Figure 1

Markov model for annual breast cancer screening with MRI and Mammography. Women begin in the Markov stages “MRI screen” or “Mammography” and alternate every 6 months (in the mammography alone arm, the “MRI screen” state is replaced with a 6-month interval with no screen). Women with positive screening results move through the right side of the model; those with no cancer (false positives) return to screening, while cancer cases continue to treatment, by stage at diagnosis. Women with cancer whose screening results are negative (false negatives) are screened once more; if their cancer remains undetected they are classified as having non-screen-detected cancers, and proceed through treatment.