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Differences in the proportion of interval cancers (PIC)\u2014cancers detected symptomatically between scheduled screening rounds\u2014have been observed across subtypes, likely reflecting heterogeneity in tumour growth dynamics. We applied a continuous\u2010growth natural history model to a cohort of 7818 breast cancer patients diagnosed between 2007 and 2020 in Sweden. Using subtype\u2010specific estimates, we quantified the distributions of interval cancers within the 2\u2010year period between screening rounds, differentiating by tumour sizes of missed interval cancers at their last negative screen. Additionally, the fitted model enabled estimation of subtype\u2010specific tumour mean doubling times (MDT) and the average duration from tumour onset to symptomatic diagnosis. Triple\u2010negative breast cancers (TNBC) exhibited the fastest growth (MDT: 126\u2009days), followed by Luminal B\u2010like (203\u2009days) and Luminal A\u2010like (332\u2009days). Corresponding mean asymptomatic times (MAT) were 4.5, 7.6, and 11.8\u2009years, respectively. Observed PICs among regular attenders were 48.9% (TNBC), 32.3% (Luminal B\u2010like), and 22.0% (Luminal A\u2010like), closely aligning with model\u2010based expectations. Approximately 17% of TNBC interval cancers were estimated to have had diameters \u2264\u20091\u2009mm at the last negative screen, versus 13% for Luminal B\u2010like and 8% for Luminal A\u2010like tumours. Our model integrates tumour growth into the detection processes to estimate subtype\u2010specific tumour dynamics and their impact on the PIC. The results support the hypothesis that higher PICs in more aggressive subtypes are driven by faster tumour growth and shorter asymptomatic periods. Our results may inform screening strategies tailored to patients' risk.<\/jats:p>","DOI":"10.1002\/ijc.70721","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:20:24Z","timestamp":1787977224000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimation of Subtype\u2010Specific Tumour Growth Rate Distributions and Interval Cancer Proportions in Breast Cancer Using Biology\u2010Inspired Natural History Models"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6075-6668","authenticated-orcid":false,"given":"Letizia","family":"Orsini","sequence":"first","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Swedish e\u2010Science Research Centre Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3656-5383","authenticated-orcid":false,"given":"Yuqi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3233-5695","authenticated-orcid":false,"given":"Kamila","family":"Czene","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-8252","authenticated-orcid":false,"given":"Keith","family":"Humphreys","sequence":"additional","affiliation":[{"name":"Department of Medical Epidemiology and Biostatistics Karolinska Institutet  Stockholm Sweden"},{"name":"Swedish e\u2010Science Research Centre Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Breast Cancer","author":"Orrantia\u2010Borunda E.","year":"2022"},{"issue":"3","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.5306\/wjco.v5.i3.412","article-title":"Biological Subtypes of Breast Cancer: Prognostic and Therapeutic Implications","volume":"5","author":"Yersal O.","year":"2014","journal-title":"World journal of clinical oncology"},{"issue":"2","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.annonc.2023.11.016","article-title":"Early Breast Cancer: Esmo Clinical Practice Guideline for Diagnosis, Treatment and Follow\u2010Up","volume":"35","author":"Loibl S.","year":"2024","journal-title":"Annals of Oncology"},{"issue":"3","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s10549-018-4796-9","article-title":"The Relationship Between Tumour Size, Nodal Status and Distant Metastases: On the Origins of Breast Cancer","volume":"170","author":"Sopik V.","year":"2018","journal-title":"Breast Cancer Research and Treatment"},{"issue":"1","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S1076-6332(97)80154-7","article-title":"Detection of Breast Cancer at a Smaller Size Can Reduce the Likelihood of Metastatic Spread: A Quantitative Analysis","volume":"4","author":"Sivaramakrishna R.","year":"1997","journal-title":"Academic Radiology"},{"issue":"21","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"5095","DOI":"10.1002\/cncr.24592","article-title":"How Cancer at the Primary Site and in the Lymph Nodes Contributes to the Risk of Cancer Death","volume":"115","author":"Michaelson J. 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