Healthcare professionals must make breast cancer screening decisions without the help of clear answers in current medical knowledge. This study used computer simulation to evaluate two screening protocols. The American Cancer Society (ACS) protocol comprising self-breast examination, professional breast examination and annual mammography was evaluated versus annual mammography alone. The effective frequency of mammography and the cost in the ACS protocol doubles the cost of mammography alone. Breast self-examination and clinical breast examination contributes to increased cost without any added health effects. These study results could be applied by healthcare professionals to assist their decision making for breast cancer screening.