Abstract: In developed countries，early screening for breast cancer is already part of health services. The screening effect is greatly affected by the screening interval，which is determined by the natural history and tumor growth rate of breast cancer in the target population. In this review，we systematically reviewed the previous global studies on natural history of breast cancer，analyzed the most important parameter of tumor progression，namely，tumor growth rate，and its influencing factors，and summarized that most natural history progression models of breast cancer are multi-phased，usually covering four-phases of non-detectable，pre-clinical，clinical and death，with more potentially associated tumor characteristic parameters incorporated；the growth rate of breast tumor is assessed by pre-clinical sojourn time and doubling time；tumor growth rate is influenced by age，BRCA1/2 gene mutation，family history of breast cancer，other traditional breast cancer risk factors，tumor histopathology features，other clinical information and so on. Understanding the growth pattern of breast cancer and its influencing factors will help to formulate the optimal screening strategy and improve early screening effects. As tumor growth rate is associated with the survival of breast cancer patients，effective assessment of tumor growth will give support to develop new treatment strategies and personalized screening interval.

Key words: Breast neoplasms, Natural history, Growth rate, Sojourn time, Tumor volume doubling time, Review

摘要： 在发达国家，乳腺癌早期筛查已作为卫生服务的一部分。乳腺癌筛查效果受筛查间期的影响较大，筛查间期又取决于目标人群的乳腺癌自然史及肿瘤生长速度。本文系统回顾了国内外有关乳腺癌自然史的研究，并针对肿瘤进展过程中最重要的参数即肿瘤生长速度及其影响因素进行分析，得出目前乳腺癌自然史进展模型多采用不可检测期、临床前期、临床期和死亡及其基础上考量更多肿瘤生长特征、参数构建的多状态模型；乳腺肿瘤生长速度采用临床前期逗留时间和肿瘤体积倍增时间进行评估；乳腺肿瘤生长速度又受年龄、BRCA 1/2基因突变、乳腺癌家族史和其他传统危险因素及肿瘤组织病理学、临床信息等诸多特征的影响。了解乳腺肿瘤的生长模式及其影响因素可为制定最佳的乳腺癌筛查策略、提高早期筛查效果提供参考依据；同时肿瘤的生长速度又影响乳腺癌患者生存情况，有效评估肿瘤增长情况也可为临床开发新的治疗策略及制定个性化筛查间期提供参考依据。

关键词: 乳腺肿瘤, 自然史, 生长速度, 逗留时间, 肿瘤体积倍增时间, 综述