10 exam-style questions with answers and explanations, straight from our 1,030-question bank. Tap an answer to check yourself. When you're ready, take the scored version in the free practice test.
The BHCN exam has 125 questions and runs 3 hours.
These 10 free BHCN questions are organized by exam domain, so you can see how each part of the Certified Breast Health Clinical Navigator blueprint is tested. Reveal the answer and explanation under each question.
A 56-year-old describes two months of itching and scaling that began on one nipple and spread onto the areola. Two short courses of topical corticosteroid produced only temporary improvement. Examination shows a crusted nipple erosion, without a palpable mass or diffuse breast edema. The nipple-centered distribution and persistence are most concerning for:
Correct answer: D - Mammary Paget disease
HER2 immunohistochemistry is 2+ on an invasive breast biopsy; estrogen receptor staining is 90% and progesterone receptor staining is 60%. To complete the HER2 assessment, the team needs the result of:
Correct answer: A - HER2 gene-amplification assessment by in situ hybridization
Diagnostic mammography and targeted ultrasound in an asymptomatic 44-year-old show an 8-mm oval, circumscribed mass. The radiologist assigns BI-RADS 3 after completing the work-up. The patient has no high-risk history, can return reliably, and accepts imaging surveillance. What should the navigator arrange for this finding?
Correct answer: B - Short-interval diagnostic imaging in six months.
A 37-year-old with heterogeneously dense breasts has a Tyrer-Cuzick lifetime breast cancer risk of 27% and a Gail five-year risk of 1.4%. Her paternal family history includes early breast cancer. Germline testing identifies a BRCA2 variant of uncertain significance but no pathogenic variant. She has no breast symptoms. Select the screening plan supported by American Cancer Society recommendations.
Correct answer: C - Annual mammography plus contrast-enhanced breast MRI, based on the lifetime risk estimate.
Following surgery without neoadjuvant treatment, the final pathology findings are: Invasive carcinoma: one 16-mm focus. Associated DCIS: a 52-mm span. Axillary sentinel nodes: one of three positive, containing a 0.8-mm metastatic deposit. No skin, chest-wall, or other regional nodal involvement. Assign the pT and pN categories using AJCC eighth-edition breast TNM definitions.
Correct answer: D - pT1c, pN1mi(sn)
The NCCN Distress Thermometer score is 6 out of 10 for a 52-year-old about to start breast cancer treatment. Her problem list identifies rent, food costs, and worry about missing work. She denies suicidal thoughts and describes support from her sister. How should this screening result shape the navigator's assessment?
Correct answer: C - This is a positive distress screen; assess the problems and arrange needs-based support.
'I'm not sure whether I'll want children, and I don't have a partner,' says a 29-year-old whose breast cancer chemotherapy is scheduled to start in 10 days. What can the navigator coordinate now to preserve her reproductive choices?
Correct answer: B - Arrange fertility consultation now, coordinating timing with oncology; egg freezing does not require a partner.
Eight days after chemotherapy, a patient leaves this message: 'My oral temperature was 38.4°C (101.1°F), but it fell to 37.2°C (99.0°F) after acetaminophen. I feel okay now. Do I still need to be seen?' No current blood count is available. The return-call advice should be:
Correct answer: A - Arrange urgent oncology evaluation now, despite the lower temperature.
Lumpectomy removes a 14-mm invasive breast carcinoma with a small associated DCIS component. The closest margin is 1 mm, with neither invasive cancer nor DCIS on ink. All other margins are widely clear, and there is no residual imaging concern. Whole-breast radiation is planned. The patient asks why another operation is not required. Which explanation accurately addresses the margin?
Correct answer: A - For invasive cancer receiving whole-breast radiation, no tumor on ink is an adequate margin.
With a qualified Spanish interpreter present, a navigator explains that biopsy results will be discussed by Friday and gives the patient a number to call if she has not heard. Her adult daughter is also present. Asked about follow-up, the patient says, 'If nobody calls, that means it was benign.' What should the navigator say next, through the interpreter?
Correct answer: D - Let me explain that again. What will you do if you haven't heard by Friday?
The full bank has 1,020 more BHCN questions with explanations.
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