General Considerations

• Claims for fibrocystic breast disease are not routinely awarded. Although this condition is termed a disease, it is a physiologic finding that is generally acute and transient. In the absence of associated pathology, service connection is not warranted. Additionally, fibrocystic breasts are not associated with increased risk of breast cancer unless the changes are associated with atypical hyperplasia.
• Claims for cervical dysplasia, also referred to as cervical intraepithelial neoplasia (CIN), is not a disease or injury. It is a cellular abnormality of the cervix revealed by papanicolaou (Pap) smear testing that generally resolves without treatment or residuals. In these cases, there is an abnormal laboratory finding but no disability, and service connection is not warranted. Service connection may be warranted if cervical dysplasia/CIN:
  • requires treatment that leaves residuals, or
  • is linked to the subsequent development of cervical cancer.
• Claims for service connection for human papilloma virus (HPV) infections usually, are asymptomatic and identified only as a finding on a pap smear. Most resolve spontaneously without residuals requiring only periodic pap smears for follow-up. In these cases, there is an abnormal laboratory finding but no disability, and service connection is not warranted. Service connection may be warranted if a disability develops as a result of an in-service HPV infection. Two circumstances that may warrant service connection are:
  • genital warts that are shown in service or by nexus to be associated with the HPV infection, and
  • HPV resulting in persistent infection that progress to cervical dysplasia and subsequently to cervical cancer.

Important: A medical nexus is required to establish an association between genital warts and in-service HPV infection or cervical cancer and in-service HPV infection.

There are multiple varieties of HPV infection which can cause common warts, plantar warts, and other findings. HPV is not limited to sexual transmission

Notes

• Natural menopause, primary amenorrhea, and pregnancy and childbirth are not disabilities for rating purposes. Chronic residuals of medical or surgical complications of pregnancy may be disabilities for rating purposes. 38 CFR §4.116 [Schedule of ratings - gynecological conditions and disorders of the breast].
• When evaluating any claim involving loss or loss of use of one or more creative organs, refer to §3.350 of this chapter to determine whether the veteran may be entitled to special monthly compensation. Footnotes in the schedule indicate conditions which potentially establish entitlement to special monthly compensation; however, almost any condition in this section might, under certain circumstances, establish entitlement to special monthly compensation. 38 CFR §4.116 [Schedule of ratings - gynecological conditions and disorders of the breast].

Problematic Issues

• Antineoplastic Agents (Chemotherapy)
• Hormone Replacement Therapy (HRT)