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Nottingham Prognostic Index: Useful tool to assess outcome inpatients of breast carcinoma

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Original Article

Author Details : Archana A. Randale*, Sanjay N Parate

Volume : 5, Issue : 1, Year : 2020

Article Page : 9-13

https://doi.org/10.18231/j.achr.2020.003

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Abstract

Introduction: Breast cancer has been ranked number one cancer among the Indian females surpassing the
incidence of cervical cancer. Multiple clinico-pathological-molecular prognostic factors are available in
decision making about potentially suitable treatment options for breast cancer. Among all, Nottingham
Prognostic Index (NPI) is the most powerful integrated index. Present study aimed to evaluate the
significance of NPI in prognosis of operable breast cancer patients.
Materials and Methods: This longitudinal (Descriptive) study was carried on 60 female patients of
operable breast carcinoma at tertiary care centre in central India.
Results: Two patients from good prognostic group (NPI3.4) (30%) had metastasis to bone & CNS. F
rom moderate prognostic group ((NPI 3.4 - 5.4) (50%) , one patient had recurrence at previous surgical
scar site and 3 patients had metastasis to liver, lung and supraclavicular lymph node each. However the
worst outcome was found in patients from poor prognostic group (NPI > 5.4) (10%). Five patients from
poor prognostic group had metastasis in liver, bone, CNS and lung with two patients had simultaneous
metastasis in liver & bone. Four patients from poor prognostic group had death within two and half year
s of primary diagnosis. Out of 60 patients, 34 patients had a follow up of more than 1000 days, so were
included in statistical analysis of survival based on Cox Proportional Hazard Model. Among 7 variables,
NPI was found to be statistically most significant with p value 0.001
Conclusion: Estimation of NPI is the powerful and reproducible index for assessing prognosis in patients
with operable breast cancer in advanced resources deprived institute. Main strength of NPI lies in the
fact that it is based on relatively simple data which can be provided in routine histopathology report of
carcinoma breast.

Keywords: Operable breast cancer, Nottingham prognostic index (NPI), Utility in outcome.

How to cite : Randale A A, Parate S N, Nottingham Prognostic Index: Useful tool to assess outcome inpatients of breast carcinoma. IP Arch Cytol Histopathol Res 2020;5(1):9-13

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