M21-1 Manual / Part V, Subpart iii, Chapter 8, Section B

Disabilities of the Breast

M21-1, Part V, Subpart iii, Chapter 8, Section B

Overview

In This Section

This section contains the topic "Disabilities of the Breast."

1. Disabilities of the Breast

Introduction

This topic contains information about evaluating disabilities of the breast, including

malignant neoplasms of the breast
disfigurement due to benign or malignant neoplasms
fibrocystic breast disease
elective breast surgery, and
gynecomastia.

Change Date

May 14, 2018

V.iii.8.B.1.a. Malignant Neoplasms of the Breast

Malignant neoplasms of male or female breast tissue (38 CFR 4.116, diagnostic code (DC) 7630) are evaluated at 100 percent for active cancer. For female Veterans, consider corresponding entitlement to special monthly compensation (SMC). Important: Separate 100-percent evaluations will be assigned for both active gynecological cancer and active breast cancer. Metastasis of a gynecological cancer or breast cancer to a different body system will also be evaluated separately. References: For more information on

temporary total evaluations for cancers, see M21-1, Part VIII, Subpart iv, 8.D.3.e
evaluating malignant neoplasms and associated impairments, see M21-1, Part V, Subpart ii, 3.D.5.a and b, and
considering SMC (k) due to loss of breast tissue, see
- 38 CFR 3.350(a), and
- M21-1, Part VIII, Subpart iv, 4.A.4.k.

V.iii.8.B.1.b. Disfigurement Due to Benign or Malignant Neoplasms

Do not evaluate disfigurement due to benign or malignant neoplasms of the breast analogous to 38 CFR 4.118, DC 7800 unless there is actual disfigurement of the head, face, or neck. DC 7800 is for evaluation of disfigurement of the head, face, or neck only.

V.iii.8.B.1.c. Fibrocystic Breast Disease

Do not routinely award service connection (SC) for fibrocystic breast disease. Although this condition is termed a disease, it is actually a physiologic finding that is generally acute and transient. In the absence of associated pathology, SC is not warranted. Additionally, fibrocystic breasts are not associated with increased risk of breast cancer unless the changes are associated with atypical hyperplasia.Examples of associated pathology that may warrant SC for fibrocystic breast disease are

persistent lumps or thickening requiring surgical excision, or
fibrocystic breast changes with associated atypical hyperplasia.

Use the table below to determine when SC for pathology associated with claimed fibrocystic breast disease is warranted as well as the proper DC to use in the evaluation.

If the service treatment records show …	And medical evidence shows …	Then award SC for …
fibrocystic breasts	continuous symptoms and/or nexus to subsequent post-service excision of persistent lumps or thickening	residuals of surgery under appropriate DCs including the 38 CFR 4.118, DC 7800 series for scars, and 38 CFR 4.116, DC 7626 for breast, surgery of.
fibrocystic breasts	the (in-service or post-service) development of atypical hyperplasia associated with the fibrocystic breasts subsequent development of breast cancer, and nexus between the fibrocystic breasts with associated atypical hyperplasia and the development of breast cancer	breast cancer and/or residuals under appropriate DCs including 38 CFR 4.116, DC 7627, or 38 CFR 4.116, DC 7626.

V.iii.8.B.1.d. Elective Breast Surgery

Breast surgeries that are not medically necessitated, such as reduction mammoplasty for cosmetic purposes and any expected residual effects thereof, are not subject to SC. Such procedures are considered elective surgeries and therefore do not meet the provisions of a disease or injury incurred coincident with service.Important: If reduction mammoplasty is recommended to alleviate physical discomfort, such as back, shoulder, or neck pain, SC should be considered on the basis of aggravation only, and if so established, SMC (k) would be payable if the resultant tissue loss meets the requirements of the statute.References: For more information about
principles relating to SC, see
38 CFR 3.303, and
M21-1, Part V, Subpart ii, 2.A
aggravation of pre-service disability, see
38 CFR 3.306, and
M21-1, Part V, Subpart ii, 2.C, and
entitlement to SMC (k), see
38 CFR 3.350(a), and
M21-1, Part VIII, Subpart iv, 4.A.4.

V.iii.8.B.1.e. Gynecomastia

SC may be established for gynecomastia when the evidence shows that it was incurred in or caused by military service. However, consideration must be given to whether there is clear evidence that the condition existed prior to service. Evaluate gynecomastia depending on symptoms and/or pre- or post-surgical resection status under

Note: Under 38 CFR 4.116, DC 7626, no more than a noncompensable evaluation can be assigned as there is no significant alteration in size or form since the removal of excess tissue results in a return to breast size within normal limits for a human male.

Source: VA M21-1 Adjudication Procedures Manual, M21-1, Part V, Subpart iii, Chapter 8, Section B (U.S. government work, reproduced for reference). Browse all sections →