Nottingham Prognostic Index (NPI) Calculator

Calculates the Nottingham Prognostic Index (NPI) for breast cancer using tumor size, lymph node status, and grade. The NPI provides prognostic stratification based on historical outcome data.

Significance of NPI: The Nottingham Prognostic Index (NPI) is a validated tool for stratifying breast cancer prognosis based on tumor size, lymph node status, and histologic grade. The table below shows the prognostic value of NPI in two time periods: 1980–1986 (no adjuvant systemic treatment) and 1990–1999 (systemic adjuvant treatment given).

Group NPI 1980–1986* 1990–1999**
Proportion (%) 10-year survival (%) Proportion (%) 10-year survival (%)
Excellent 2.02–2.4 12 88 15 96
Good 2.41–3.4 19 72 21 93
Moderate 1 3.41–4.4 29 61 28 81
Moderate 2 4.41–5.4 24 42 22 74
Poor 5.41–6.4 11 15 10 55
Very Poor 6.41–6.8 5 12 4 38

*No adjuvant systemic treatment given
**Systemic adjuvant treatment given

References:

  • Lee AHS, Ellis IO. Pathol. Oncol. Res. (2008) 14:113-115.
  • Balslev I, Axelsson CK, Zedeler K, Rasmussen BB, Carstensen B, Mouridsen HT (1994) The Nottingham Prognostic Index applied to 9,149 patients from the studies of the Danish Breast Cancer Cooperative Group (DBCG). Breast Cancer Res Treat 32:281–290.
  • Brown JM, Benson EA, Jones M (1993) Confirmation of a longterm prognostic index for breast cancer. Breast 2:144–147.
  • Sundquist M, Thorstenson S, Brudin L, Nordenskjold B, South East Swedish Breast Cancer Study Group (1999) Applying the Nottingham Prognostic Index to a Swedish breast cancer population. Breast Cancer Res Treat 53:1–8.