Nottingham Prognostic Index

Nottingham Prognostic Index

A histopathological system for predicting the prognosis for a particular patient with breast cancer, based on three parameters found to have the greatest value in predicting invasive tumour behaviour:
(1) Tumour size in cm;
(2) Lymph node stage: 1 = node negative; 2 = 1 to 3 positive nodes; 3 = 4+ positive nodes, or apical node, or any positive axillary node plus internal mammary node;
(3) Histological grade based on tubule/acinar/glandular formation, nuclear atypia/pleomorphism and frequency of mitoses, with each accorded a grade of 1 to 3.

The NPI is based on a formula, NPI = 0.2 X tumour size + lymph node stage (1, 2 or 3) + histologic grade (1, 2 or 3), where the higher the NPI score the worse the prognosis. Patients with an NPI score of ≤ 3.0 have an equivalent survival to age-matched controls (3% annual mortality). Patients with an NPI score of ≤ 3.4 have a good prognosis. Women with an NPI of ≥ 5.4 have a poor prognosis, and may be advised to undergo more aggressive adjuvant therapy. Choice of adjuvant treatment for patients with an NPI score between 3.4 and 5.4 depends on other variables—e.g., hormone receptor status and the patient’s general health.
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Breast carcinoma grading, estimation of tumor size, axillary lymph node status, staging and Nottingham Prognostic Index scoring on mastectomy specimens.
The Nottingham prognostic index considers tumor size, lymph node metastasis, and tumor grade to obtain an estimate of recurrence riskin patients with breast cancer [28, 29].
Ferrarese, "Prognostic factors in breast cancer: the predictive value of the Nottingham Prognostic Index in patients with a long-term follow-up that were treated in a single institution," European Journal of Cancer, vol.
The study also found that the existing Nottingham Prognostic Index for breast cancer can be improved by including low mammographic breast density and HER2 status in the index.
She was staged as T1 N3a Mx and the tumour had a Nottingham Prognostic Index of 5.32.
These tools include Nottingham prognostic index (NPI) and Adjuvant!
The Nottingham Prognostic Index (NPI) was calculated online using the following formula (http://primed.info/finprog/npi_expl.asp): [12]
Histological grade forms part of the multifactorial Nottingham prognostic index, together with tumour size and lymph node stage and used to stratify individual patients for appropriate therapy [4].
A number of prognostic schemes have been devised, the most notable of which is the Nottingham Prognostic Index. (48-58)
Similar findings were observed in the study of Zubair Ahmad et al, 200915 who studied 120 cases of invasive breast carcinoma to acquire the information about the extent and spread of breast carcinoma by grading the tumors (based on modified Bloom and Richardson grading system), determining the tumor size & axillary lymph node status, tumor staging and Nottingham prognostic index (NPI) scoring.
Multiparametric tools have been developed to improve the predictive value of the above individual factors; these include TNM staging, Nottingham prognostic index (NPI) and Adjuvant!

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