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The Nottingham Prognostic Index for Invasive Carcinoma of the Breast

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  • Published:
Pathology & Oncology Research

Abstract

A useful prognostic factor in breast cancer has key roles, including identification of a group of patients whose prognosis is so good they do not require further treatment, such as adjuvant systemic therapy, after local surgery, and secondly a group with a poor prognosis for whom additional treatment would be appropriate. To be of clinical use, prognostic factors must show a wide separation in the outcome of the groups identified and select adequate numbers in each group. No single prognostic factor in invasive carcinoma of the breast satisfies all these criteria. However, the Nottingham prognostic index (NPI), which combines nodal status, tumour size and histological grade, does satisfy these criteria. The NPI has been validated by further studies in Nottingham and by studies in several other countries. Predictive factors, such as oestrogen receptor and HER-2 status, predict whether a tumour is likely to respond to a treatment, and are complimentary to prognostic factors. The NPI can be used in combination with predictive factors to select patients for systemic adjuvant treatments. There is the potential to improve the NPI by inclusion of other factors, such as vascular invasion, but any such alterations would require further validation.

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Abbreviations

NPI:

Nottingham Prognostic Index

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Acknowledgement

We thank the European Journal of Cancer for permission to reproduce the data shown in Table 1 from reference 12.

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Authors and Affiliations

  1. Department of Histopathology, Nottingham University Hospitals, City Hospital Campus, Nottingham, NG5 1PB, UK

    Andrew H. S. Lee & Ian O. Ellis

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  1. Andrew H. S. Lee
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  2. Ian O. Ellis
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Correspondence to Andrew H. S. Lee.

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Lee, A.H.S., Ellis, I.O. The Nottingham Prognostic Index for Invasive Carcinoma of the Breast. Pathol. Oncol. Res. 14, 113–115 (2008). https://doi.org/10.1007/s12253-008-9067-3

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