Nottingham Prognostic Index

The Nottingham prognostic index (NPI) is used to determine prognosis following surgery for breast cancer.[1][2] Its value is calculated using three pathological criteria: the size of the tumour; the number of involved lymph nodes; and the grade of the tumour.[1] It is calculated to select patients for adjuvant treatment.

Calculation

The index is calculated using the formula:[3]

NPI = [0.2 x S] + N + G

Where:

  • S is the size of the index lesion in centimetres[3]
  • N is the node status: 0 nodes = 1, 1-3 nodes = 2, >3 nodes = 3[3]
  • G is the grade of tumour: Grade I =1, Grade II =2, Grade III =3[3]

Interpretation
Score 5-year survival[4]
>/=2.0 to </=2.4 93%
>2.4 to </=3.4 85%
>3.4 to </=5.4 70%
>5.4 50%

References
  1. Griffiths, K.; Nicholson, R. I.; Campbell, F. C.; P. J. Doyle; Johnson, J.; Elston, C. W.; Blamey, R. W.; Haybittle, J. L. (1982). "A prognostic index in primary breast cancer". British Journal of Cancer. 45 (3): 361–366. doi:10.1038/bjc.1982.62. ISSN 1532-1827. PMC 2010939. PMID 7073932.
  2. Haybittle, J. L.; Blamey, R. W.; Hinton, C. P.; I. O. Ellis; Elston, C. W.; Williams, M. R.; Dowle, C.; Todd, J. H. (1987). "Confirmation of a prognostic index in primary breast cancer". British Journal of Cancer. 56 (4): 489–492. doi:10.1038/bjc.1987.230. ISSN 1532-1827. PMC 2001834. PMID 3689666.
  3. Lee, Andrew H. S.; Ellis, Ian O. (2008-06-01). "The Nottingham Prognostic Index for Invasive Carcinoma of the Breast". Pathology & Oncology Research. 14 (2): 113–115. doi:10.1007/s12253-008-9067-3. ISSN 1532-2807. PMID 18543079. S2CID 24513251.
  4. Garner, Jeff. (2004). "In the case of breast cancer, how can these be combined to give prognostic information?". Questions for the MRCS vivas. London: Arnold. p. 231. ISBN 0340812923. OCLC 57193230.
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