Tumor growth and calcification in evolving microenvironmental geometries.

In this paper, we apply the diffuse domain framework developed in Chen and Lowengrub (Tumor growth in complex, evolving microenvironmental geometries: A diffuse domain approach, J. Theor. Biol. 361 (2014) 14-30) to study the effects of a deformable basement membrane (BM) on the growth of a tumor in a confined, ductal geometry, such as ductal carcinoma in situ (DCIS). We use a continuum model of tumor microcalcification and investigate the tumor extent beyond the microcalcification. In order to solve the governing equations efficiently, we develop a stable nonlinear multigrid finite difference method. Two dimensional simulations are performed where the adhesion between tumor cells and the basement membrane is varied. Additional simulations considering the variation of duct radius and membrane stiffness are also conducted. The results demonstrate that enhanced membrane deformability promotes tumor growth and tumor calcification. When the duct radius is small, the cell-BM adhesion is weak or when the membrane is slightly deformed, the mammographic and pathologic tumor extents are linearly correlated, as predicted by Macklin et al. (J. Theor. Biol. 301 (2012) 122-140) using an agent-based model that does not account for the deformability of the basement membrane and the active forces that the membrane imparts on the tumor cells. Interestingly, we predict that when the duct radius is large, there is strong cell-BM adhesion or the membrane is highly deformed, the extents of the mammographic and pathologic tumors are instead quadratically correlated. The simulations can help surgeons to measure DCIS surgical margins while removing less non-cancerous tissue, and can improve targeting of intra- and post-operative radiotherapy.