ONCC CBCN Certification Exam Syllabus

• Breast anatomy and physiology (e.g., hormonal influence, breast development  and changes)
• Benign conditions (e.g., mastodynia, fibroadenomas, infection, nipple discharge)
• Screening (e.g., imaging modalities and results)
• Clinical breast exam (e.g., breast awareness education, normal, abnormal)
• Considerations related to special populations

- Cancer risk assessment

• Breast cancer risk prediction models (e.g., Tyrer-Cuzick, Breast Cancer Risk Assessment Tool [BCRAT])
• Risk Factors (e.g., modifiable, non-modifiable, high-risk lesions, epidemiology)
• Screening recommendations based on risk
• Genetic counseling and testing
• Risk reduction interventions (e.g., endocrine therapy, risk-reducing surgery, lifestyle behaviors)

- Patient navigation process

• Advocacy and resources
• Barriers to care (e.g., financial, health literacy, language, transportation)
• Interprofessional collaboration

- Surveillance and survivorship

• Psychosocial issues
• Physical issues (e.g., lymphedema, bone health, neuropathy, cardiac)
• Surveillance (e.g., imaging, symptom directed work-up, subsequent malignancies, declination of treatment)

• Imaging modalities
• Imaging results
• Biopsies (e.g., fine needle aspiration [FNA], core, surgical)

- Pathology

• Prognostic features (e.g., type, grade, histology, lymphovascular invasion, extranodal extension, proliferation index)
• Biomarkers (e.g., ER/PR, HER2)
• Genomic testing

- Staging

• Clinical
• Pathologic
• Additional studies (e.g., magnetic resonance imaging [MRI], bone scan, computed tomography [CT] scan, positron-emission tomography [PET])

• Breast (e.g., breast conservation, mastectomy)
• Axilla (e.g., sentinel lymph node biopsy, axillary lymph node dissection)

- Surgical reconstruction

• Expander/Implant
• Autologous
• Oncoplastic procedures

- Radiation therapy (e.g., external beam, brachytherapy)
- Systemic (e.g., endocrine therapy, chemotherapy, bispecific antibodies)
- Considerations for specific conditions:

• Triple-negative disease
• HER2-positive disease
• Inflammatory breast cancer
• Paget disease
• Phyllodes tumor (malignant and benign)
• Angiosarcoma

- Treatment consideration for special populations (e.g., gender and sexual minorities, male, young adult)

• Surgical (e.g., lymphedema, wound complications, pain, decreased range of motion)
• Medical (e.g., myelosuppression, integumentary alterations, gastrointestinal complications, menopausal symptoms, cardiovascular alterations)
• Radiation (e.g., integumentary alterations, fatigue, cardiopulmonary)
• Complementary and integrative modalities (e.g., massage, acupuncture, Reiki therapy, nutrition)
• Rehabilitation (e.g., physical therapy, occupational therapy, pelvic floor)

- Oncologic emergencies (i.e., anaphylaxis, extravasation, hypercalcemia, hypersensitivity, pleural effusion, sepsis, spinal cord compression, thromboembolic events)
- Professional practice (e.g., practice guidelines, shared decision-making, community outreach, legislative issues, accreditation standards)
- Clinical trials
- Self-care (e.g., managing compassion fatigue, burnout, substance use)