Women ages 30 and older who have a 15% 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:
A history of breast cancer, ductal carcinoma in situ, lobular carcinoma in situ, atypical ductal hyperplasia, or atypical lobular hyperplasia
Extremely dense breasts when viewed by mammogram
A known BRCA1 or BRCA2 gene mutation
A 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
A 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 Provisional Coverage.
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:
A known BRCA1 or BRCA2 gene mutation
A first-degree relative (parent, child, sibling) with a BRCA1 or BRCA2 gene mutation, and haven’t had genetic testing themselves
Radiation therapy to the chest between the ages of 10 and 30 years
A 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 providerAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. DS before BRCA1 or BRCA2 gene testing:
For women identified as high risk for breast cancer by their primary care manager
For men if it’s 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
If you have a history of Li-Fraumeni, Cowden, or Bannayan-Riley-Ruvalcaba syndrome, or a parent, child, or sibling with a history of one of these syndromes
Disclaimer:
This list of covered services is not all inclusive. TRICARE covers services that are medically necessary and considered proven. There are special rules or limits on certain services, and some services are excluded.
