100+ Free CBCN Practice Questions

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What is the PRIMARY purpose of neoadjuvant chemotherapy in breast cancer treatment?

To shrink the tumor before surgery to enable breast conservation or operability

To replace radiation therapy after surgery

To prevent cancer in the contralateral breast

To cure the cancer without surgery

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2026 Statistics

Key Facts: CBCN Exam

165

Exam Questions

ONCC (125 scored + 40 pretest)

Exam Time

ONCC CBCN handbook

25%

Diagnosis/Staging Weight

ONCC test content outline

25%

Treatment Modalities Weight

ONCC test content outline

$300/$420

Member/Non-member Fee

ONCC fee schedule

4 years

Certification Validity

ONCC renewal policy

The CBCN exam from ONCC tests 165 multiple-choice questions (125 scored, 40 pretest) over 3 hours. Requirements include an active RN license, 2,000 hours of breast care nursing experience, and 10 CE hours. Content domains: Breast Health/Risk Assessment/Screening (20%), Diagnosis/Staging/Treatment Planning (25%), Treatment Modalities (25%), Symptom Management/Supportive Care (20%), and Survivorship/Professional Practice (10%). Exam fee is $300 for ONS members, $420 for non-members.

Sample CBCN Practice Questions

Try these sample questions to test your CBCN exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which imaging modality is recommended as the primary screening tool for breast cancer in average-risk women aged 40 and older?

A.Breast MRI

B.Breast ultrasound

C.Digital mammography

D.Thermography

Explanation: Digital mammography is the recommended primary screening tool for breast cancer in average-risk women aged 40 and older per guidelines from the American College of Radiology and most major organizations. It can detect calcifications, masses, and architectural distortions before they are palpable. Breast MRI is reserved for high-risk patients, ultrasound is supplemental, and thermography is not recommended as a screening tool.

2A 35-year-old woman with a BRCA1 mutation asks about breast cancer screening. In addition to annual mammography, which supplemental screening is recommended?

A.Annual thermography

B.Annual breast MRI with contrast

C.Biannual breast ultrasound only

D.No additional screening is needed

Explanation: For women with BRCA1/BRCA2 mutations, annual breast MRI with contrast is recommended in addition to annual mammography, typically starting at age 25-30. MRI has higher sensitivity than mammography for detecting cancers in dense breast tissue common in younger high-risk women. Thermography is not a validated screening tool, and ultrasound alone is insufficient for this risk level.

3Which risk assessment model incorporates both genetic and non-genetic risk factors to estimate a woman's lifetime risk of developing breast cancer?

A.Framingham Risk Score

B.Gail Model

C.Tyrer-Cuzick (IBIS) Model

D.CHADS2 Score

Explanation: The Tyrer-Cuzick (IBIS) model is the most comprehensive breast cancer risk assessment tool, incorporating both genetic factors (family history including second-degree relatives, known mutations) and non-genetic factors (reproductive history, BMI, hormone use, benign breast disease). The Gail Model is simpler but does not include paternal family history or second-degree relatives. Framingham and CHADS2 scores are cardiovascular risk tools.

4Which benign breast condition is characterized by bilateral breast pain that worsens before menstruation and is associated with fibrous and cystic changes?

A.Fibroadenoma

B.Fibrocystic changes

C.Phyllodes tumor

D.Intraductal papilloma

Explanation: Fibrocystic changes are the most common benign breast condition, affecting up to 60% of women. They are characterized by bilateral breast pain (mastalgia) that typically worsens in the luteal phase before menstruation. The condition involves fibrous tissue proliferation and cyst formation. Fibroadenomas are painless, firm mobile masses; phyllodes tumors are rare stromal tumors; and intraductal papillomas cause nipple discharge.

5A woman's Gail Model 5-year risk score is 2.5%. What does this indicate about her eligibility for chemoprevention?

A.She is not a candidate for chemoprevention

B.She meets the threshold for discussing chemoprevention with tamoxifen or raloxifene

C.She requires immediate bilateral mastectomy

D.She should begin annual breast MRI screening

Explanation: A 5-year Gail Model risk of 1.67% or greater is the threshold at which chemoprevention should be discussed. With a 2.5% five-year risk, this woman is eligible for chemoprevention with tamoxifen (pre- or postmenopausal) or raloxifene (postmenopausal only), which can reduce breast cancer risk by 30-50%. This risk level alone does not warrant prophylactic mastectomy or MRI screening, which requires a lifetime risk of 20% or greater.

6Which breast biopsy technique uses a hollow needle to remove a cylinder of tissue and is the preferred method for tissue diagnosis of a palpable mass?

A.Fine needle aspiration (FNA)

B.Core needle biopsy

C.Excisional biopsy

D.Punch biopsy

Explanation: Core needle biopsy uses a large hollow needle to remove cylinders of tissue, providing histological architecture for definitive diagnosis including receptor status testing. It is the preferred initial biopsy method for most breast lesions because it is less invasive than excisional biopsy, provides more tissue than FNA, and allows biomarker testing (ER/PR/HER2). FNA provides cytology only and cannot distinguish invasive from in situ disease.

7A breast cancer specimen is reported as ER-positive, PR-positive, and HER2-negative. Which treatment approach is MOST appropriate for this tumor profile?

A.Trastuzumab-based targeted therapy

B.Endocrine (hormonal) therapy

C.Triple-drug chemotherapy only

D.No systemic therapy needed

Explanation: ER-positive, PR-positive, HER2-negative breast cancer (luminal A subtype) responds to endocrine therapy such as tamoxifen (premenopausal) or aromatase inhibitors (postmenopausal). Hormonal therapy is the cornerstone of treatment for hormone receptor-positive disease. Trastuzumab targets HER2-positive tumors. Chemotherapy may be added based on genomic assays (e.g., Oncotype DX) and staging, but endocrine therapy is always included for HR-positive disease.

8What does a HER2/neu 3+ result on immunohistochemistry (IHC) indicate?

A.HER2 is negative; no targeted therapy needed

B.HER2 is equivocal; FISH testing required

C.HER2 is positive; patient is a candidate for HER2-targeted therapy

D.The test is invalid and must be repeated

Explanation: A HER2/neu IHC score of 3+ indicates HER2 overexpression and the tumor is considered HER2-positive. This makes the patient a candidate for HER2-targeted therapies such as trastuzumab (Herceptin), pertuzumab, and ado-trastuzumab emtansine (T-DM1). A score of 0 or 1+ is negative, and 2+ is equivocal requiring confirmatory FISH (fluorescence in situ hybridization) testing to determine gene amplification status.

9In the TNM staging system for breast cancer, what does T2 indicate?

A.Tumor is 2 cm or less in greatest dimension

B.Tumor is more than 2 cm but not more than 5 cm

C.Tumor is more than 5 cm

D.Tumor involves the chest wall or skin

Explanation: In the AJCC TNM staging system for breast cancer, T2 indicates a tumor that is more than 2 cm but not more than 5 cm in greatest dimension. T1 is 2 cm or less, T3 is more than 5 cm, and T4 involves extension to the chest wall or skin (including inflammatory breast cancer). Accurate T staging is essential for treatment planning and prognosis determination.

10Which genomic assay is used to determine the benefit of adjuvant chemotherapy in early-stage, ER-positive, HER2-negative breast cancer?

A.BRCA1/BRCA2 genetic test

B.Oncotype DX Recurrence Score

C.CA 27-29 tumor marker

D.HER2 FISH test

Explanation: Oncotype DX is a 21-gene genomic assay that generates a Recurrence Score (0-100) to predict the benefit of adding chemotherapy to endocrine therapy in early-stage, ER-positive, HER2-negative, node-negative (or limited node-positive) breast cancer. A low score (<26 for women 50+, <16 for women under 50) suggests chemotherapy provides minimal benefit. BRCA testing assesses hereditary risk, CA 27-29 monitors metastatic disease, and FISH confirms HER2 status.

About the CBCN Exam

The CBCN certification validates specialized knowledge in breast care nursing across the continuum from screening through survivorship. Administered by ONCC, it covers risk assessment, diagnosis, treatment modalities, symptom management, and professional practice for RNs dedicated to breast cancer care.

Assessment

125 scored + 40 pretest

Time Limit

3 hours

Passing Score

Criterion-referenced scaled score

Exam Fee

$300 ONS members / $420 non-members (ONCC)

CBCN Exam Content Outline

20%

Breast Health/Risk Assessment/Screening

Breast anatomy, risk models, benign conditions, mammography, MRI, ultrasound, and genetic counseling

25%

Diagnosis/Staging/Treatment Planning

Biopsy types, biomarkers (ER/PR/HER2), TNM staging, and multidisciplinary treatment planning

25%

Treatment Modalities

Surgery, radiation, chemotherapy, hormonal therapy, targeted therapy, and immunotherapy

20%

Symptom Management/Supportive Care

Side effects, lymphedema, pain management, psychosocial support, and palliative care

10%

Survivorship/Professional Practice

Survivorship care plans, follow-up surveillance, patient education, and evidence-based practice

How to Pass the CBCN Exam

What You Need to Know

Passing score: Criterion-referenced scaled score
Assessment: 125 scored + 40 pretest
Time limit: 3 hours
Exam fee: $300 ONS members / $420 non-members

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CBCN Study Tips from Top Performers

1Focus on Diagnosis/Staging/Treatment Planning and Treatment Modalities — they account for 50% of the exam combined

2Master biomarker interpretation (ER/PR/HER2/Ki-67) as it drives treatment decisions across multiple domains

3Study the differences between breast-conserving surgery, mastectomy types, and reconstruction options

4Know lymphedema risk factors, prevention strategies, and management — a frequently tested supportive care topic

5Review BRCA1/BRCA2 genetic testing indications, counseling, and risk-reduction strategies

Frequently Asked Questions

How many questions are on the CBCN exam?

The CBCN exam contains 165 multiple-choice questions: 125 are scored and 40 are unscored pretest items. You have 3 hours to complete the entire exam. Pretest questions are indistinguishable from scored questions, so treat every question seriously.

What are the CBCN eligibility requirements?

To sit for the CBCN, you need a current, active RN license, a minimum of 2,000 hours of breast care nursing practice within the past 4 years, and at least 10 contact hours of continuing education in breast care nursing within the past 4 years.

How much does the CBCN exam cost?

The CBCN exam fee is $300 for Oncology Nursing Society (ONS) members and $420 for non-members. Joining ONS before applying can save $120 on the exam fee.

What content domains does the CBCN exam cover?

The CBCN exam covers five domains: Breast Health/Risk Assessment/Screening (20%), Diagnosis/Staging/Treatment Planning (25%), Treatment Modalities (25%), Symptom Management/Supportive Care (20%), and Survivorship/Professional Practice (10%).

How long is CBCN certification valid?

CBCN certification is valid for 4 years. To renew, you must complete 1,000 hours of breast care nursing practice and earn continuing education credits, or you can retake the examination.

What topics should I focus on for the CBCN exam?

Focus on the two highest-weighted domains: Diagnosis/Staging/Treatment Planning and Treatment Modalities (25% each). Key topics include biomarker interpretation (ER/PR/HER2), TNM staging, surgical options, chemotherapy regimens, targeted therapies, and radiation therapy principles.