## 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.
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