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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.
The grading of a cancer in the breast depends on the microscopic similarity of breast cancer cells to normal breast tissue, and classifies the cancer as well differentiated (low-grade), moderately differentiated (intermediate-grade), and poorly differentiated (high-grade), reflecting progressively less normal appearing cells that have a ...
Grading in cancer is distinguished from staging, which is a measure of the extent to which the cancer has spread. Pathology grading systems classify the microscopic cell appearance abnormality and deviations in their rate of growth with the goal of predicting developments at tissue level (see also the 4 major histological changes in dysplasia ).
Tumor grading was based on the Nottingham system, also termed the Elston and Ellis modification, which scores the tumor cells' tubule formation, nuclear pleomorphism, and mitotic counts (see Nottingham system for grading breast cancer tumors). A higher grade tumor is more likely to have a poorer prognosis than a lower grade tumor. The patients ...
Staging breast cancer is the initial step to help physicians determine the most appropriate course of treatment. As of 2016, guidelines incorporated biologic factors, such as tumor grade, cellular proliferation rate, estrogen and progesterone receptor expression, human epidermal growth factor 2 (HER2) expression, and gene expression profiling into the staging system.
The US Preventive Services Task Force (USPTF) has issued new breast cancer screening guidelines for 2024, including suggesting mammograms start earlier.
G (1–4): the grade of the cancer cells (i.e. they are "low grade" if they appear similar to normal cells, and "high grade" if they appear poorly differentiated) S (0–3): elevation of serum tumor markers; R (0–2): the completeness of the operation (resection-boundaries free of cancer cells or not) Pn (0–1): invasion into adjunct nerves
The system is designed to standardize reporting and is used by medical professionals to communicate a patient's risk of developing breast cancer, particularly for patients with dense breast tissue. The document focuses on patient reports used by medical professionals, not "lay reports" that are provided to patients.