Which of the following best describes the Nottingham Prognostic Index (NPI) in breast cancer?

Question

Accepted Answer

D. A combined score incorporating tumor size, lymph node status, and histological grade. ## Nottingham Prognostic Index (NPI)

**Key Point:** The NPI is a **combined prognostic tool** for breast cancer that integrates three independent variables:

| Component | Weight |
|-----------|--------|
| Tumor size (cm) | ×0.2 |
| Lymph node stage (0–3) | ×1.0 |
| Histological grade (1–3) | ×1.0 |

**Formula:** NPI = (0.2 × tumor size) + lymph node stage + histological grade

**Prognostic Groups:**
- NPI ≤2.4: Excellent prognosis (>95% 10-year survival)
- NPI 2.4–5.4: Intermediate prognosis
- NPI >5.4: Poor prognosis (<50% 10-year survival)

**High-Yield:** The NPI is **superior to TNM alone** for breast cancer risk stratification and is widely used in UK and European guidelines. It combines morphologic grading with anatomic staging.

Answer

A. A grading system that evaluates only nuclear pleomorphism and mitotic activity

Answer

B. A molecular classification based on hormone receptor and HER2 expression alone

Answer

C. A staging system that replaces TNM classification for all solid tumors

Which of the following best describes the Nottingham Prognostic Index (NPI) in breast cancer?

Explanation

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