeons who perform stereotactic breast procedures. The program is based on the principles for the proper performance of stereotactic breast procedures as outlined in the Society’s Performance and Practice Guidelines for Stereotactic Breast Procedures.

There are three components to the stereotactic certification process: (1) a clinical application, (2) a written exam and (3) a practical exam. The practical exam may only be taken after an applicant successfully passes both the clinical application and the written exam components. The examinations and submission of the clinical application must occur within the same 12 month period. The written and practical examinations may be retaken up to two times within a two year period.

Details about the written and practical exams and sample questions are available here.

You may order the clinical application or register for the examinations by mail, phone, fax, or email. A $50 non-refundable document fee is required. Check or credit card payment is accepted. An application on computer disk will be mailed to you. Click here for printable clinical application order form

The Society has established the following minimum prerequisites for surgeons who may choose to undertake certification for stereotactic breast procedures:

*Evaluation means review of the mammographic films in direct consultation with an MQSA qualified physician and/or independent review of mammograms with the authenticated mammographic report.

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The Ultrasound Facility Accreditation Program was developed in order to provide surgeons utilizing breast ultrasound in their practices a method to demonstrate that the ultrasound technology employed, and the facility procedures meet accepted standards of proper performance and safety. This is an optional program, but one the Society believes that surgeons employing breast ultrasound should achieve.

The Society believes it is important that surgeons be given a process that allows them to demonstrate to their patients, regulatory bodies, and payers that the accepted standards for the technology and the facility have been met.

The optional Breast Ultrasound Facility Accreditation Program has been approved by the Society’s Board of Directors, and will be available to those facilities that wish to apply. This program is designed to ensure that facilities receiving such accreditation have met the applicable requirements regarding the equipment, personnel (physicians, ultrasound technologists, physician assistants, nurse practitioners, and nurses), quality control and quality assurance programs and accuracy of examinations and procedures being performed.  Membership in the Society is not required for facility accreditation.

Facility accreditation requires that at least one surgeon be certified in breast ultrasound by the Society and be responsible for the overall ultrasound program.  In addition, all physicians and allied health personnel who perform breast ultrasound must be certified or actively working toward certification under the supervision of the surgeon certified by the Society.  Appropriate certification is through the Society for surgeons and American Registry for Diagnostic Medical Sonographers (ARDMS) for all other allied health personnel.  In order to maintain accreditation, all personnel who are working toward certification must become certified within 3 years from the time accreditation is granted to the facility.  Physicians and allied health personnel who join the practice after accreditation is granted will have 3 years from the time they join the practice to become certified.  If the responsible surgeon moves to a different practice location, he/she remains certified by the Society for the duration of the certification or recertification, but further application is required in order to maintain accreditation for the former facility or to obtain accreditation for the new practice facility.

If an application for facility accreditation is received within 2 years of the time of individual certification or recertification, no additional case submissions are required.  For practices where an individual has been certified or recertified more than 2 years or less than 5 years, two additional case submissions (in the same format as individual recertification) are required.  If it has been five or more years since the individual certified or recertified, it is necessary to submit 10 cases.
Facilities must recertify every five years.

All physicians, physician assistants, nurse practitioners, technologists, nurses, or other allied health care professionals who work in the facility must be listed in the application, including whether they perform breast ultrasound.  Those who perform breast ultrasound must provide evidence of their certification or a statement reflecting what they are doing to obtain certification.  Annual volumes of diagnostic and interventional breast ultrasound must be listed for each person.  Each individual who is not yet certified must provide a detailed list of CME activities.

A list of ultrasound equipment used in any location (hospital, ambulatory surgery center, office, etc.) along with documentation of proper inspection and maintenance by the manufacturer, a qualified engineer, or a medical physicist must be submitted.  The Society must be notified in the event of any equipment or maintenance changes that could reasonably be expected to adversely affect the quality of images obtained.

The facility policy on transducer cleaning and on the prevention of transmission of infectious diseases must be submitted along with a statement as to whether the facility is in compliance with all regulations of the Occupational Safety and Health Administration or the Accreditation Association for Ambulatory Health Care.

Each practice must record and track quality assurance indicators outlined below.  The records should be updated at least every six months, and must be submitted as a part of the re-accreditation process 5 years after accreditation is granted.  The Society reserves the right to randomly audit practices for compliance during the accreditation period at any time prior to application for recertification.    Data must be recorded and tracked for all ultrasound guided biopsies and aspirations except for simple cysts in which the fluid is discarded.  Data that must be tracked includes the following:

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Stereotactic Facility Accreditation Program

This program is designed to meet the needs of individual surgeons who either own or are directly responsible for the equipment and the personnel involved in stereotactic breast biopsy procedures in one or more facilities.  Individual surgeons performing stereotactic breast biopsy procedures in a stereotactic facility accredited program must either be certified or be in the process of certification by the Society in stereotactic breast procedures.  It is not necessary for surgeons who perform stereotactic procedures to apply for this facility accreditation program if the stereotactic procedures are being performed in a facility not owned or under direct control and supervision of the surgeon.  As in the Society’s Stereotactic Breast Procedure Certification Program, this program is based, in part, on the principles for the proper performance of stereotactic breast procedures as outlined in the Society Performance and Practice Guidelines for stereotactic breast procedures.

The Society’s Stereotactic Facility Accreditation Program is designed to ensure that facilities receiving such accreditation have met the applicable requirements regarding the equipment, personnel (physicians, mammographic technologists, and physicists), quality control and quality assurance programs and accuracy of the procedures being performed.  Membership in the society is not required for facility accreditation.

Equipment Requirements:

Equipment used in the performance of stereotactic breast procedures needs to be FDA approved. Please provide information regarding the manufacturer, model, date of manufacture and date placed into service. Maintenance records need to be kept on site and are subjected to on-site inspections. Radiation producing equipment must meet all state and local requirements. Please provide documentation of meeting these requirements. If a facility and/or equipment are outside FDA jurisdiction, they must comply with all of the standards for the performance of stereotactic procedures.

Personnel:

Surgeon’s Qualifications

Mammographic Technologist Qualifications

Initial:

A. Qualified to perform mammography under MQSA
B. 3 Category A CEUs in stereotactic breast procedures
C. Participated in 5 stereotactic breast biopsy procedures under supervision of a qualified physician or technologist

Continuing Experience: 12 stereotactic breast procedures per year and 3 CEU’s in stereotactic procedures every 3 years. Technologists must be MQSA qualified

Medical Physicist Qualifications*:

Initial:

A. Qualified to perform mammography surveys under MQSA
B. Performed 1 hands-on stereotactic breast biopsy survey under a qualified medical physicist or at least 3 independent surveys prior to 6/1/97

Continuing Experience

A. 1 stereotactic breast biopsy unit physics survey per year
B. 3 CEU’s in stereotactic breast biopsy every 3 years

*medical physicists must be currently qualified under MQSA

Annual Requirements

 The medical physicists and the technologist must meet specific survey and quality control measures as outlined in the Accreditation Application. These are in keeping with the good practices of these individuals as spelled out by the ACR.

Application
Outcome data from the past 12 months, clinical case experience, documentation for specific cases, appropriate case reports, and the submission of clinical images for two cases must accompany the application.

Recertification

Fee

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Society Contact Information:

Address:
The American Society of Breast Surgeons
5950 Symphony Woods Road
Suite 212
Columbia, MD 21044

Telephone: 410-992-5470 or (toll free) 877-992-5470
Fax: 410-992-5472

E-Mail:
contact@breastsurgeons.org