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Clinical calculator summary

Nottingham Prognostic Index (NPI)

The Nottingham Prognostic Index (NPI) is used to determine the prognosis of patients with operable primary breast cancer.

Evidence-based context for fast calculator use

Purpose:
Nottingham Prognostic Index calculates invasive breast cancer prognosis using tumor size, grade, and nodal status to guide adjuvant therapy.
Population:
patients undergoing breast cancer risk, staging, pathology, recurrence, or treatment-benefit assessment
Factors:
Tumor Size, Lymph Nodes, Tumor Grade
Reference:
Haybittle JL, Blamey RW, Elston CW, et al. A prognostic index in primary breast cancer. Br J Cancer. 1982;45(3):361-366.
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Nottingham Prognostic Index (NPI)

cm

Clinical Context & Background

The Nottingham Prognostic Index (NPI) is used to determine the prognosis of patients with operable primary breast cancer. It combines tumor size, lymph node stage, and tumor grade to stratify patients into prognostic groups.
Primary Source EvidenceHaybittle JL, Blamey RW, Elston CW, et al. A prognostic index in primary breast cancer. Br J Cancer. 1982;45(3):361-366.
Formula Logic
NPI = (0.2 × Size [cm]) + Lymph Node Stage (1-3) + Grade (1-3)

Reference Data

Prognostic GroupScore5-Year Survival
Excellent Prognosis≤ 3.494%
Moderate Prognosis3.41 - 5.474%
Poor Prognosis> 5.434%

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

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

When To Use

  • Use Nottingham Prognostic Index (NPI) when nottingham Prognostic Index calculates invasive breast cancer prognosis using tumor size, grade, and nodal status to guide adjuvant therapy.
  • 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 Excellent Prognosis through Poor Prognosis.
  • 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 Tumor Size, Lymph Nodes, Tumor Grade, 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 Nottingham Prognostic Index (NPI) 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 Nottingham Prognostic Index (NPI) 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.