FALLS CHURCH, Va. –
Screening for breast cancer is important. That’s because it’s the second most common cancer in women in the U.S., according to the
Centers for Disease Control and Prevention. It’s also the second leading cause of cancer death in women.
Fortunately, getting preventive screenings can help detect breast cancer before you show any signs or symptoms.
“Screening for breast cancer can help you find breast cancer at an earlier stage, when it may be easier to treat,” said Dr. Stacy Usher, lead nurse, TRICARE Health Plan, at the Defense Health Agency.
There are different ways to screen for breast cancer. Your age and your risk for breast cancer determine which tests are recommended for you and covered by TRICARE. Read on to learn about your options.
Getting preventive care
Breast cancer screenings are
preventive services. This means:
- You have no out-of-pocket costs for TRICARE-covered preventive services when you follow your plan’s rules for getting care.
- In most cases, you don’t need a referral for preventive services. But you might want to talk to your primary care manager or provider about which breast cancer screenings are right for you.
Do you have TRICARE For Life? In the U.S. and U.S. territories, you must also follow Medicare’s rules for getting preventive care.
Mammograms
A
mammogram is an X-ray exam of your breasts. Mammograms are the best way to find breast cancer for most women of screening age, according to the CDC.
To screen for breast cancer, TRICARE covers mammograms every 12 months for:
- Women ages 40 and older
- Women ages 30 and older who have certain risk factors or a 15% or greater lifetime risk of developing breast cancer
Go to Mammogram Coverage to learn more about these risk factors.
Note: The U.S. Preventive Services Task Force recommends that women ages 40 to 74 who are at average risk for breast cancer get a mammogram every two years. Talk to your provider about how often you should get a mammogram.
Breast MRI
Magnetic resonance imaging uses magnets and radio waves to take detailed pictures of inside your body. Breast MRI is used with mammograms to screen women who are at
high risk for getting breast cancer.
TRICARE covers an annual breast MRI screening for women ages 30 and older who have a 20% or greater lifetime risk of developing breast cancer or have these risk factors:
- You or a first-degree relative has a known BRCA 1 or BRCA 2 gene mutation or a history of certain syndromes. (A first-degree relative is a parent, child, or sibling.)
- You or a first-degree relative has a history of Li-Fraumeni, Cowden, or Bannayan-Riley-Ruvalcaba syndrome
- You had radiation therapy to your chest between the ages of 10 and 30.
Learn more about breast MRI coverage.
Genetic counseling and testing
You’re at greater risk for breast cancer if you or a first-degree relative has a known BRCA1 or BRCA2 gene mutation.
TRICARE may cover genetic counseling before BRCA1 and BRCA2 gene testing as preventive care if your PCM or provider identifies you as being high risk for breast cancer. TRICARE may also cover this counseling in certain other situations.
You must see a TRICARE-authorized provider for TRICARE to cover this counseling. Learn more about BRCA1 and BRCA2 genetic counseling coverage.
TRICARE may cover BRCA1 and BRCA2 gene testing as part of the Laboratory Developed Tests Demonstration Project. Call your regional contractor to learn more about tests included in this demonstration.
Breast exams
A clinical breast exam is a physical examination of your breasts. Your provider will use their hands to feel your breasts and under your arms for lumps or anything else that seems unusual.
TRICARE covers clinical breast exams during covered Health Promotion and Disease Prevention Examinations and well-woman exams.
Keep in mind that a clinical breast exam on its own isn’t adequate to screen for breast cancer. Your HP&DP Examination or well-woman exam is a good time to ask your provider about your breast cancer risk and which screenings are recommended for you.
Screening for breast cancer vs. diagnosing breast cancer
A screening test isn’t the same as a diagnostic test. Breast cancer screening tests look for breast cancer before you show signs or symptoms. Your provider may order diagnostic testing if your screening test shows abnormal results.
Diagnostic tests are also used if you have signs or symptoms of breast cancer. For example, if you have a lump in your breast, your provider may order diagnostic testing to determine if you have cancer or another medical condition.
TRICARE covers medically necessary diagnostic testing. Mammograms, breast MRI, breast ultrasound, and biopsies are examples of tests used to diagnose breast cancer.
Other health services for women
From
cancer screenings to
contraception, TRICARE covers a variety of health services specific to your needs. This includes:
Take a moment to review some of the preventive services and women’s health services that may be available to you.
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