Background/Objectives: Fibroepithelial tumors (FETs) of the breast, including fibroadenomas (FAs) and phyllodes tumors (PTs), are among the most common breast masses encountered by breast radiologists and pathologists. Differentiating FAs from benign or borderline PTs can be challenging, especially on core biopsy specimens where sampling limitations obscure key histologic features. Although imaging techniques provide useful diagnostic context, their predictive accuracy for pathologic classification remains limited. Methods: We conducted a single-institution pilot study to assess whether tumor growth rate (TGR) derived from serial imaging could serve as a noninvasive correlate of histopathologic outcomes in FETs. Thirty-two patients with serial imaging and subsequent surgical excision (January 2020–May 2025) were analyzed. TGR, expressed as percentage volume increase per month, was calculated from diameter-based volumetrics. Results: The cohort included conventional FA (n= 10), cellular FA (n= 4), benign PT (n= 8), borderline PT (n= 6), and malignant PT (n= 4). Malignant PTs demonstrated significantly higher median TGRs (180.4%/month) and shorter imaging intervals (1.1 months) compared with other groups (p= 0.0357 andp= 0.005, respectively). These large effect-size differences suggest clinically meaningful growth dynamics. Conclusions: As a pilot, this study establishes foundational variance and effect-size estimates for powering a multicenter trial. If validated, TGR may provide an objective, noninvasive metric to enhance preoperative risk stratification and guide management of breast FETs.
背景/目的：乳腺纤维上皮性肿瘤（FETs）包括纤维腺瘤（FAs）和叶状肿瘤（PTs），是乳腺影像科医师和病理科医师最常见的乳腺肿块类型。区分纤维腺瘤与良性或交界性叶状肿瘤具有挑战性，尤其在空心针活检标本中，采样限制常掩盖关键组织学特征。尽管影像学技术能提供有价值的诊断背景，但其对病理分类的预测准确性仍有限。方法：我们开展了一项单机构试点研究，评估连续影像学衍生的肿瘤生长率（TGR）是否可作为FETs组织病理学结果的无创性关联指标。分析了32例具有连续影像学资料并后续接受手术切除的患者（2020年1月至2025年5月）。基于直径的体积测量计算出TGR，以每月体积增长百分比表示。结果：队列包括普通型FA（10例）、细胞型FA（4例）、良性PT（8例）、交界性PT（6例）和恶性PT（4例）。与其他组别相比，恶性PT表现出显著更高的中位TGR（180.4%/月）和更短的影像学随访间隔（1.1个月）（p值分别为0.0357和0.005）。这些较大效应量的差异提示了具有临床意义的生长动力学特征。结论：作为试点研究，本研究为开展多中心试验提供了基础变异度和效应量估计。若经验证，TGR可能成为一种客观、无创的指标，用于加强乳腺纤维上皮性肿瘤的术前风险分层并指导临床管理。
肿瘤(癌症)患者之家