Breast Exams

• Women age 40 or older.
• Women age 30 and older who have a 15% or greater lifetime risk of breast cancer, according to risk assessment tools based on family history, or who have any of the following risk factors:
  • History of breast cancer, Ductal Carcinoma In Situ (DCIS), Lobular Carcinoma In Situ (LCIS), Atypical Ductal Hyperplasia (ADH), or Atypical Lobular Hyperplasia (ALH)
  • Extremely dense breasts when viewed by mammogram
  • Known BRCA1 or BRCA2 gene mutation,
  • First degree relative (parent, child, sibling) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
  • Radiation therapy to the chest between the ages of 10 and 30 years
  • History of Li-Fraumeni, Cowden, or Bannayan-Riley-Ruvalcaba syndrome, or a first degree relative with a history of one of these syndromes
• TRICARE covers 3D mammograms (digital breast tomosynthesis) for diagnostic purposes. For information on additional 3D mammography coverage, visit the Provisional Coverage page.  

Beginning at age 30, for women who have a 20% or greater lifetime risk of breast cancer.  Your risk is determined by risk assessment tools based on family history, or if you have any of the following risk factors:

• Known BRCA1 or BRCA2 gene mutation
• First degree relative (parent, child, sibling) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
• Radiation therapy to the chest between the ages of 10 and 30 years
• History of Li-Fraumeni, Cowden, or Bannayan-Riley-Ruvalcaba syndrome, or a first degree relative with a history of one of these syndromes

TRICARE covers genetic counseling provided by a TRICARE authorized provider before BRCA1 or BRCA2 gene testing:

• For women identified as high risk for breast cancer by their primary care manager.
• For men if it is medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and appropriate. 
• If you have a history of radiation therapy to the chest between the ages of 10 and 30.