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.
Mentioned in ?
References in periodicals archive ?
These tools include Nottingham prognostic index (NPI) and Adjuvant
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.
Additionally, researchers found that the RS can provide UK physicians and patients with additional prognostic information beyond that currently provided by the Nottingham Prognostic Index (NPI), the current decision aid frequently used to make adjuvant breast cancer treatment decisions in the region.
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

Full browser ?