CBCN Exam Facts, 2026 Blueprint & Study Plan
Key Takeaways
The CBCN exam has 165 multiple-choice questions in a three-hour session; 125 are scored and 40 are unscored pretest items (ONCC 2026 Test Registration Manual).
The 2026 CBCN blueprint weights are Care Continuum 19%, Diagnosis and Staging 21%, Treatment Modalities and Considerations 24%, Nursing Practice 24%, and Psychosocial Dimensions of Care 12%.
ONCC sets the CBCN passing standard at a scaled score of 55 on a 25-to-75 scale, and candidates see an official pass/fail result before leaving the PSI test center.
CBCN candidates need an active RN license, 24 months of RN experience and 2,000 breast care practice hours within 48 months, and 10 breast care contact hours within 36 months.
The CBCN test fee is $300 for ONS/APHON members and $420 for nonmembers; ONCC reported a 78% first-time pass rate for the CBCN in 2025.
What the CBCN Credential Is
The Certified Breast Care Nurse (CBCN®) credential is awarded by the Oncology Nursing Certification Corporation (ONCC). It is an NCCA-accredited specialty certification for registered nurses who work anywhere on the breast care continuum: screening and risk assessment, diagnosis, surgery, systemic and radiation therapy, survivorship, and end-of-life care. Practice may be direct care, administration, education, research, or consultation. Certification is valid for four years.
Use this guide alongside the official materials. The exam writers test knowledge that a competent breast care nurse applies, so every chapter pairs clinical facts with nursing actions, patient education, and safety checks. ONCC items use generic drug names only, so learn tamoxifen, not a brand name.
Current Exam Facts (ONCC 2026 Test Registration Manual)
| Item | Current fact |
|---|---|
| Questions | 165 multiple-choice items with four options and one correct answer |
| Scored vs. pretest | 125 scored; 40 unscored pretest items that are not identified |
| Session length | 3 hours, including a 15-minute computer tutorial and a post-test survey |
| Breaks | None scheduled; the clock keeps running if you step out |
| Delivery | Computer-based testing at PSI test centers, year-round in the U.S., its territories, and Canada |
| Fee | $300 ONS/APHON member; $420 nonmember |
| DoubleTake option | $100 extra at the initial application; apply for the second attempt within 180 days |
| International testing | June 1–30, 2026 window; $75 additional fee; application deadline March 1, 2026 |
| Authorization to Test (ATT) | Emailed by PSI within 4 to 6 weeks of application; valid for 90 days |
| Passing standard | Scaled score of 55 (scale 25 to 75) |
| Results | Official pass/fail on screen, then an emailed report with performance by subject area |
ONCC has posted notices that application processing can take up to 8 weeks during high-volume periods, so apply well before your target date.
Eligibility for Initial Certification
All criteria must be met at application and at testing:
- A current, active, unencumbered RN license in the U.S., its territories, or Canada.
- At least 24 months of RN experience within the 48 months before application.
- At least 2,000 hours of breast care nursing practice within the 48 months before application.
- At least 10 contact hours of accredited nursing continuing education (or an academic elective) in breast care within the 36 months before application. Up to 5 of the 10 hours may be accredited CME or CPE in breast care.
Retakes, Renewal, and Pass Rates
A candidate who fails may reapply once the current ATT expires but may not sit for the same exam more than once in a 90-day eligibility period. After three failures within three years, the candidate waits one year. The DoubleTake option lowers the cost of a second attempt when purchased up front.
Renewal requires current CBCN certification, an active RN license, 12 months of RN experience within 36 months, and 1,000 hours of breast care practice within the 30 months before application, plus one of three options: practice hours with professional development points, practice hours with a passing test, or points with a passing test. The early-bird renewal deadline is September 15 and the final deadline is October 15 of the expiration year.
ONCC publishes annual statistics. For 2025, 78% of first-time CBCN candidates passed (109 of 139), 48% of repeat candidates passed, and the overall rate was 75% (127 of 169).
The 2026 Test Content Outline
The 2026 outline comes from a role delineation study of breast care nursing completed in 2024. Every form includes each domain at its assigned percentage, but not every subtopic appears on every form. Multiply each percentage by 125 to estimate scored items.
| Domain | Weight | Approximate scored items | Main subtopics |
|---|---|---|---|
| I. Care Continuum | 19% | 24 | Breast health and screening, risk assessment, patient navigation, surveillance and survivorship |
| II. Diagnosis and Staging | 21% | 26 | Carcinogenesis, diagnostic evaluation, pathology, staging |
| III. Treatment Modalities and Considerations | 24% | 30 | Surgery, reconstruction, radiation, systemic therapy, specific conditions, special populations |
| IV. Nursing Practice | 24% | 30 | Symptom management, oncologic emergencies, professional practice, clinical trials, self-care |
| V. Psychosocial Dimensions of Care | 12% | 15 | Culture and identity, family dynamics, body image, reproductive and sexual health, distress, social determinants |
How This Guide Maps to the Blueprint
- Care Continuum: breast anatomy, clinical breast examination, benign conditions, screening, special populations, high-risk lesions, risk models, genetics, navigation, survivorship surveillance, and lifestyle.
- Diagnosis and Staging: carcinogenesis, imaging and BI-RADS, biopsy, histopathology and prognostic features, biomarkers, genomic assays, AJCC staging, and staging studies.
- Treatment: breast and axillary surgery, reconstruction, radiation, chemotherapy, endocrine, HER2-directed, CDK4/6, PARP, immunotherapy, Trop-2 and PI3K-pathway agents, triple-negative and HER2-positive pathways, inflammatory breast cancer, Paget disease, phyllodes tumors, angiosarcoma, and special populations.
- Nursing Practice: chemotherapy toxicities, lymphedema, bone and menopausal symptoms, integrative care, rehabilitation, two emergency chapters, professional practice, clinical trials, and nurse self-care.
- Psychosocial: distress and coping, culture and identity, family and caregivers, body image, and reproductive and sexual health.
Study Strategy
- Weight your time. Treatment and Nursing Practice together are nearly half the exam; Psychosocial is the smallest domain but the easiest to underprepare.
- Learn decision points, not trivia. Items test when to act: which margin is adequate, which patient needs genetic referral, which symptom is an emergency.
- Use the official resources. ONCC offers a free 50-question CBCN practice test and a reference list that includes the ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (2023) and Bland and Copeland's The Breast (2024).
- Drill questions. After each chapter, work the quizzes here and the free CBCN practice questions, then review every rationale, including the ones you answered correctly.
A candidate wants to estimate how many scored CBCN items come from the Nursing Practice domain. Using ONCC's method, about how many scored items is that?
24
30
40
45
An RN has 2,500 hours of breast care nursing practice in the past 3 years and 8 contact hours of breast care continuing education earned in the past 2 years. What prevents this nurse from applying for initial CBCN certification?
The nurse needs at least 4,000 practice hours in breast care.
The practice hours must all be direct patient care in a surgical setting.
The nurse needs at least 10 breast care contact hours within the 36 months before applying.
The nurse must first hold the OCN credential.
A candidate asks what a scaled score of 55 on the CBCN results report means. Which reply is accurate?
It is the passing standard on a 25-to-75 scale, converted from the number of scored items answered correctly on that form.
It means the candidate answered 55% of all 165 questions correctly.
It is a percentile rank showing the candidate outperformed 55% of test takers.
It is a provisional score that ONCC hand-scores again before deciding the result.
Sections you finish are checked off in the contents.