Abstract
Breast cancer is a disease in which abnormal cells in the breast tissue grow out of control to form tumors and can spread to other parts of the body. While it can affect both men and women, it poses a greater risk to women, and it is a leading cause of cancer-related deaths worldwide. This study aimed to examine different mammography screening interval strategies using a body mass index (BMI)-dependent tumor growth model and a simulation approach. The goal was to identify the optimal screening strategy for various BMI levels by investigating the association between BMI and tumor growth rate, and further examine the relationship between BMI and screening outcomes, using a continuous growth model and Cox regression, respectively. Our results indicated that a biennial screening interval yielded the best outcomes for all BMI levels compared to annual and triennial strategies. Obese individuals may require higher screening sensitivity and are likely to benefit from shorter screening intervals than those with other body weights within the screening age range of 30 to 65 years. Additionally, obese individuals have a slightly higher risk of being diagnosed with interval-detected cancers rather than screen-detected cancers. In contrast, women with a normal body weight have a greater chance of being detected through screening rather than at intervals. These findings suggest that breast cancers may become symptomatic more quickly in obese individuals than in those with lower body weights. Consequently, the standard two-year screening interval may not be optimal for this group, indicating that more frequent screenings (14-18 months) could be necessary. This underscores the potential impact of improved screening practices to enhance the treatment and management of breast cancer.