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Clinical calculator summary

Breast Cancer Index (BCI)

The Breast Cancer Index (BCI) reports two results: the BCI Prognostic Score (risk of late distant recurrence) and the BCI Predictive (H/I) Ratio (likelihood of benefit from extended endocrine therapy beyond 5 years).

Evidence-based context for fast calculator use

Purpose:
Breast Cancer Index predicts late distant recurrence risk and evaluates benefit of extending endocrine therapy beyond 5 years in HR+ breast cancer.
Population:
patients undergoing breast cancer risk, staging, pathology, recurrence, or treatment-benefit assessment
Factors:
BCI Predictive Result, BCI Prognostic Risk
Reference:
Sestak I, Cuzick J, Dowsett M, et al. Prediction of late distant recurrence after 5 years of endocrine treatment: a combined analysis of patients from the Austrian Breast and Colorectal Cancer Study Group 8 and Arimidex, Tamoxifen, Alone or in Combination randomized trials using the PAM50 risk of recurrence score. J Clin Oncol. 2015;33(8):916-922.
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Breast Cancer Index (BCI)

Clinical Context & Background

The Breast Cancer Index (BCI) reports two results: the BCI Prognostic Score (risk of late distant recurrence) and the BCI Predictive (H/I) Ratio (likelihood of benefit from extended endocrine therapy beyond 5 years). It is the only test guideline-endorsed specifically for the EET decision.
Primary Source EvidenceSestak I, Cuzick J, Dowsett M, et al. Prediction of late distant recurrence after 5 years of endocrine treatment: a combined analysis of patients from the Austrian Breast and Colorectal Cancer Study Group 8 and Arimidex, Tamoxifen, Alone or in Combination randomized trials using the PAM50 risk of recurrence score. J Clin Oncol. 2015;33(8):916-922.
Formula Logic
H/I Ratio Interpretation.

Reference Data

H/I RatioPredictive ResultRecommendation
HighHigh Likelihood of BenefitExtend Endocrine Therapy to 10 years
LowLow Likelihood of BenefitStop Endocrine Therapy at 5 years (unless high clinical risk)

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use Breast Cancer Index (BCI) when breast Cancer Index predicts late distant recurrence risk and evaluates benefit of extending endocrine therapy beyond 5 years in HR+ breast cancer.
  • Confirm that the patient, diagnosis, disease phase, and available inputs match the cited model before calculation.

How To Interpret

  • Interpret the displayed result using the calculator-specific formula and reference table, spanning High through Low.
  • A boundary result should prompt input verification and clinical review rather than false precision.

What To Do Next

  • Integrate the result with invasive versus in-situ status, stage, receptor biology, treatment timing, genomic testing, comorbidity, and patient goals.
  • Document the inputs, result, timing, and clinical context so the assessment can be reproduced.

Limitations

  • Do not interchange screening-risk, DCIS, invasive prognosis, genomic, and post-neoadjuvant tools.
  • The result supports clinician judgment and does not independently determine treatment.

Validated Population

patients undergoing breast cancer risk, staging, pathology, recurrence, or treatment-benefit assessment

How to apply this result

For a representative case, verify BCI Predictive Result, BCI Prognostic Risk, calculate the result, and confirm that its classification matches the highlighted reference band before continuing the disease-specific pathway.

Breast Cancer hubContinue to related calculators and clinical workflow resources.

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Frequently Asked Questions

When should Breast Cancer Index (BCI) be used?

Use it for patients undergoing breast cancer risk, staging, pathology, recurrence, or treatment-benefit assessment when all required inputs and the intended clinical setting are confirmed.

Can Breast Cancer Index (BCI) determine treatment by itself?

No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.

Evidence-based oncology decision support. Verify with clinical guidelines.