Veterans Don’t Get a Breast Cancer “Pass”

By Donna Reuss

Alexandria, VA – Breast cancer (BC) doesn’t give a “pass” to those in uniform or the veterans who put our lives on the line to serve our country. We actually may be more susceptible to cancers in general based on the toxic situations experienced during our military service. Determining any correlation, though, remains a complex issue.

The effects of military environmental exposures (MEE) on military servicemembers are the focus of The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022. Toxins may include volatile organic compounds, endocrine-disrupting chemicals, tactile herbicides, airborne hazards, and burn pits, even depleted uranium. The Act provides for presumptive conditions which allow veterans to receive care for ongoing health concerns of unknown causation but presumed to be related to exposure to any of these toxins. Breast cancer is a presumptive condition under the Act.

Researchers are investigating the relationship between MEE and the risk of BC, but results of studies so far are mixed and limited. In the meantime, The Dr. Kate Hendricks Thomas Supporting Expanded Review for Veterans In Combat Environments (SERVICE) Act, signed into law on June 7, 2022, expands toxic-exposure eligibility to ensure that veterans deployed in specified locations during defined periods are eligible for BC risk assessment and mammogram.

In addition to the intricacies of exposure classification, part of the problem in determining any relational epidemiologic trends is the need for long-term follow-up. Most BC cases occur in women over 50. The 2023 Office of Women’s Health – State of Reproductive Health governmental report found that abnormal breast conditions were reported as one of the top five reproductive and sexual health concerns for women veterans aged 45+. Servicemembers from post-9/11 conflicts simply may not be in this age group yet.

Another sampling factor may be what is called the Healthy Soldier Paradox, the premise that healthier personnel may be chosen for deployment or more dangerous duties over less fit personnel. Such a bias could lead to inaccurate conclusions between deployment and health outcomes.

The 2024 Department of Defense report to Congress on a cohort study of BC incidence among active-duty servicemembers (ADSM) from 2011 to 2022 found that information on BC rates varies depending on the methods used to obtain it. While stating that BC remains the most common form of cancer among ADSM, “research…does not demonstrate that ADSM who deploy are at greater risk than those who do not deploy.” This study was conducted prior to passing of the PACT Act. Increased and more rigorous research on the effects of MEE may net a different conclusion in the future.

And let’s not forget that men can get BC too. While less than 1% in the general population, BC in men is deadlier than in women. Military men with BC tend to present at a more advanced stage and with a larger tumor size than military women. Continued research on MEE effects will need to look at any increase in BC incidence rate among male servicemembers as well.

Women are the fastest-growing population within the military, and nearly 15% of the veteran population. While the Department of Veterans Affairs (VA) has increased its support for Gulf War and post-9/11 veterans, the substantial increase in the number of women military members and veterans over the past few decades points to the continued need for more research and resources for women, and more clinical and educational efforts on women’s unique health issues.

If you are a veteran, veteran’s family member, or know a veteran who needs help, go to Virginia Board Veterans Services at About DVS | Virginia Department of Veterans Services; contact American Legion Post 24 Veteran Service Officer at [email protected]; or check out the Resources List on the Post 24 website at valegionpost24.com. For crisis intervention and suicide prevention services, dial 988 and Press 1, or text 838255, for the Veterans Crisis Line.

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