Nottingham Prognostic Index
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The Nottingham prognostic index (NPI) is used to determine prognosis following surgery for breast cancer. 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. It is calculated to select patients for adjuvant treatment.
Calculation
The index is calculated using the formula:
- NPI = [0.2 x S] + N + G
Where:
- S is the size of the index lesion in centimetres
- N is the node status: 0 nodes = 1, 1-3 nodes = 2, >3 nodes = 3
- G is the grade of tumour: Grade I =1, Grade II =2, Grade III =3
Interpretation
| Score | 5-year survival |
|---|---|
| >/=2.0 to </=2.4 | 93% |
| >2.4 to </=3.4 | 85% |
| >3.4 to </=5.4 | 70% |
| >5.4 | 50% |