- BHCN here means Certified Breast Health Clinical Navigator, offered through the National Consortium of Breast Centers (NCBC).
- The exam has 125 multiple-choice questions (100 scored, 25 unscored) in a 3-hour sitting; the fee is $295.
- Screening, Diagnosis and Treatment plus Education & Resources each carry 28%, together 56% of the exam.
- Eligibility requires RN or imaging licensure, 1,500 navigation hours in two years, and eight relevant education hours.
What BHCN Means in This Article
Several unrelated credentials share the same four-letter acronym, which is a common source of confusion when you search online. On this site, BHCN stands for Certified Breast Health Clinical Navigator, a professional credential for clinicians who guide patients through breast screening, diagnosis, treatment, and survivorship. Everything below applies only to that credential. If you are comparing wording variations, our short explainers on what BHCN stands for and BHCN meaning cover the terminology in more depth.
The credential is aimed at working navigators rather than students. It does not certify entry-level knowledge. It certifies that a licensed nurse or imaging professional who already spends significant time in navigation work can apply breast health knowledge, coordinate care, and communicate effectively with patients and multidisciplinary teams.
Who Runs the Credential
The Certified Breast Health Clinical Navigator credential is administered by the National Consortium of Breast Centers, Inc. (NCBC). NCBC is an organization centered on breast centers and the professionals who staff them, and it owns the exam outline, eligibility rules, fee schedule, and renewal requirements.
The exam content outline has been in effect since 2022, and the currently linked description is a Version 2 document uploaded in July 2023. Because outlines get revised, always download the current outline from NCBC before you build a study plan rather than relying on a secondhand summary, including this one.
The Navigator's Role: What the Credential Is Testing
A breast health navigator is the person who keeps a patient from falling through the cracks. After an abnormal mammogram, a patient may need a diagnostic workup, a biopsy, a surgical consult, medical oncology, radiation oncology, genetic counseling, financial counseling, and survivorship planning. Each handoff is a place where delays, confusion, or loss to follow-up can occur. The navigator owns the thread that ties those steps together.
The exam therefore leans toward applied, scenario-style thinking. Expect questions that ask what a navigator should do next, what a patient needs to understand at a given point in their pathway, or which resource fits a particular barrier. Pure memorization of definitions will not carry you through; you need to connect clinical knowledge with coordination and communication judgment.
Typical navigation concerns
- Closing the loop on abnormal screening results so follow-up actually happens
- Helping patients understand diagnostic and staging information at a level they can act on
- Coordinating appointments across surgery, oncology, radiology, and supportive services
- Identifying and reducing barriers such as transportation, cost, language, and fear
- Connecting patients with education and community resources
Eligibility Gates You Must Clear First
Unlike some exams that anyone can sit, this one has a real experience gate. You must hold a valid RN license or valid medical-imager/radiologic-technologist licensure. You also need 1,500 navigation hours within the past two years and eight hours of relevant education, of which up to four may come from tumor boards.
The 1,500-hour figure is the requirement that most often trips up applicants who are only partly in a navigation role. Think carefully about how your hours accumulate, and keep a log with dates and activities so documentation is easy when you apply. For a full walkthrough of the prerequisites, see our guide to BHCN requirements and how to qualify.
Eligibility checklist
Confirm each item before you pay anything.
- Active RN or medical-imager/radiologic-technologist license in good standing
- 1,500 navigation hours within the most recent two years
- Eight relevant education hours, with no more than four from tumor boards
- Residence in the United States, since the exam is US-only
Exam Format and Scoring
The exam consists of 125 multiple-choice questions, of which 100 are scored and 25 are unscored. You have three hours. The unscored questions are pretest items, and you will not know which ones they are, so treat every question as if it counts.
Delivery
The exam is offered in paper-and-pencil format or by live remote proctoring. NCBC's publicly linked 2023 policy names Examity for remote proctoring, though current vendor branding is unconfirmed, so verify the arrangement when you register. Unauthorized aids are prohibited. We could not verify any calculator entitlement, so do not assume one will be available.
Cut scores
| Exam Form | Cut Score |
|---|---|
| Forms A, C, and D | 75% |
| Form B | 79% |
The different cut score for Form B reflects form-level difficulty adjustment, a standard practice in credentialing exams. You will not choose your form, so aim for comfortable mastery rather than a bare pass. Our dedicated page on the BHCN passing score goes deeper on how to interpret these numbers.
What the published pass data show
Published pass counts work out to 80.63% for 2025 (129 of 160) and 69.23% for the currently posted 2026 tally (54 of 78). Be careful with these figures. The 2026 number is a running tally rather than a final annual rate, and neither figure is a first-attempt pass rate. Small samples and mid-year snapshots move a lot, so treat them as rough context. We unpack the caveats in what the pass-rate data show, and you can gauge relative difficulty in how hard the BHCN exam is.
The Five Content Domains
The exam blueprint divides content into five domains. Two of them, Screening, Diagnosis and Treatment and Education & Resources, each carry 28%, so together they account for 56% of the exam. That concentration should shape how you allocate study hours.
| 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 foundational clinical knowledge a navigator needs to follow what the care team is doing and why.
- Breast anatomy, normal findings, and common benign conditions
- Breast cancer types, risk factors, and staging concepts
- Risk assessment and when higher-risk pathways apply
Domain 2: Screening, Diagnosis and Treatment (28%)
The largest clinical domain, covering the full pathway from a screening test through treatment decisions.
- Screening modalities, intervals, and how results are categorized and followed up
- Diagnostic imaging and biopsy processes
- Treatment modalities, including surgery, systemic therapy, and radiation, and how they sequence
Domain 3: Care Coordination (19%)
The operational heart of navigation: moving patients through a fragmented system.
- Tracking referrals, appointments, and results to prevent loss to follow-up
- Working with multidisciplinary teams, including tumor board processes
- Identifying and addressing barriers to care
Domain 4: Education & Resources (28%)
Equal in weight to Domain 2, and easy to underestimate because it sounds soft.
- Providing patient and community education suited to the patient's level of understanding
- Knowing which support, financial, and community resources fit which situation
- Survivorship and ongoing wellness resources
Domain 5: Communication (10%)
The smallest domain, but one that shows up inside scenario questions in other domains too.
- Therapeutic communication with patients in distress
- Culturally sensitive and plain-language communication
- Documentation and professional communication with the care team
For a section-by-section breakdown of what is covered in each area, see our complete guide to the five BHCN content areas.
Registration, Fees and Retakes
The exam fee is $295. Budget separately for any education hours you still need and for the annual renewal described below. For a consolidated view of what the whole credential costs over time, see our BHCN certification cost breakdown, and check scheduling windows in BHCN exam dates and deadlines.
Retake rules
- There must be a minimum of six months between attempts.
- You are entitled to one retake at no additional fee within 12 months.
The six-month gap means a failed attempt carries a real time cost, not just a financial one. That is a good reason to prepare thoroughly the first time. You can sanity-check your readiness with a timed BHCN practice test before committing to a sitting.
Annual Renewal
This credential renews annually, which is more frequent than many professional certifications. Renewal requires valid licensure and eight continuing education credits: four general or tumor board credits plus four navigation-specific credits.
On cost, the live renewal page advertises $150 including membership, but older wording showing $159.34 still appears in places. Confirm the amount at checkout rather than assuming either figure.
Key Takeaway
Plan your CE from day one. Because renewal is annual and splits credits into two buckets, spreading tumor board attendance and navigation-specific education across the year is far easier than scrambling near your renewal date.
Where the Credential Gets Used
Certified Breast Health Clinical Navigators typically work where patients enter and move through breast care. Common settings include:
- Hospital-based and freestanding breast centers
- Cancer centers with dedicated breast programs
- Imaging centers and mammography programs that need strong follow-up systems
- Health systems building patient navigation programs
Because the credential requires an RN or imaging license plus substantial navigation hours, employers can read it as evidence of both clinical grounding and hands-on navigation experience. Whether it justifies the investment for you depends on your setting and goals; our ROI analysis and salary guide examine that question, and our listing of BHCN jobs shows how the credential appears in postings. For a broader overview of the credential itself, start with the BHCN certification page.
Sequencing Your Prep by Domain
Rather than a generic schedule, order your study around the weights and around how the domains build on each other. The outline below assumes you are already working in navigation and need to fill gaps. Our BHCN study guide and one-page cheat sheet can supplement it.
Domain 1 and the clinical base
- Review breast anatomy, benign conditions, cancer types, and staging
- Build the vocabulary you will need for Domain 2
Domain 2: Screening, Diagnosis and Treatment
- Walk the full pathway from screening to treatment decisions
- Practice scenario questions on result follow-up and treatment sequencing
Domain 4: Education & Resources
- Give this the same time as Domain 2, since the weights match at 28%
- Catalog patient education approaches and resource types by situation
Domains 3 and 5
- Review care coordination workflows and barrier reduction
- Rehearse communication scenarios, including sensitive conversations
Timed mixed practice
- Sit full-length practice exams under a three-hour limit
- Review misses by domain and revisit the weakest areas
Domain 1 comes first because it supplies the language for everything else. Domains 2 and 4 get the most time because together they make up 56% of the exam. Domains 3 and 5 are smaller, but scenario questions often blend coordination and communication, so a final mixed review matters.
Frequently Asked Questions
It stands for Certified Breast Health Clinical Navigator, a credential administered by the National Consortium of Breast Centers (NCBC). Other credentials share the acronym, so confirm you are looking at the right one. See also what BHCN certification is.
Candidates need a valid RN license or valid medical-imager/radiologic-technologist licensure, 1,500 navigation hours within the past two years, and eight relevant education hours, with up to four allowed from tumor boards.
It has 125 multiple-choice questions, with 100 scored and 25 unscored, over three hours. It can be taken paper-and-pencil or through live remote proctoring, and it is available in the US only.
You must wait at least six months before another attempt. One retake is available at no additional fee within 12 months of your first attempt.
Renewal is annual. You need valid licensure and eight CE credits, four general or tumor board and four navigation-specific. Confirm the fee at checkout, since the live page advertises $150 including membership while older wording shows $159.34.
If you are weighing whether this credential fits your career, start with the eligibility rules, build your plan around the two 28% domains, and test yourself with a realistic practice exam before you register.