84 of 2023 as amended | |
85 of 2023 as amended |
SOP Bulletin 238 [3]
This SOP covers primary malignant neoplasms of breast epithelial tissue. Note that this SOP applies to males as well as females.
Diagnosis requires histology from a biopsy or surgical specimen.
The appropriate medical specialist is an oncologist or breast surgeon.
* another SOP applies
# non-SOP condition
Clinical onset will generally be when a breast lump (subsequently confirmed to be a breast cancer) is first found or when a screening mammogram first shows evidence of the condition.
The only SOP worsening factor is for inability to obtain appropriate clinical management. The disease has a very variable course and prognosis. It is particularly amenable to treatment if found early. A delay in appropriate treatment could result in worsening of the condition. Establishing whether worsening beyond the normal course of the disease has occurred will generally require expert medical opinion.
Place holder node for Rulebase for malignant neoplasm of the breast
Malignant neoplasm of the breast - A course of therapeutic radiation to the chest Factor
Last reviewed for CCPS 05 October 2006.
Preliminary questions [8800]
7629 [5] there is some evidence that therapeutic radiation may be a factor in the development of the condition under consideration.
8873 [6] the veteran has received a course of therapeutic radiation to the chest at some time. 8876 — the course of therapeutic radiation to the chest was received for treatment of an illness or injury which is identifiable. [Default true] 8878 — the veteran has established the causal connection between the course of therapeutic radiation and VEA service for the clinical onset of malignant neoplasm of the breast. 8880 — the veteran has established the causal connection between the course of therapeutic radiation and eligible service for the clinical onset of malignant neoplasm of the breast. or 8879 — the veteran has established the causal connection between the course of therapeutic radiation and operational service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [8879] 8883 — the identified illness or injury for which the course of therapeutic radiation to the chest was received is causally related to operational service. [8] [9] Clinical onset and eligible service [8880]
8884 — the identified illness or injury for which the course of therapeutic radiation to the chest was received is causally related to eligible service. [12] [9]
Malignant neoplasm of the breast - Alcohol consumption Factor
Last reviewed for CCPS 05 October 2006.
Investigative Documents
Claimant Report - Alcohol Consumption [CRD904] [13] Claimant Report - Alcohol Consumption [CRV904] [14] Medical Report - Alcohol Consumption [MR9244] Preliminary questions [8804] 8933 — the veteran has established the causal connection between the alcohol consumption and VEA service for the clinical onset of malignant neoplasm of the breast. 8934 — the veteran has established the causal connection between the alcohol consumption and operational service for the clinical onset of malignant neoplasm of the breast. or 8935 — the veteran has established the causal connection between the alcohol consumption and eligible service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [8934] Clinical onset and eligible service [8935]
Malignant neoplasm of the breast - Atomic radiation Factor
Last reviewed for CCPS 05 October 2006.
Investigative Documents
Claimant Report - Exposure to Atomic Radiation [CR9171] Preliminary questions [8802]
36406 — the veteran has established the causal connection between atomic radiation and VEA service for the clinical onset of malignant neoplasm of the breast.
36407 — the veteran has established the causal connection between atomic radiation and operational service for the clinical onset of malignant neoplasm of the breast.
or
36408 — the veteran has established the causal connection between atomic radiation and eligible service for the clinical onset of malignant neoplasm of the breast.
Clinical onset and operational service [36407]
36409 [23] the veteran has received a cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the affected breast at some time. the veteran received a cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the affected breast where this dose was accumulated at least five years before the clinical onset of the condition under consideration. operational service made a material contribution to the veteran receiving a cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the affected breast where this dose was accumulated at least five years before the clinical onset of the condition under consideration. the cumulative equivalent dose of at least 0.05 Sievert of atomic radiation to the affected breast, to which operational service made a material contribution and the dose was accumulated at least five years before the clinical onset of the condition under consideration, was due to the veteran's serious default, wilful act or serious breach of discipline. Clinical onset and eligible service [36408]
Malignant neoplasm of the breast - Cessation of breast feeding Factor
Last reviewed for CCPS 05 October 2006.
Preliminary questions [36433]
36434 [30] there is some evidence that cessation of breast feeding may be a factor in the development of the condition under consideration.
1169 — the veteran is a woman. [31] 36435 — the veteran satisfies the occurrence provisions for ceasing to breast feed and VEA service for the clinical onset of malignant neoplasm of the breast. or 36436 — the veteran has established the causal connection between ceasing to breast feed and VEA service for the clinical onset of malignant neoplasm of the breast. 36437 — the veteran has established the causal connection between ceasing to breast feed and operational service for the clinical onset of malignant neoplasm of the breast. or 36438 — the veteran has established the causal connection between ceasing to breast feed and eligible service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [36437] or
36446 — the identified illness or injury, which caused the veteran to stop breastfeeding, is causally related to operational service. [36] Clinical onset and eligible service [36438] or
36447 — the identified illness or injury, which caused the veteran to stop breastfeeding, is causally related to eligible service. [39] [40]
Malignant neoplasm of the breast - Diagnostic radiation to the breast Factor
Last reviewed for CCPS 05 October 2006.
Preliminary questions [36417]
36418 [41] there is some evidence that diagnostic radiation to the breast may be a factor in the development of the condition under consideration.
36419 [41] the veteran has received diagnostic radiation to the affected breast at some time. 36420 — the veteran has established the causal connection between the diagnostic radiation to the breast and VEA service for the clinical onset of malignant neoplasm of the breast. 36422 — the veteran has established the causal connection between the diagnostic radiation to the breast and eligible service for the clinical onset of malignant neoplasm of the breast. or 36421 — the veteran has established the causal connection between the diagnostic radiation to the breast and operational service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [36421] 36428 — the identified illness or injury, for which the veteran received diagnostic radiation to the affected breast, is causally related to operational service. [45] [46] Clinical onset and eligible service [36422]
36429 — the identified illness or injury, for which the veteran received diagnostic radiation to the affected breast, is causally related to eligible service. [50] [46]
Malignant neoplasm of the breast - First live birth or full-term pregnancy after age 30 Factor
Last reviewed for CCPS 05 October 2006.
Preliminary questions [36448]
36449 [51] there is some evidence that having a first live birth or first full-term pregnancy after the age of 30 may be a factor in the development of the condition under consideration.
1169 — the veteran is a woman. [31] the veteran had her first live birth or first full-term pregnancy after the age of 30 years. the veteran had her first live birth or first full-term pregnancy after the age of 30 years before the clinical onset of the condition under consideration. 36452 — the veteran has established the causal connection between having a first pregnancy after age 30 and VEA service for the clinical onset of malignant neoplasm of the breast. 36453 — the veteran has established the causal connection between having a first pregnancy after age 30 and operational service for the clinical onset of malignant neoplasm of the breast. or 36454 — the veteran has established the causal connection between having a first pregnancy after age 30 and eligible service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [36453] Clinical onset and eligible service [36454]
Malignant neoplasm of the breast - Hormone replacement therapy Factor
Last reviewed for CCPS 05 October 2006.
Preliminary questions [23825]
21468 [56] there is some evidence that hormone replacement therapy may be a factor in the development of the condition under consideration.
1169 — the veteran is a woman. [31] the veteran has had hormone replacement therapy at some time. 8816 — the veteran has established the causal connection between the hormone replacement medication and VEA service for the clinical onset of malignant neoplasm of the breast. 8820 — the veteran has established the causal connection between the hormone replacement medication and eligible service for the clinical onset of malignant neoplasm of the breast. or 8819 — the veteran has established the causal connection between the hormone replacement medication and operational service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [8819] 8823 — the identified illness or injury, for which the veteran had hormone replacement therapy, is causally related to operational service. [61] [62] Clinical onset and eligible service [8820]
8824 — the identified illness or injury, for which the veteran had hormone replacement therapy, is causally related to eligible service. [67] [62]
Malignant neoplasm of the breast - Inability to obtain appropriate clinical management for breast cancer Factor
Last reviewed for CCPS 05 October 2006.
Investigative Documents
Medical Report - Inability to Obtain Appropriate Clinical Management - [GQACM] Preliminary questions [8805] 11109 — the condition under consideration has been accepted on the basis of inability to obtain appropriate clinical management for the condition under consideration.
7334 [69] the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service. the condition under consideration permanently worsened. the veteran was unable to obtain appropriate clinical management for the condition under consideration at some time.
7379 [72] the inability to obtain appropriate clinical management for the condition under consideration contributed to the clinical worsening of the condition under consideration. 11234 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and VEA service for the clinical worsening of the condition under consideration. 11235 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and operational service for the clinical worsening of the condition under consideration. or 11236 — the veteran has established the causal connection between the inability to obtain appropriate clinical management for the condition under consideration and eligible service for the clinical worsening of the condition under consideration. Clinical worsening and operational service [11235] or 7390 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to operational service. [76] [77] Clinical worsening and eligible service [11236] or 7391 — the identified illness or injury which prevented the veteran from obtaining appropriate clinical management for the condition under consideration is causally related to eligible service. [76] [77]
Malignant neoplasm of the breast - Inability to undertake any physical activity greater than 3 METs Factor
Last reviewed for CCPS 05 October 2006.
Investigative Documents
Claimant Report - Inability to Undertake Physical Activity [CR9213] [84] Medical Report - Inability to Undertake Physical Activity [MR9321] Preliminary questions [36471]
36472 — the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and VEA service for the clinical onset of malignant neoplasm of the breast.
36474 — the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and eligible service for the clinical onset of malignant neoplasm of the breast.
or
36473 — the veteran has established the causal connection between the inability to undertake any physical activity greater than 3 METs and operational service for the clinical onset of malignant neoplasm of the breast.
Clinical onset and operational service [36473]
36475 [86] the veteran was unable to undertake any physical activity greater than 3 METs for at least 10 years, within the 30 years before the clinical onset of malignant neoplasm of the breast. the veteran's inability to undertake any physical activity greater than 3 METs for at least 10 years within the 30 years before the clinical onset of malignant neoplasm of the breast was materially contributed to by an illness or injury which is identifiable. 33921 — the identified illness or injury which caused the inability to undertake any physical activity greater than 3 METs is causally related to operational service. [88] [89] Clinical onset and eligible service [36474]
33922 — the identified illness or injury which caused the inability to undertake any physical activity greater than 3 METs is causally related to eligible service. [93] [89]
Malignant neoplasm of the breast - Nulliparous to age 30 years or over Factor
Last reviewed for CCPS 05 October 2006.
Investigative Documents
Medical Report - Being Nulliparous - Malignant Neoplasm of the Breast [MR9040] Preliminary questions [23817]
1169 — the veteran is a woman. [31] the veteran was at least 30 years of age at the time of the clinical onset of malignant neoplasm of the breast. the veteran was nulliparous at the time of the clinical onset of malignant neoplasm of the breast. the veteran was nulliparous at the time of the clinical onset of malignant neoplasm of the breast because of an illness or injury which is identifiable. [98]
23819 — the veteran has established the causal connection between being nulliparous until age 30 and VEA service for the clinical onset of malignant neoplasm of the breast.
23820 — the veteran has established the causal connection between being nulliparous until age 30 and operational service for the clinical onset of malignant neoplasm of the breast.
or
23821 — the veteran has established the causal connection between being nulliparous until age 30 and eligible service for the clinical onset of malignant neoplasm of the breast.
Clinical onset and operational service [23820]
8870 — the identified illness or injury which caused the veteran to be nulliparous is causally related to operational service. [99] [100]
Clinical onset and eligible service [23821]
14101 — the identified illness or injury which caused the veteran to be nulliparous is causally related to eligible service. [101] [100]
Malignant neoplasm of the breast - Obesity Factor
Last reviewed for CCPS 05 October 2006.
Investigative Documents
Claimant Report - Obesity [CR9230] [102] Medical Report - Obesity [MR9305] Preliminary questions [8803]
587 [103] the veteran has a history of obesity. 36457 — the veteran satisfies the gender-specific requirements relating to obesity for malignant neoplasm of the breast. or 8909 — the veteran has established the causal connection between the obesity and VEA service for the clinical onset of malignant neoplasm of the breast. 8910 — the veteran has established the causal connection between the obesity and operational service for the clinical onset of malignant neoplasm of the breast. or 8911 — the veteran has established the causal connection between the obesity and eligible service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [8910] 36463 — the veteran satisfies the gender-specific requirements relating to obesity and operational service for malignant neoplasm of the breast. 1168 — the veteran is a man. [107] [108] or or
36461 [114] the veteran was morbidly obese for a period of at least three years, within the ten years before the clinical onset of malignant neoplasm of the breast.
36465 — the veteran satisfies the gender-specific requirements relating to morbid obesity and operational service for malignant neoplasm of the breast.
or
36469 [115] where the veteran was morbidly obese for a period of at least three years, within the ten years before the clinical onset of malignant neoplasm of the breast, the veteran was postmenopausal throughout that three year period.
9005 — the morbid obesity is causally related to operational service. [116] Clinical onset and eligible service [8911] 36464 — the veteran satisfies the gender-specific requirements relating to obesity and eligible service for malignant neoplasm of the breast. 1168 — the veteran is a man. [119] [108] or or
36462 [123] the veteran was morbidly obese for a period of at least five years, within the ten years before the clinical onset of malignant neoplasm of the breast.
36466 — the veteran satisfies the gender-specific requirements relating to morbid obesity and eligible service for malignant neoplasm of the breast.
or
36470 [124] where the veteran was morbidly obese for a period of at least five years, within the ten years before the clinical onset of malignant neoplasm of the breast, the veteran was postmenopausal throughout that five year period.
9006 — the morbid obesity is causally related to eligible service. [125] [126]
Malignant neoplasm of the breast - Taking oral contraceptives Factor
Last reviewed for CCPS 05 October 2006.
Preliminary questions [23812]
31141 [127] there is some evidence that regularly ingesting a combined oral contraceptive pill may be a factor in the development of the condition under consideration.
1169 — the veteran is a woman. [31] the veteran has ingested a combined oral contraceptive pill at some time. the veteran ingested a combined oral contraceptive pill for a continuous period of at least three years at some time. 23814 — the veteran has established the causal connection between ingesting a combined oral contraceptive pill and VEA service for the clinical onset of malignant neoplasm of the breast. 23815 — the veteran has established the causal connection between ingesting a combined oral contraceptive pill and operational service for the clinical onset of malignant neoplasm of the breast. or 23816 — the veteran has established the causal connection between ingesting a combined oral contraceptive pill and eligible service for the clinical onset of malignant neoplasm of the breast. Clinical onset and operational service [23815] or 10774 — the identified illness or injury which made a material contribution to the ingestion of a combined oral contraceptive pill is causally related to operational service. [133] [134] Clinical onset and eligible service [23816] or
10775 — the identified illness or injury which made a material contribution to the ingestion of a combined oral contraceptive pill is causally related to eligible service. [139] [134]
Links
[1] http://www.rma.gov.au/assets/SOP/2023/a5acf4f5e0/084.pdf
[2] http://www.rma.gov.au/assets/SOP/2023/db8fec7972/085.pdf
[3] https://clik.dva.gov.au/system/files/media/SOP%20Bulletin%20238%20.pdf
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/63750%23comment-form
[5] https://clik.dva.gov.au/ccpsb029rc-15
[6] https://clik.dva.gov.au/ccpsb019rc-1
[7] clikpopup://CCPS/reject8873No
[8] clikpopup://CCPS/reject23829No
[9] clikpopup://CCPS/reject8883,8884No
[10] clikpopup://CCPS/For treatment of illness had TR to chest 10 years before onset of MN breast
[11] clikpopup://CCPS/reject23830No
[12] clikpopup://CCPS/reject8884No
[13] https://clik.dva.gov.au/ccpsclaimant-21
[14] https://clik.dva.gov.au/ccpsmedical-19
[15] https://clik.dva.gov.au/10447-veteran-having-been-prisoner-war-japan
[16] clikpopup://CCPS/reject25686No
[17] clikpopup://CCPS/reject23834No
[18] clikpopup://CCPS/reject25698No
[19] clikpopup://CCPS/rejectwilful
[20] clikpopup://CCPS/reject23835No
[21] clikpopup://CCPS/reject25704No
[22] https://clik.dva.gov.au/ccpsclaimant-240
[23] https://clik.dva.gov.au/8802-atomic-radiation
[24] https://clik.dva.gov.au/reasons-decision-151
[25] clikpopup://CCPS/reject36410No
[26] clikpopup://CCPS/reject36411No
[27] clikpopup://CCPS/reject36413No
[28] clikpopup://CCPS/reject36414No
[29] clikpopup://CCPS/reject36415No
[30] https://clik.dva.gov.au/ccpsb019rc
[31] clikpopup://CCPS/reject1169No
[32] clikpopup://CCPS/Breastfed under 6 months before onset of MN breast
[33] clikpopup://CCPS/reject36439No
[34] clikpopup://CCPS/reject36440No
[35] clikpopup://CCPS/reject36441No
[36] clikpopup://CCPS/reject36446No
[37] clikpopup://CCPS/Breastfeeding under 3 months before onset of MN breast due to El service
[38] clikpopup://CCPS/reject36442No
[39] clikpopup://CCPS/reject36447No
[40] clikpopup://CCPS/reject36446,36447No
[41] https://clik.dva.gov.au/ccpsb019rc-11
[42] clikpopup://CCPS/reject36419No
[43] clikpopup://CCPS/reject36423No
[44] clikpopup://CCPS/reject36425No
[45] clikpopup://CCPS/reject36426No
[46] clikpopup://CCPS/reject36428,36429No
[47] clikpopup://CCPS/Received 0.5 Sievert of diagnostic radiation to the affected breast 10 years before onset of MN breast
[48] clikpopup://CCPS/reject36424No
[49] clikpopup://CCPS/reject36427No
[50] clikpopup://CCPS/reject36429No
[51] https://clik.dva.gov.au/ccpsb019rc-12
[52] clikpopup://CCPS/reject36450No
[53] clikpopup://CCPS/reject36727No
[54] clikpopup://CCPS/reject36455No
[55] clikpopup://CCPS/reject36456No
[56] https://clik.dva.gov.au/ccpsb019rc-16
[57] clikpopup://CCPS/reject36719No
[58] clikpopup://CCPS/reject23826No
[59] clikpopup://CCPS/reject36720No
[60] clikpopup://CCPS/reject25868No
[61] clikpopup://CCPS/reject36431No
[62] clikpopup://CCPS/reject8823,8824No
[63] clikpopup://CCPS/Had HRT for 4 years before onset of MN breast
[64] clikpopup://CCPS/reject23827No
[65] clikpopup://CCPS/reject25869No
[66] clikpopup://CCPS/reject36432No
[67] clikpopup://CCPS/reject8824No
[68] https://clik.dva.gov.au/ccpsother-31
[69] https://clik.dva.gov.au/node/71643
[70] clikpopup://CCPS/Reject/OnsetAfterService
[71] clikpopup://CCPS/Reject/NoPermanentWorsening
[72] clikpopup://CCPS/Breast cancer/ACM - contributed to worsening
[73] clikpopup://CCPS/ACM/NoContribution
[74] clikpopup://CCPS/ACM/NotOpService
[75] clikpopup://CCPS/ACM/NotOperDuties
[76] clikpopup://CCPS/ACM/NoIllness
[77] clikpopup://CCPS/reject7390,7391No
[78] clikpopup://CCPS/Breast cancer/ACM - onset prior to operational service
[79] clikpopup://CCPS/ACM/OnsetFailOper
[80] clikpopup://CCPS/ACM/NotEligService
[81] clikpopup://CCPS/ACM/NotEligDuties
[82] clikpopup://CCPS/Breast cancer/ACM - onset prior to eligible service
[83] clikpopup://CCPS/ACM/OnsetFailElig
[84] https://clik.dva.gov.au/ccpsclaimant-74
[85] https://clik.dva.gov.au/ccpsg006rc-16
[86] clikpopup://CCPS/No strenuous activity for 10 years in 30 years before onset of MN breast
[87] clikpopup://CCPS/reject36475No
[88] clikpopup://CCPS/reject36477No
[89] clikpopup://CCPS/reject33921,33922No
[90] clikpopup://CCPS/No strenuous activity for 20 years in 30 years before onset of MN breast
[91] clikpopup://CCPS/reject36476No
[92] clikpopup://CCPS/reject36478No
[93] clikpopup://CCPS/reject33922No
[94] https://clik.dva.gov.au/ccpsmedical-94
[95] https://clik.dva.gov.au/ccpsb019rc-13
[96] clikpopup://CCPS/reject24019No
[97] clikpopup://CCPS/reject23823No
[98] clikpopup://CCPS/reject23824No
[99] clikpopup://CCPS/reject8870No
[100] clikpopup://CCPS/reject8870,14101No
[101] clikpopup://CCPS/reject14101No
[102] https://clik.dva.gov.au/ccpsclaimant-78
[103] https://clik.dva.gov.au/ccpsb019rc-6
[104] clikpopup://CCPS/reject587No
[105] clikpopup://CCPS/reject36458No
[106] clikpopup://CCPS/reject22382No
[107] clikpopup://CCPS/reject36459No
[108] clikpopup://CCPS/reject1168Yes
[109] clikpopup://CCPS/reject1169Yes
[110] clikpopup://CCPS/Obese and menopausal for 3 years in 10 years before onset of MN breast
[111] clikpopup://CCPS/reject36467No
[112] clikpopup://CCPS/reject591No
[113] clikpopup://CCPS/reject9004No
[114] clikpopup://CCPS/Morbidly obese for 3 years in 10 years before onset of MN breast
[115] clikpopup://CCPS/Morbidly obese and postmenopausal for 3 years in 10 years before onset of MN breast
[116] clikpopup://CCPS/reject9005No
[117] clikpopup://CCPS/Obese for 5 years for MN breast
[118] clikpopup://CCPS/reject22383No
[119] clikpopup://CCPS/reject36460No
[120] clikpopup://CCPS/Obese and menopausal for 5 years in 10 years before onset of MN breast
[121] clikpopup://CCPS/reject36468No
[122] clikpopup://CCPS/reject3407No
[123] clikpopup://CCPS/Morbidly obese for 5 years in 10 years before onset of MN breast
[124] clikpopup://CCPS/Morbidly obese and postmenopausal for 5 years in 10 years before onset of MN breast
[125] clikpopup://CCPS/reject9006No
[126] clikpopup://CCPS/reject9005,9006No
[127] https://clik.dva.gov.au/ccpsj009rc-9
[128] clikpopup://CCPS/reject8844No
[129] clikpopup://CCPS/reject36724No
[130] clikpopup://CCPS/reject36479No
[131] clikpopup://CCPS/reject35528No
[132] clikpopup://CCPS/reject25867No
[133] clikpopup://CCPS/reject36481No
[134] clikpopup://CCPS/reject10774,10775No
[135] clikpopup://CCPS/Ingested COCP for 3 years within 10 years before onset of MN breast
[136] clikpopup://CCPS/reject36480No
[137] clikpopup://CCPS/reject35529No
[138] clikpopup://CCPS/reject36482No
[139] clikpopup://CCPS/reject10775No