A unifying framework for continuous tumour growth modelling of breast cancer screening data.

The aim of the current article is to present theory that can help unify continuous growth approaches for modelling breast cancer tumour growth based on human data. We present a framework that has three main features: a general likelihood function to account for patient specific screening regiments; stable disease assumptions describing tumour population dynamics; and mathematical models describing tumour growth, individual variation in tumour growth, a hazard for symptomatic detection, and screening test sensitivity. The framework is able to incorporate any random effects distributions for the tumour growth rate parameter, any hazard functions for symptomatic tumour detection, as well as any monotonously increasing function for the tumour growth model. Based on a sample of 1902 incident breast cancer cases with data on mammography screening, we show how the framework can be used to estimate tumour growth based on different growth functions.