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. Author manuscript; available in PMC: 2019 Apr 1.

Published in final edited form as: Med Decis Making. 2018 Apr;38(1 Suppl):126S–139S. doi: 10.1177/0272989X17729358

Schematic overview of models for the natural history of DCIS and invasive breast cancer. Invasive cancer can either develop through pre-clinical screening detectable DCIS (Figure 1C), or also develop directly from pre-clinical DCIS not detectable at screening (Figure 1A, 1B and 1D). Models include progression from preclinical screen-detectable DCIS to either clinical DCIS or preclinical invasive disease (Figure 1A, 1B, 1C, 1D), regression from preclinical DCIS to normal tissue (Figure 1D), to pre-clinical undetectable DCIS (Figure 1A), or to a ‘no breast cancer’ (absorbing) state in which women are no longer at risk for developing DCIS or invasive breast cancer (Figure 1B and 1C). Regression from invasive disease is also possible (Figure 1D).

Schematic overview of models for the natural history of DCIS and invasive breast cancer. Invasive cancer can either develop through pre-clinical screening detectable DCIS (Figure 1C), or also develop directly from pre-clinical DCIS not detectable at screening (Figure 1A, 1B and 1D). Models include progression from preclinical screen-detectable DCIS to either clinical DCIS or preclinical invasive disease (Figure 1A, 1B, 1C, 1D), regression from preclinical DCIS to normal tissue (Figure 1D), to pre-clinical undetectable DCIS (Figure 1A), or to a ‘no breast cancer’ (absorbing) state in which women are no longer at risk for developing DCIS or invasive breast cancer (Figure 1B and 1C). Regression from invasive disease is also possible (Figure 1D).