Randomized controlled trials have shown that mammographic screening reduces breast cancers death, but it remains to be established how to use screening to its maximal life-sparing effect, particularly as regards the optimal screening interval. Over the last several years, my colleagues and I have assembled data on the rates of breast cancer growth and spread as well as on the limits of mammographic detectability. We have also developed of a computer simulation model of breast cancer growth and spread, which can calculate such things as the relationship between the screening interval and the fraction of women likely to die from breast cancer. The results of these studies have indicated that great reductions in breast cancer death should be achievable by prompt compliance with the annual screening recommendation, and that even greater numbers of lives might be saved by screening more frequently than once a year. However, from the analysis of the patterns of utilization among women who use screening, it is clear that full utilization of screening in very incomplete, and this provides a barrier to the realization of the full life-sparing potential of screening mammography.

Ongoing research concerns the collection of data for improved estimates of breast cancer growth, spread, and operational detectability, as well as data on the operational aspects of breast cancer screening. Particular interest concerns what determines whether a woman will return (or fail to return) for screening, as well as development of tools, such as computer driven automated telephony reminder systems, which can improve the utilization of screening.

If you would like additional information on this research project, please contact:
James S. Michaelson, PhD at 617-724-3868