Van Nuys Prognostic Index
In order to be able to assess whether there is a risk of recurrence after DCIS therapy, the Van Nuys Prognostic Index was established: In this index, various characteristics are taken into account and evaluated with a point system, including the size of the area, the degree of differentiation (grading) and the width of the incision edge of the findings removed during surgery. The degree of differentiation is assessed by a pathologist to whom the removed tissue is sent. If the cancer cells still resemble the tissue from which they originated, they are called differentiated.
The more the cells have changed, the less differentiated they are and the less favourable the prognosis. On the tissue sent in, the pathologist can also see how much space there is between the cancerous tissue and the edges of the incision in healthy tissue. A greater distance is safer, but at the same time less gentle on the healthy breast tissue.
Each criterion (size, margin, grading) is graded with 1-3 points and added together to give values from a minimum of 3 to a maximum of 9, with 3 points representing the lowest risk of recurrence. As an extension of the Van Nuys Prognostic Index, the age of the patient is now also taken into account. Advanced age is favourable for the prognosis. On the basis of the classification in the Van Nuys Prognostic Index, the further therapeutic procedure is additionally derived. Van Nuys Prognostic Index
- 1 point grading by the pathologist: Hardly any nuclear changes and no necroses Cutting edge in mm: more than 9 Size of tumor in mm: less than 16
- Grading by the pathologist: Hardly any nuclear changes and no necroses
- Cutting edge in mm: more than 9
- Size of the tumour in mm: less than 16
- 2 point grading by the pathologist: Hardly any nuclear changes but necroses Cutting edge in mm: 9-1 Size of the tumor in mm: 16-40
- Grading by the pathologist: Hardly any nuclear changes but necroses
- Cutting edge in mm: 9-1
- Size of the tumour in mm: 16-40
- 3 point grading by the pathologist: Severe nuclear changes and necroses Cutting edge in mm: less than 1 Size of tumor in mm: greater than 40
- Grading by the pathologist: severe nuclear changes and necroses
- Cutting edge in mm: less than 1
- Size of the tumour in mm: greater than 40
- Grading by the pathologist: Hardly any nuclear changes and no necroses
- Cutting edge in mm: more than 9
- Size of the tumour in mm: less than 16
- Grading by the pathologist: Hardly any nuclear changes but necroses
- Cutting edge in mm: 9-1
- Size of the tumour in mm: 16-40
- Grading by the pathologist: severe nuclear changes and necroses
- Cutting edge in mm: less than 1
- Size of the tumour in mm: greater than 40
