Npi score

NPI = Nottingham prognostic index. It is a tool they use to try get an idea of prognosis and the chances of mets. Size and grade of the tumour are factors in this calculation. 

One reason for the change in size and grade from scans/biopsy to pathology report could be that the scans can give an idea of size but only having the whole tumour to hand can give an accurate measurement, and while the biopsy may have hit grade 2 cells, when checking the whole tumour they have access to all of it and have found grade 3 cells.

The main thing here is that they have taken the tumour out, so quite possibly you are now cancer-free. The NPI data would still be useful to the MDT to determine the best course of treatment to make sure they do everything and do it correctly to get rid of any possible microscopic cells anywhere, which is a normal standard. 

Thank you for that reply. It has helped x

Hi GreyCats

You might not know the answer to this but given the Nottingham Prognostic Index was first devised in the 1980s I think I  presume it predicts potential prognosis  without adjuvant treatment such as RT / chemo / Hormorne blockers ? 

I wonder whether Predict has now superceded the NPI although Predict doesn't factor in radiotherapy currently so that doesn't factor in everything but does factor in receptor status 

Hi Jurrasicgirl,

They used both NPI and Predict when I was diagnosed in 2018, I think one thing to remember is they are only tools and as such are used to predict the outcome but can be inaccurate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202586/  The first and last paragraphs of the "Abstract" section may answer some of this, and explain what is taken into account for the calculation. 

One other tool I know of gives statistical prediction over 5/10 years period, and in that tool you can input with or without various systemic treatments, but I am  not sure if it applies to all cancer types.

It's probably best to go over this with the consultant, because his explanations will be tailored to the individual patient's presentation, and the consultant would also explain why certain predictive tools are or aren't being used for that specific case.

Thanks for the info. I don't know what was ( or wasn't) used in determining my treatment as I have never had that info given to me interestingly.

I have asked for the MDT notes as I'm curious and know from the NICE BC pathway that I'm having what is recommended  for post menopausal early BC i.e. Hormone therapy and RT so ok with that. I've also done the Predict tool on line to check ! 

My treatment has been speedy and I'm grateful for that but feel now like I'm being fast tracked out of the system as my treatment is coming to an end. I only saw the oncologist for 5 mins as my oncology appointment was with a registra who had clearly been tasked with getting my RT consent signed and I don't have any other appointments. It was my surgeon at the results appointment who gave me the initial prescription for anasrazole and calcium tablets

I'm hoping seeing the MDT discussions will help me fully understand the decision making specific to me ! 

The RT consultant (clinical oncology) should be able to answer any questions you may have for medical oncology, but if you don't get satisfactory answers then perhaps you could ask the nurse for an appointment with the consultant who oversaw your treatment previously, and especially if the MDT notes bring up anything you want clarified.

I like the idea of speedy treatment for all the obvious reasons, but it does seem to leave little time to digest everything. I wish they had a protocol in place that takes that into account.

Totally agree with your comments ! Speedy is good but one needs to understand and process. That article was really helpful thank you and explains why I didn't have oncotype testing ! 

Thanks again x