Breast cancer is being reviewed more favorably, and the outlook is good if the disease is localized or limited to breast tissue and adjacent lymph nodes only. Evidence of tumor spread reduces the likelihood of certification.
The FAA now allows for an office issuance of any class of medical under the CACI (Conditions AMEs Can Issue) policy, based upon whether the cancer was metastatic and how the tumor was staged. Breast carcinoma is graded by staging on a scale of 0-4, with 0 being a non-invasive tumor and 4 indicating tumor that has spread (metastasized) beyond the breast tissue. Breast tumors may also be characterized by other designations: T, N, or M.
"T" indicates tumor size and may be indicated by a range from Tx, tumor not present or can't be found, up to about T4, indicating a large tumor. "N" identifies the amount of lymph node involvement, where NX shows no lymph nodes involved and N1-3 indicates a higher number of identified positive nodes. Finally, the "M" grades the amount of metastasis from the primary tumor site.
The extent of lymph node involvement will affect the outcome of review and the frequency of required follow-up intervals. If tumor is found in any lymph nodes, certification will require a brain MRI at the time of the initial application, and annually for continued recertification. An MRI is usually not required if the cancer was confined to the breast tissue only.
If the tumor involves distant metastasis, the FAA may require an extended observation period before certification can be considered.
Updated January, 2018