What this means
m21-1:V.iii.8.B explains disabilities of the breast. In plain terms, the official guidance says malignant neoplasms of male or female breast tissue (38 CFR 4.116, diagnostic code (DC) 7630) are evaluated at 100 percent for active cancer. It also addresses 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.
How this may help with a claim
Use m21-1:V.iii.8.B when organizing evidence or checking VA's handling of disabilities of the breast. Compare your application, supporting records, and notice with this source-specific point: Malignant neoplasms of male or female breast tissue (38 CFR 4.116, diagnostic code (DC) 7630) are evaluated at 100 percent for active cancer. 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. Save proof of submission and identify the exact condition, exception, or missing development step before requesting correction or choosing a review option.
What to review in your file
- Check the file against this official condition: 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.
- Confirm that the record or notice addresses this source point: If the service treatment records show … — And medical evidence shows … — Then award SC for …;
- Document how this stated step or exception applies: 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.
Important limits
m21-1:V.iii.8.B explains VA guidance for disabilities of the breast; it does not guarantee an award or replace the statutes, regulations, binding decisions, and review instructions that control an individual claim. Conditions and exceptions still matter, including this source point: Malignant neoplasms of male or female breast tissue (38 CFR 4.116, diagnostic code (DC) 7630) are evaluated at 100 percent for active cancer. 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.
Search terms when useful
Phrases that may help when searching your claim file or this library.
- Disabilities of the Breast
- m21-1:V.iii.8.B
- Disabilities Breast
- malignant neoplasms breast
- disfigurement benign malignant neoplasms
- fibrocystic breast disease
- elective breast surgery
- gynecomastia.
Original VA guidance
The official VA text of this section
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.
Scroll sideways to see the full table.
| 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 DC(s) including the 38 CFR 4.118, DC 7800 series for scars, and/or 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 a nexus between the fibrocystic breasts with associated atypical hyperplasia and the development of breast cancer | breast cancer and/or residuals under appropriate DC(s) 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
- 38 CFR 4.116, DC 7626
- 38 CFR. 4.116, DC 7631, or
- 38 CFR 4.118, DC 7804/7805.
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.