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Breast Cancer: Computer Simulation Method for Estimating Optimal Intervals for Screening¹

¹ From the Departments of Pathology (J.S.M.) and Radiology (E.H., D.B.K.), Harvard Medical School, Boston, Mass, and the Massachusetts General Hospital Cancer Center, 149 13th St, Charlestown, MA 02129 (J.S.M.). From the 1998 RSNA scientific assembly. Received August 7, 1998; revision requested September 8; final revision received December 30; accepted February 9, 1999. Address reprint requests to J.S.M. (e-mail: michaelj@helix.mgh.harvard.edu).

PURPOSE: To develop and evaluate a mathematic method that can be used to determine the optimal screening interval for detection of breast cancer prior to distant metastatic spread.

MATERIALS AND METHODS: A computer simulation was developed with the use of biologically based data from the literature on the rates of tumor growth and spread, which can be used to calculate the course of breast cancer growth and metastasis.

RESULTS: On the basis of the data available at this time, the results of the simulations suggested that a screening interval of 2 years would result in a 22% reduction in the rate of distant metastatic disease, an interval of 1 year would result in a 51% reduction, and an interval of 6 months would result in an 80% reduction.

CONCLUSION: These findings suggest that more frequent screening could dramatically reduce the death rate from breast cancer.

Index terms: Breast neoplasms, 00.32 • Breast neoplasms, metastases, **.33² • Breast radiography, utilization • Cancer screening, 00.11 • Computers, simulation

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