Diagnostic Code 7626 · 38 CFR §4.116
DC 7626 covers the surgical treatment of breast conditions, primarily mastectomy and lumpectomy procedures. This code rates the residual effects of the surgery itself rather than the underlying disease (breast cancer is separately rated at 100 percent under DC 7630 during active treatment). The ratings vary based on the type and extent of surgery performed and whether one or both breasts were affected. Radical mastectomy (removing the breast, chest wall muscles, and lymph nodes) receives the highest ratings, while wide local excision without significant tissue loss may receive a zero percent rating.
| Rating | Criteria |
|---|---|
| 80% | Radical mastectomy of both breasts. Radical mastectomy means removal of the entire breast, underlying pectoral muscles, and regional lymph nodes. |
| 60% | Modified radical mastectomy of both breasts. Modified radical mastectomy means removal of the entire breast and axillary lymph nodes with preservation of the pectoral muscles. |
| 50% | Radical mastectomy of one breast, OR simple mastectomy or wide local excision with significant alteration of size or form of both breasts. |
| 40% | Modified radical mastectomy of one breast. |
| 30% | Simple mastectomy or wide local excision with significant alteration of size or form of one breast. |
| 0% | Wide local excision without significant alteration of size or form of one or both breasts. |
Surgical reports detailing the type and extent of surgery are the primary evidence. The operative report should clearly state whether a radical mastectomy, modified radical mastectomy, simple mastectomy, or wide local excision was performed. Pathology reports and post-surgical records document the outcome. For service connection, evidence of qualifying exposure (radiation, chemical exposure, Camp Lejeune service) or other service-related cause is needed. Post-treatment records showing ongoing effects like lymphedema, neuropathy from surgery, or restricted range of motion support secondary claims.
DC 7630 covers active breast cancer (malignant neoplasms of the breast) and provides a 100 percent rating during treatment. DC 7626 rates the surgical residuals after cancer treatment ends. After the six-month post-treatment period, the VA evaluates the lasting effects of surgery under DC 7626 based on the type and extent of the procedure.
Yes. While much less common, male breast cancer and breast surgery are rated using the same criteria. The same service connection pathways apply regardless of gender.
This is a clinical determination made by the examiner. Generally, if a lumpectomy or wide local excision removed enough tissue that the breast is noticeably different in size or shape compared to before surgery, that qualifies as significant alteration. This distinction matters because it determines whether you receive a 30 percent rating or a 0 percent rating for a unilateral procedure.