- The exam has 125 multiple-choice questions, 100 scored and 25 unscored, in a 3-hour sitting.
- Screening, Diagnosis and Treatment and Education & Resources are 28% each, together 56% of the exam.
- Cut scores are 75% for forms A, C and D, and 79% for form B.
- Eligibility requires 1,500 navigation hours in the past two years plus eight relevant education hours.
Which BHCN This Cheat Sheet Covers
The acronym BHCN is shared by more than one credential, so a quick clarification saves you from studying the wrong material. This page covers the Certified Breast Health Clinical Navigator credential, offered through the National Consortium of Breast Centers, Inc. (NCBC). Everything below applies to that credential only. If you want the full background on the title itself, see What Is BHCN Certification? and What Does BHCN Stand For?.
Think of this article as the one-page version of your prep: the numbers you need to memorize, the rules you need to follow, and the topic areas you need to be fluent in. For the slower, deeper walkthrough, pair it with the BHCN Study Guide 2026.
The Exam at a Glance
| Item | What to Know |
|---|---|
| Certifying body | National Consortium of Breast Centers, Inc. (NCBC) |
| Question count | 125 multiple-choice questions |
| Scored vs. unscored | 100 scored, 25 unscored |
| Time allowed | 3 hours |
| Exam fee | $295 |
| Delivery | Paper/pencil or live remote proctored; US-only |
| Content outline | Effective 2022; current linked description is V2 (July 2023 upload) |
What the 25 unscored questions mean for you
Of the 125 items, 25 do not count toward your score. You will not be told which ones they are, so treat every question as if it counts. The practical implication: do not burn time agonizing over a single item. With 125 questions in 3 hours, you have roughly a minute and a half per question on average, which is comfortable for a navigator who knows the material but punishing for someone who stalls.
Question style
Expect scenario-driven multiple-choice items rooted in navigation work: a patient with an abnormal screening result, a delay between diagnosis and first appointment, a patient who is hesitant about treatment, a gap in insurance coverage. The best answer is usually the one that reflects a navigator's actual role, which means coordinating, educating, connecting resources and communicating clearly, rather than making clinical decisions that belong to the treating team.
Eligibility Snapshot
You cannot sit for the exam on interest alone. The published requirements are:
- A valid RN license, or valid licensure as a medical imager / radiologic technologist
- 1,500 navigation hours within the past two years
- Eight relevant education hours, of which up to four may come from tumor boards
The navigation-hours requirement is the one that trips people up, because it is a rolling two-year window rather than a lifetime total. Start documenting your hours early. For the full eligibility discussion, including how to qualify, read BHCN Requirements 2026.
Domain Weights and What Each One Tests
The exam outline has five domains. Two of them carry the majority of the weight, and that should shape where your hours go.
| Domain | Weight |
|---|---|
| Domain 1: Breast Health/Breast Cancer | 15% |
| Domain 2: Screening, Diagnosis and Treatment | 28% |
| Domain 3: Care Coordination | 19% |
| Domain 4: Education & Resources | 28% |
| Domain 5: Communication | 10% |
Domain 1: Breast Health/Breast Cancer (15%)
The foundation. You need working fluency in how breast disease is understood and described so that the rest of your navigation decisions make sense.
- Core breast anatomy and common benign versus malignant concerns
- Risk concepts a navigator should recognize when talking with patients
- The vocabulary used in reports and care-team conversations
Domain 2: Screening, Diagnosis and Treatment (28%)
One of the two heavyweight domains. Questions here follow the patient pathway from screening through diagnostic workup to treatment.
- Screening and imaging pathways, and what typically follows an abnormal finding
- The diagnostic workup sequence and why timeliness matters
- Treatment modalities at a navigator's level of understanding, so you can explain the process and anticipate patient needs
Domain 3: Care Coordination (19%)
The operational core of the job: keeping a patient moving through a fragmented system.
- Tracking appointments, results and referrals so nothing falls through
- Working across radiology, surgery, oncology and support services
- Recognizing and addressing barriers that delay care
Domain 4: Education & Resources (28%)
The other heavyweight. This domain covers what you teach patients and where you send them.
- Matching educational content to what a patient actually needs to know at each stage
- Identifying community, financial, emotional and survivorship resources
- Knowing when a patient's need exceeds navigation and requires a referral
Domain 5: Communication (10%)
The smallest slice, but it shows up inside scenarios across the other domains.
- Clear, compassionate conversation with anxious or overwhelmed patients
- Communicating with the care team and documenting appropriately
- Adapting to differences in health literacy, culture and language
For a deeper domain-by-domain breakdown, see BHCN Exam Domains 2026: Complete Guide to All 5 Content Areas.
Key Takeaway
Domains 2 and 4 together make up 56% of the exam. A candidate strong in those two but average elsewhere is in a better position than one who spreads effort evenly across all five.
Scoring, Cut Scores and Pass Counts
The cut score is not a single number across every form of the exam. The published cut scores are:
- 75% for forms A, C and D
- 79% for form B
You will not choose which form you receive, so the safe planning target is the higher of the two. Aim to be comfortably above 79% on practice material rather than hovering near 75%. Because only 100 questions are scored, each scored item is worth a meaningful slice of your result. Our BHCN Passing Score article digs into how to interpret these thresholds.
Reading the published pass data carefully
NCBC's published pass counts yield 80.63% for 2025 (129 of 160) and 69.23% for the currently posted 2026 tally (54 of 78). Treat both with caution. The 2026 figure is a running tally, not a final annual rate, and neither number is a first-attempt pass rate. A partial-year count can swing considerably as more results come in, so do not read the lower 2026 figure as proof that the exam suddenly got harder. For context on interpreting these numbers, see BHCN Pass Rate 2026: What the Data Shows and How Hard Is the BHCN Exam?.
Fees, Proctoring and Retake Rules
Cost and delivery
- Exam fee: $295
- Formats: paper/pencil or live remote proctored
- Geography: US-only
- Remote proctoring vendor: a publicly linked 2023 policy names Examity, but current vendor branding is unconfirmed, so check the live NCBC instructions before exam day
Unauthorized aids are prohibited, and a calculator entitlement has not been verified. Do not assume you may bring one; confirm the permitted-materials rules directly before test day. The exam is knowledge- and scenario-based, so you should not need heavy calculation anyway.
If you need a second attempt
- There is a minimum of six months between attempts.
- One no-additional-fee retake is available within 12 months.
That six-month gap is the reason to prepare seriously the first time. A failed attempt costs you half a year, not just a weekend. For the full cost picture, including how fees fit with renewal, see BHCN Certification Cost 2026, and for timing details see BHCN Exam Dates 2026.
Renewal Cheat Sheet
Certification is not a one-and-done event. Renewal is annual and requires:
- Valid licensure
- Eight CE credits per cycle: four general/tumor board credits plus four navigation-specific credits
On cost, the live renewal page advertises $150 including membership, but older wording of $159.34 still appears in places. Confirm the amount at checkout rather than assuming either figure. Building CE into your routine from day one prevents a last-minute scramble.
Where Certified Navigators Work
Breast health navigators typically work in settings where patients move between screening, diagnosis and treatment: breast centers, imaging facilities, hospital cancer programs and oncology practices. The credential signals that you can coordinate care across those touchpoints. Whether it translates into higher pay or better opportunities depends on your employer and region, so read our qualitative breakdowns in BHCN Salary Guide 2026, Is the BHCN Certification Worth It? and BHCN Jobs rather than trusting any single headline number.
Which Domain to Study When
You do not need a generic template here, just a sensible order tied to this exam's weighting. Build from foundation to heavyweight domains, and leave your highest-yield areas for repeated passes close to test day.
Foundations and Vocabulary
- Domain 1: breast health concepts and terminology
- Skim the current outline so you know what is in scope
The Patient Pathway
- Domain 2: screening, diagnosis and treatment sequence
- Practice pathway-style scenario questions
Coordination
- Domain 3: tracking, referrals and barrier resolution
Education and Communication
- Domain 4: resources and patient education
- Domain 5: communication scenarios
- Full-length timed practice, then revisit weak spots in Domains 2 and 4
You can test your readiness against exam-style questions on the BHCN practice test site, and a full walkthrough of study approaches lives in the BHCN Study Guide 2026. If you want structured learning beyond self-study, see BHCN Training.
Frequently Asked Questions
There are 125 multiple-choice questions in 3 hours. Of those, 100 are scored and 25 are unscored. You will not know which are which, so answer every item carefully.
The cut score is 75% for forms A, C and D and 79% for form B. Since you cannot choose your form, aim comfortably above 79% in practice.
Screening, Diagnosis and Treatment and Education & Resources are each 28% of the exam, for a combined 56%. Care Coordination is 19%, Breast Health/Breast Cancer is 15%, and Communication is 10%.
There is a minimum six-month wait between attempts, and one no-additional-fee retake is available within 12 months. That wait is a strong reason to prepare thoroughly the first time.
Renewal is annual and requires valid licensure plus eight CE credits: four general/tumor board credits and four navigation-specific credits. The live renewal page advertises $150 including membership, but confirm the amount at checkout because older $159.34 wording still appears.
Use this sheet as your quick-reference anchor, then go deeper where you are weakest. Start with the heavyweight domains, confirm the current exam rules directly with NCBC before you register, and put in timed practice on the BHCN Exam Prep practice tests before test day.