Breast Magnetic Resonance Imaging (MRI)
Covered by TRICARE? | Limits |
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Yes
| When and how often depends on your age and cancer risk
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TRICARE covers an annual breast MRI screening beginning at age 30, for women who have a 20% 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:
- Women with a known BRCA1 or BRCA2 gene mutation
- Women with a first degree relative (parent, child, sibling) with a BRCA1 or BRCA2 mutation, and have not had genetic testing themselves
- History of radiation therapy to the chest between the ages of 10 and 30
- History of LiFraumeni, Cowden, or hereditary diffuse gastric cancer syndrome, or first-degree relative with a history of one of these syndromes
TRICARE may cover Breast MRI for the following indications:
- Detection of breast implant rupture if the implants were covered by TRICARE
- Occult breast cancer with a negative physical exam and negative mammography
- Presurgical planning for locally advanced breast cancer, before and after completion of noeadjuvant chemotherapy
- Evaluation of suspected cancer recurrence
- Detection of muscle or chest wall invasion in patients with posteriorly located tumor
- Guidance for procedures such as vacuum assisted biopsy or preoperative wire localization of lesions
(Other indications may be covered if your provider or regional contractor determines them to be medically necessary and appropriate.)
TRICARE doesn't cover Breast MRI for:
- Screening of women considered to be at low or average risk for developing breast cancer
- Diagnosis of lesions to avoid biopsy
- To evaluate response to neoadjuvant chemotherapy
- To differentiate cysts from solid lesions
See Breast Exams.