Using Simulation Modeling to Inform Strategies to Reduce Breast Cancer Mortality in Black Women in the District of Columbia

Table 2

Comparison of all model runs under base case. *Dissemination screening and treatment from 1975 to 2010 and then new screening/treatment scenario from 2011 onward.

	Absolute numbers for each screening/treatment scenario					Potential benefits (versus actual screening & treatment)		Potential harms (versus actual screening & treatment)
Screening scenario^*	Number of mammograms per 100,000 Women	Number of breast cancers per 100,000 women		Breast cancer deaths per 100,000 women	False positives per 100,000 women	Cancer deaths averted per 100,000 Women	Percent mortality reduction	False positives per 100,000 women	Number of mammograms per death averted
		DCIS	Invasive
A. Actual screening & actual treatment^a	24,350	66	224	49	2,885
B. 100% annual 40–79 & actual treatment^b	60,060	83	209	43	7,321	7	13.8	4,436	5,213.7
C. Actual screening & 100% treatment	24,350	66	225	42	2,886	8	15.3
D. 100% annual 40–79 & 100% treatment	60,050	84	209	35	7,330	14	28.8	4,445	2,506.2
E. 100% biennial 40–79 & actual treatment^c	29,530	73	212	45	3,630	5	9.5	745	1,100.3
F. 100% biennial 40–79 & 100% treatment	29,520	72	212	39	3,634	10	20.9	748	499.8
G. 100% annual 50–79 & actual treatment^d	42,500	78	215	46	4,840	4	7.8	1,955	4,683.2
H. 100% annual 50–79 & 100% treatment	42,490	77	215	38	4,848	11	22.8	1,963	1,607.0
I. 100% biennial 50–79 & actual treatment	21,680	70	218	47	2,488	2	4.0	−397^†	−1,350.3^†
J. 100% biennial 50–79 & 100% treatment	21,670	70	218	40	2,487	9	19.1	−398^†	−284.1^†

^a Row A presents the results assuming current screening and treatment patterns continue.
^b Comparing Row B and Row A shows the added benefits and harms of increasing screening from actual rates to annual for all women aged 40–79. Comparing Row C to Row A shows the added benefits and harms of improving treatment from actual rates but keeping screening at current patterns.
^c Rows E and F demonstrate the impact of biennial rather than annual screening.
^d Rows G–J demonstrate the impact of starting screening at age 50 rather than 40.
^† Negative number denotes fewer false positives/mammograms per death averted than actual screening and treatment.