- What the Certified Breast Health Clinical Navigator Credential Is
- Who Runs the Credential and How It Is Delivered
- Who Can Sit for the Exam
- Exam Format, Scoring, and Cut Scores
- The Five Content Domains
- Fees, Retakes, and Renewal
- Where Certified Navigators Work
- Sequencing Your Preparation by Domain
- Is It the Right Credential for You?
- Frequently Asked Questions
- The exam is 125 multiple-choice questions in 3 hours; 100 are scored and 25 are unscored.
- Screening, Diagnosis and Treatment and 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 education hours.
- The exam fee is $295; a no-additional-fee retake is allowed within 12 months, with six months between attempts.
What the Certified Breast Health Clinical Navigator Credential Is
The Certified Breast Health Clinical Navigator credential, abbreviated BHCN, recognizes clinicians who guide patients through the breast health continuum: from an abnormal screening result, through diagnostic workup and treatment decisions, to survivorship and community resources. It is a credential for people who already work in navigation, not an entry-level certificate you earn before starting the job.
That distinction matters for how you read the exam. The questions are written for someone who has coordinated mammography callbacks, tracked biopsy results, explained a treatment plan to an anxious patient, and chased down insurance authorizations. If you want the shorter definitional versions of this topic, our pages on what BHCN is and what BHCN stands for cover the basics, and the BHCN certification overview gives the big picture.
Who Runs the Credential and How It Is Delivered
The credential is administered by the National Consortium of Breast Centers, Inc. (NCBC), an organization built around the interdisciplinary breast center model. That lineage shows in the exam content, which treats navigation as a team function connected to imaging, surgery, oncology, pathology, and supportive services.
The certification is available in the United States only. Candidates can test in a paper-and-pencil format or through live remote proctoring. NCBC's publicly linked 2023 policy named Examity as the remote proctoring vendor, though current vendor branding is unconfirmed, so verify the platform and its technical requirements when you register rather than assuming. Unauthorized aids are prohibited during the exam, and we have not verified any calculator entitlement, so plan to answer without one.
For testing windows and scheduling logistics, see our guide to BHCN exam dates and deadlines.
Who Can Sit for the Exam
Eligibility is the first real hurdle, and it filters candidates before the content ever matters. The requirements are:
- A valid RN license, or valid licensure as a medical imager or 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 two-year window on navigation hours is worth tracking carefully. If you split time between navigation and other duties, such as technologist work, start logging navigation-specific hours now rather than reconstructing them when you apply. Tumor board attendance is a convenient way to satisfy part of the education requirement, and it doubles as exam preparation because tumor boards expose you to exactly the multidisciplinary reasoning the test rewards.
Our dedicated BHCN requirements guide walks through eligibility in more detail.
Exam Format, Scoring, and Cut Scores
The exam contains 125 multiple-choice questions, and you have 3 hours. Of those 125 items, 100 are scored and 25 are unscored. You will not know which are which, so treat every question as if it counts. The unscored items are typically how a testing program pilots new questions, which is one reason a handful of questions may feel oddly worded or outside what you studied.
| Exam Detail | What to Know |
|---|---|
| Question count | 125 multiple-choice (100 scored, 25 unscored) |
| Time allowed | 3 hours |
| Cut score, forms A/C/D | 75% |
| Cut score, form B | 79% |
| Delivery | Paper/pencil or live remote proctored |
| Outline | Effective 2022; current linked description is V2 (July 2023 upload) |
The cut score depends on which form you receive: 75% on forms A, C, and D, and 79% on form B. Different forms carry different thresholds because forms vary slightly in difficulty. You cannot choose your form, so aim to be comfortably above the higher number in your practice scores rather than hovering near 75%. Our BHCN passing score guide explains how to interpret these thresholds.
What the Published Pass Counts Say
Published counts show 129 of 160 candidates passing in 2025, which works out to 80.63%, and 54 of 78 in the currently posted 2026 tally, or 69.23%. Treat these cautiously. The 2026 figure is a running tally, not a final annual result, and neither number is a first-attempt pass rate. The gap between the two years may reflect partial-year data rather than a real shift in difficulty. For a fuller discussion, read what the pass-rate data shows and how hard the BHCN exam is.
The Five Content Domains
The exam outline divides content into five domains. The weighting is lopsided in a way that should drive your preparation: two domains account for 56% of the exam.
| 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 knowledge layer: how breast disease develops, how risk is understood, and the vocabulary you need to follow clinical conversations.
- Anatomy, benign conditions, and the spectrum from atypia to invasive disease
- Risk factors and risk assessment concepts
- Hereditary risk and when genetic evaluation enters the picture
Domain 2: Screening, Diagnosis and Treatment (28%)
The clinical pathway from screening to treatment. Expect scenario questions where you must identify the correct next step for a patient.
- Screening modalities and how abnormal findings move to diagnostic workup
- Biopsy approaches, pathology results, and staging concepts
- Treatment modalities: surgery, radiation, systemic therapy, and how they sequence
- Timeliness of follow-up after abnormal results
Domain 3: Care Coordination (19%)
The operational heart of navigation: making sure the right services reach the right patient at the right time.
- Tracking patients through appointments, results, and referrals
- Working with multidisciplinary teams and tumor boards
- Identifying and addressing barriers to care
Domain 4: Education & Resources (28%)
Equal in weight to Domain 2, and easy to underestimate because it feels less clinical. It tests what you teach patients and where you send them.
- Patient education on diagnosis, treatment, side effects, and survivorship
- Community, financial, and support resources
- Matching education to health literacy and cultural context
Domain 5: Communication (10%)
The smallest domain, but one where well-written distractors can trip up experienced clinicians.
- Therapeutic communication with patients in distress
- Interprofessional communication and handoffs
- Documentation and appropriate boundaries
For a deeper breakdown of each area, see the complete guide to all five BHCN content areas.
Fees, Retakes, and Renewal
Cost of Sitting for the Exam
The exam fee is $295. If you do not pass, the retake rules are fairly generous: there is a minimum of six months between attempts, and one retake is available at no additional fee when taken within 12 months. That six-month gap means a failed attempt is a real scheduling setback, so it pays to be ready the first time instead of treating the first sitting as a trial run. Our BHCN certification cost breakdown covers the full financial picture.
Keeping the Credential Active
Renewal is annual. To renew you need valid licensure and eight CE credits: four general or tumor board credits plus four navigation-specific credits. The live renewal page advertises $150 including membership, but older wording citing $159.34 still appears in places, so confirm the amount at checkout rather than relying on either figure.
| Item | Detail |
|---|---|
| Exam fee | $295 |
| Retake | One no-additional-fee retake within 12 months; minimum six months between attempts |
| Renewal cycle | Annual |
| Renewal CE | Eight credits: four general/tumor board, four navigation-specific |
| Renewal fee | $150 advertised with membership; older $159.34 wording persists, confirm at checkout |
Where Certified Navigators Work
Because the credential comes from an organization centered on breast centers, the natural employers are the places that run them: hospital-based breast centers, comprehensive cancer programs, freestanding imaging centers, and multidisciplinary oncology practices. Roles often carry titles such as breast nurse navigator, clinical navigator, or patient navigator, and the people holding them are typically nurses or imaging professionals, which mirrors the licensure the certification requires.
A few practical observations about the job market:
- Programs pursuing or maintaining accreditation often value staff who can demonstrate navigation competency.
- Imaging-side professionals moving into navigation can use the credential to show clinical depth beyond technical imaging skills.
- Nurses transitioning from bedside or oncology floors can use it to signal specialized breast health knowledge.
For openings and role types, see our BHCN jobs overview. For compensation context, the BHCN salary guide examines what the data does and does not support, and we avoid quoting unsupported figures here.
Sequencing Your Preparation by Domain
Because the exam is weighted so heavily toward two domains, your schedule should be too. One workable ordering for an eight-week plan follows. It assumes you are already working in navigation and have your hours and education requirements in order.
Domain 1 Foundations, Then Domain 2
- Refresh breast disease basics and risk concepts quickly, since this domain is only 15%.
- Begin Domain 2 early: screening pathways, biopsy and pathology terminology, and treatment sequencing.
Finish Domain 2, Start Domain 3
- Work scenario questions on abnormal results and follow-up timeliness.
- Map care coordination tasks: tracking, referrals, tumor board roles, barrier assessment.
Domain 4 Education & Resources
- Review patient education content for each treatment type and survivorship concerns.
- Build a mental inventory of resource categories: financial, community, psychosocial, and support services.
Domain 5, Then Full-Length Practice
- Cover communication scenarios, then take timed practice sets sized to the 125-question, 3-hour format.
- Review misses by domain and revisit your weakest 28% area first.
Practicing at full length matters because the 3-hour window over 125 questions gives you roughly a minute and a half per item. A BHCN practice test taken under timed conditions shows you whether pacing is a problem before exam day. The BHCN study guide offers a more detailed preparation framework, and the BHCN cheat sheet is useful for a final-week review.
Key Takeaway
Do not let clinical confidence lull you into skimming Domain 4. Education & Resources is worth the same 28% as Screening, Diagnosis and Treatment, and its questions reward knowing specific patient teaching points and resource pathways rather than general good judgment.
Is It the Right Credential for You?
The credential makes the most sense if you already meet the hour and licensure requirements and want formal recognition of work you are doing anyway. It is less compelling as a speculative move for someone who has not yet logged navigation experience, since the 1,500-hour requirement means you cannot sit for the exam without that foundation.
Weigh the costs honestly: the $295 exam fee, your preparation time, and the ongoing annual renewal with eight CE credits. Against that, consider whether your employer values or requires certification, whether it supports advancement in your program, and whether you want a structured way to verify your knowledge across all five domains. Our ROI analysis works through that decision in more depth, and our pages on what BHCN certification is and BHCN training can help you plan next steps. When you are ready to test your readiness, start with a practice exam modeled on the real format.
Frequently Asked Questions
In this context, BHCN stands for Certified Breast Health Clinical Navigator, a credential administered by the National Consortium of Breast Centers, Inc. (NCBC). Other credentials elsewhere use the same acronym, so confirm you are reading about the NCBC credential.
You need a valid RN license or valid licensure as a medical imager or radiologic technologist, 1,500 navigation hours in the past two years, and eight relevant education hours, up to four of which may come from tumor boards. The certification is US-only.
There are 125 multiple-choice questions and a 3-hour time limit. One hundred questions are scored and 25 are unscored, and candidates cannot tell which is which. The cut score is 75% for forms A, C, and D and 79% for form B.
You must wait at least six months between attempts. One retake is available at no additional fee if taken within 12 months. Because of that waiting period, thorough preparation before the first attempt is worthwhile.
Renew annually with valid licensure and eight CE credits: four general or tumor board credits and four navigation-specific credits. The live renewal page advertises $150 including membership, but older $159.34 wording remains online, so confirm the amount at checkout.