The growth law of primary breast cancer as inferred from mammography screening trials data

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Abstract
Despite considerable progress in understanding tumour development, the law of growth for human tumours is still a matter of some dispute. In this study, we used large-scale mammography screening trial data to deduce the growth law of primary breast cancer. We compared the empirical tumour population size distributions of primary breast cancer inferred from these data to the distributions that correspond to various possible theoretical growth functions. From this, we showed that the data are inconsistent with the exponential, logistic and Gompertz laws, but support power law growth (exponent approximately 0.5). This law indicates unbounded growth but with slowing mass-specific growth rate and doubling time. In the clinical size ranges, it implies a greater decline in the mass-specific growth rate than would be predicted by the Gompertz law using the accepted parameters. This suggests that large tumours would be less sensitive to cycle-specific therapies, and be better treated first by non-cell cycle-specific agents. We discussed the use of our study to estimate the sensitivity of mammography for the detection of small tumours. For example, we estimated that mammography is about 30% less sensitive in the detection of tumours in the 1 to 1.5-cm range than it is in detecting larger tumours.