- BHCN here means Certified Breast Health Clinical Navigator, granted through the National Consortium of Breast Centers (NCBC).
- The exam has 125 multiple-choice questions, 100 scored and 25 unscored, over three hours; the fee is $295.
- Screening, Diagnosis and Treatment and Education & Resources are each 28% of content, together 56%.
- Eligibility requires RN or imaging-technologist licensure plus 1,500 navigation hours in the past two years and eight education hours.
What the Credential Is
BHCN stands for Certified Breast Health Clinical Navigator. It is a professional certification for clinicians who guide patients through the breast health continuum: from an abnormal screening result or a new symptom, through diagnostic workup and treatment decisions, and into survivorship or ongoing surveillance. The credential signals that a navigator has hands-on navigation experience and has passed a standardized exam covering clinical knowledge, care coordination, patient education and communication.
If you landed here searching for the meaning of the acronym, note that "BHCN" is shorthand shared by several unrelated credentials in healthcare and elsewhere. This site and this article concern only the breast health navigator certification. For related phrasing of the same question, see our pages on what BHCN stands for and the meaning of BHCN.
Who a BHCN Actually Is on the Job
A breast health clinical navigator is not simply a scheduler or a patient advocate in the general sense. The role sits at the intersection of clinical knowledge and logistics. A navigator tracks a patient from the moment an abnormality is flagged, makes sure follow-up imaging and biopsies happen on time, helps the patient understand what pathology and staging results mean in plain language, and links them to surgeons, medical oncologists, radiation oncologists, genetic counselors, financial counselors and support services.
In practice, the day-to-day work often includes:
- Following up on abnormal mammogram, ultrasound or MRI results so patients do not fall through the cracks
- Preparing patients for biopsies and explaining what to expect
- Presenting or tracking cases for multidisciplinary tumor boards
- Identifying barriers to care such as transportation, cost, language, health literacy or fear
- Providing education about treatment options, side effects and community resources
- Documenting navigation activity and outcomes
Who Grants It and How It Works
The certification is administered by the National Consortium of Breast Centers, Inc. (NCBC), an organization focused on breast center quality and the professionals who work in them. NCBC publishes the exam outline, eligibility rules, retake policy and renewal requirements. A publicly linked 2023 policy names Examity for remote proctoring, though current vendor branding is not confirmed, so check the NCBC candidate materials before you schedule.
Key mechanics to know up front:
- Exam fee: $295
- Delivery: paper/pencil or live remote proctored; the credential is US-only
- Rules: unauthorized aids are prohibited, and no calculator entitlement has been verified, so do not assume you may bring one
- Outline: effective 2022; the current linked description is V2, uploaded July 2023
For a full cost breakdown including renewal, see BHCN Certification Cost 2026: Complete Pricing Breakdown. For the broader overview of the credential, visit our BHCN certification page.
Who Can Sit for It
Unlike entry-level certifications, this one is experience-gated. You cannot simply study and test. Candidates must hold a valid license in one of two clinical tracks and document recent, substantial navigation work.
| Requirement | Detail |
|---|---|
| Licensure | Valid RN license, or valid medical imager / radiologic technologist licensure |
| Navigation experience | 1,500 navigation hours within the past two years |
| Education | Eight relevant education hours, up to four of which may come from tumor boards |
| Geography | US-only |
The inclusion of imaging technologists alongside nurses reflects how many breast navigators come from the screening and diagnostic imaging side of care. If you are weighing whether you qualify, our BHCN requirements guide walks through eligibility and documentation in more detail.
Exam Format at a Glance
The exam is a single timed multiple-choice test. Here is what the published details tell us:
| Feature | BHCN Detail |
|---|---|
| Total questions | 125 multiple-choice |
| Scored questions | 100 |
| Unscored questions | 25 |
| Time limit | 3 hours |
| Cut score | 75% for forms A, C and D; 79% for form B |
| Retake spacing | Minimum six months between attempts |
| Retake fee | One no-additional-fee retake within 12 months |
Two details deserve attention. First, the 25 unscored questions are mixed in with the scored ones and you cannot tell which is which, so treat every item as if it counts. Second, the cut score depends on the exam form you receive, with form B carrying a higher threshold than the others. You will not choose your form, which is one more reason to aim for comfortable mastery rather than a bare pass. Our BHCN passing score guide explains how to think about the cut scores, and the exam dates and scheduling page covers timing.
On pass rates, published counts show 80.63% in 2025 (129 of 160) and 69.23% on the currently posted 2026 tally (54 of 78). Those are raw posted tallies, not final annual figures or first-attempt rates, so interpret them cautiously. We unpack them in BHCN Pass Rate 2026: What the Data Shows, and the broader question of difficulty is covered in How Hard Is the BHCN Exam?
The Five Content Domains
The exam outline divides content into five domains. Understanding the weighting is the single most useful thing you can do to focus your preparation.
| 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. Candidates need to understand breast anatomy and physiology, risk factors, and the basics of how breast cancer develops and is classified.
- Risk factors and risk assessment concepts
- Benign versus malignant breast conditions
- Cancer types, staging and biology at a navigator's working level
Domain 2: Screening, Diagnosis and Treatment (28%)
One of the two heaviest domains. This is where clinical fluency is tested most directly.
- Screening modalities and how screening guidelines apply to different patients
- Diagnostic workup after an abnormal finding, including imaging and biopsy pathways
- Treatment modalities: surgery, radiation, systemic therapy and how they are sequenced
Domain 3: Care Coordination (19%)
The operational heart of navigation: moving a patient through a complex system efficiently.
- Tracking and follow-up to prevent lost-to-follow-up outcomes
- Multidisciplinary teamwork and tumor board processes
- Referrals, scheduling and transitions between care settings
Domain 4: Education & Resources (28%)
Tied for the heaviest weighting. Navigators are teachers and connectors, and the exam reflects that.
- Patient and family education about diagnosis, treatment and side effects
- Community, financial, psychosocial and support resources
- Survivorship, supportive care and addressing barriers to care
Domain 5: Communication (10%)
The smallest domain, but one that shows up inside scenario questions from every other area.
- Therapeutic communication and active listening
- Communicating with patients across literacy, cultural and emotional contexts
- Professional communication with the care team
For a deeper look at each area, read BHCN Exam Domains 2026: Complete Guide to All 5 Content Areas.
What the Questions Actually Test
Because the exam is multiple-choice and aimed at working clinicians, expect scenario-driven items that ask what a navigator should do, say or recognize in a given situation, rather than pure memorization of definitions. A typical question might describe a patient with an abnormal finding and ask for the most appropriate next step in the pathway, or present a barrier to care and ask which resource or action best addresses it.
That means your preparation should connect facts to decisions. Knowing that a particular imaging study exists is less valuable than knowing when it fits into the diagnostic sequence and what a patient needs explained before it.
Key Takeaway
Domains 2 and 4 together make up 56% of the exam. If you have limited study time, build your strongest foundation in the screening-to-treatment pathway and in patient education and resources, then layer in coordination, breast cancer fundamentals and communication.
Where BHCNs Work
Breast health navigators are typically found wherever breast care is delivered. Common settings include:
- Breast centers and comprehensive breast programs, the natural home of NCBC-affiliated professionals
- Hospital and health system cancer centers, often within oncology or imaging service lines
- Diagnostic imaging centers handling screening mammography and follow-up
- Community and nonprofit programs focused on access, outreach and underserved populations
Employers value the credential as evidence that a navigator has met a recognized standard of both experience and knowledge. Whether it translates into higher pay or better opportunities depends on your employer and region, so we avoid quoting figures here. For a candid look, see the BHCN salary guide, Is the BHCN Certification Worth It? and our overview of BHCN jobs.
Keeping the Credential Current
Certification is not a one-time event. Renewal is annual and requires a valid license plus eight continuing education credits: four in the general/tumor board category and four that are navigation-specific. The live renewal page advertises a $150 fee that includes membership, though older wording listing $159.34 is still visible in places, so confirm the amount at checkout.
Sequencing Your Prep by Domain
You do not need an elaborate system, just a sensible order. Because the clinical pathway in Domain 2 gives context to everything else, tackle it early, and save communication scenarios for last when you can apply them across topics. Here is one way to sequence an eight-week plan, with the reasoning tied to the exam weighting.
Domain 1 and Domain 2 foundations
- Review breast anatomy, risk and cancer types (15% of exam)
- Start the screening, diagnosis and treatment pathway, the largest clinical domain (28%)
Finish Domain 2 and begin Domain 4
- Complete treatment modalities and sequencing
- Start patient education content and resources (28%)
Domain 3 and Domain 4 depth
- Study care coordination, tracking and tumor board processes (19%)
- Deepen resources, barriers to care and survivorship topics
Domain 5 and full-exam practice
- Work communication scenarios across all domains (10%)
- Take timed practice sets and review every miss against the domain outline
When you are ready to test yourself under realistic conditions, try the BHCN practice tests. For a fuller plan, read the BHCN Study Guide 2026, keep the BHCN cheat sheet handy for last-minute review, and explore BHCN training options if you want structured instruction. You can start practicing anytime at the main practice site.
Frequently Asked Questions
A BHCN is a Certified Breast Health Clinical Navigator, a clinician who has met eligibility requirements and passed the NCBC exam, demonstrating knowledge of breast health, screening, diagnosis, treatment, care coordination, education and communication.
Candidates need a valid RN license or valid medical imager/radiologic technologist licensure, 1,500 navigation hours in the past two years, and eight relevant education hours, with up to four from tumor boards. The credential is US-only.
The exam has 125 multiple-choice questions, of which 100 are scored and 25 are unscored, with a three-hour time limit. The fee is $295.
Screening, Diagnosis and Treatment and Education & Resources are each 28% of the exam, together 56%. Care Coordination is 19%, Breast Health/Breast Cancer is 15%, and Communication is 10%.
There must be at least six months between attempts, and one retake is available at no additional fee within 12 months. Confirm current details with NCBC before scheduling.
Understanding what a BHCN is, who qualifies and how the exam is built puts you in a strong position to decide whether to pursue it. For related explainers, see What Is BHCN Certification?, What Does BHCN Mean? and What Is BHCN?