Background: Models of cancer growth have been developed that predict tumor size and growth dynamics for invasive tumors. However, it has been difficult to model ductal carcinoma in situ (DCIS) because of the constraints introduced by its containment within the duct system.
Materials and Methods: We have developed a spherical model of growth of solid type DCIS using chemical engineering models of reaction and diffusion in porous media to represent the spread of DCIS in the duct systems. The model predicts tumor diameter based on four input parameters: the ratio of the apoptosis rate to the proliferation rate (A), the diffusion penetration length for nutrient to sustain the tumor growth (L), the volume fraction that tumor cells occupied within the involved breast tissue (V), and the time taken for a cell to complete mitosis(T). We have estimated L, V, and T from the literature, and then back-calcuated A for a range of diameters. We have used these four parameters as inputs and studied the time dependence of the evolution of DCIS.
Results: We have found that the range of the values of A that we determined are within an adeqaute physiological range based on rates of proliferation and apoptosis taken from the literature. Using the model, the time to reach at least 95% of the maximum size ranges from less than 30 days for DCIS measuring 0.5 cm to almost 80 days for DCIS measuring 6 cm in diameter.
Discussion: There has been little understanding of how long it takes for DCIS to grow, and whether it reaches a steady state size. Our simulations show that DCIS can grow to sizes as large as 6 cm in less than 3 months if it has the correct properties, including a high proliferation rate relative to the apoptosis rate and appropriate access to nutrients. This finding may help to explain why many cases of DCIS are not diagnosed before they progress to invasive carcinoma.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1165.
- ©2009 American Association for Cancer Research.