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Clinical calculator summary

NHS PREDICT Breast Cancer Prognostic Model

PREDICT is the NHS-developed prognostic model that estimates overall and breast cancer-specific survival at 5 and 10 years, with and without adjuvant therapy, for early invasive breast cancer.

Evidence-based context for fast calculator use

Purpose:
Estimate survival benefit of adjuvant chemotherapy, endocrine therapy, and trastuzumab
Population:
Women with early invasive breast cancer (operable, non-metastatic)
Factors:
Age, Tumour size, Tumour grade, Positive nodes, ER status, HER2 status, KI-67, Detection method
Reference:
Wishart et al., Breast Cancer Research 2010; PREDICT v2.2
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PREDICT Breast (Prognostic Index)

years
mm

Clinical Context & Background

PREDICT Breast is a prognostication tool for early invasive breast cancer. It estimates the survival benefit of adjuvant chemotherapy, endocrine therapy, and trastuzumab. This calculator computes the baseline Prognostic Index (PI), which correlates with overall survival risk.
Primary Source EvidenceCandido Dos Reis FJ, Wishart GC, Dicks EM, et al. An updated PREDICT breast cancer prognostication and treatment benefit prediction model with independent validation. Breast Cancer Res. 2017;19(1):58.
Formula Logic
PI based on Age, Size, Grade, Nodes, ER, HER2, Ki67, and Mode of Detection.

Reference Data

Prognostic Index (PI)Risk Level
Lower PIBetter Survival Probability
Higher PIWorse Survival Probability

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

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

When To Use

  • Use after surgery for early invasive, non-metastatic breast cancer when pathology and receptor status are available.
  • Best suited for framing baseline prognosis and possible absolute benefit from adjuvant systemic therapy.
  • Use with staging, genomic assays, and multidisciplinary review when treatment decisions are borderline.

How To Interpret

  • This OncoToolkit implementation returns a simplified prognostic risk index rather than official 5- or 10-year survival percentages.
  • A lower index suggests a more favorable clinicopathologic profile; a higher index reflects greater tumor burden or adverse biology.
  • For exact calibrated survival and treatment-benefit estimates, verify with the official PREDICT Breast tool and local guideline context.

What To Do Next

  • Pair the result with AJCC stage, receptor profile, nodal status, patient fitness, and treatment preferences.
  • For HR-positive/HER2-negative disease where chemotherapy benefit is uncertain, consider whether a validated genomic assay such as Oncotype DX is indicated.
  • At the 5-year endocrine therapy decision point, use CTS5 to estimate late distant recurrence risk rather than reusing baseline PREDICT alone.

Limitations

  • Do not use for DCIS, metastatic breast cancer, recurrence, or post-neoadjuvant residual disease estimation.
  • This simplified index is not a substitute for the official NHS PREDICT survival calculator.
  • Treatment decisions should account for comorbidities, menopausal status, genomic testing, toxicity risk, and patient goals.

Validated Population

Early invasive breast cancer after primary surgery, before final adjuvant systemic therapy decisions, with complete clinicopathologic data.

Example use

A 62-year-old with a 16 mm grade 2 ER-positive, HER2-negative, node-negative screen-detected tumor usually generates a lower-risk profile; the next clinical question may be whether endocrine therapy alone is reasonable or whether genomic testing would change chemotherapy discussion.

Breast cancer calculator hubSee risk, staging, recurrence, and treatment-decision calculators together.AJCC breast stagingConfirm baseline stage before prognosis discussions.Oncotype DX recurrence scoreGenomic recurrence score context for selected early breast cancers.CTS5 late recurrenceEstimate late recurrence risk after 5 years of endocrine therapy.PREDICT comparison guideCompare PREDICT, CTS5, Oncotype DX, and related tools.

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Related Tools

CTS5 Late Breast Cancer RecurrenceOncotype DX Recurrence Score Calculator — Breast Cancer Genomic RiskAJCC Prognostic Stage (Breast)

Frequently Asked Questions

Does this page reproduce the official NHS PREDICT percentages?

No. It returns a simplified prognostic index. Exact calibrated survival and treatment-benefit estimates should be checked with the official PREDICT Breast tool.

When should CTS5 be used instead of PREDICT?

CTS5 addresses late distant recurrence after five years of endocrine therapy in its validated population; PREDICT addresses baseline early invasive breast cancer prognosis and adjuvant treatment-benefit context.

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