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Nottingham Prognostic Index

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Title: Nottingham Prognostic Index  
Author: World Heritage Encyclopedia
Language: English
Subject: Breast cancer
Collection: Breast Cancer
Publisher: World Heritage Encyclopedia

Nottingham Prognostic Index

The Nottingham prognostic index (NPI) is used to determine prognosis following surgery for breast cancer. Its value is calculated using three pathological criteria: the size of the lesion; the number of involved lymph nodes; and the grade of the tumour.


The index is calculated using the formula:

NPI = [0.2 x S] + N + G


  • S is the size of the index lesion in centimetres
  • N is the node status: 0 nodes = 1, 1-4 nodes = 2, >4 nodes = 3
  • G is the grade of tumour: Grade I =1, Grade II =2, Grade III =3


Score 5-year survival
>/=2.0 to 93%
>2.4 to 85%
>3.4 to 70%
>5.4 50%


  • Haybittle JL, Blamey RW, Elston CW, Johnson J, Doyle PJ, Campbell FC, Nicholson RI, Griffiths K. A prognostic index in primary breast cancer. British journal of cancer. 1982 Mar; 45(3):361-6.
  • Todd JH, Dowle C, Williams MR, Elston CW, Ellis IO, Hinton CP, et al. Confirmation of a prognostic index in primary breast cancer.
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