Haybittle et al developed a prognostic index for infiltrating ductal carcinoma based on certain quantitative measures. This was developed at the Nottingham City Hospital and Tenovus Institute for Cancer Research in England.
Parameters:
(1) histologic grade
(2) tumor size in cm
(3) lymph node stage
Lymph Node Stage:
• Based on histological examination of three lymph nodes (low axillary, apical axillary and internal mammary)
• This manner of lymph node examination is not routine in the US.
Parameter
Finding
Points
histologic grade
well differentiated
1
moderately differentiated
2
poorly differentiated
3
lymph node stage
A (no metastases)
1
B (metastases in low axillary lymph node)
2
C (metastases in apical axillary and/or internal mammary lymph node)
3
prognostic index =
= (0.2 * (tumor size in cm)) + (points for lymph node stage) + (points for histologic grade)
Interpretation:
• minimum score: just over 2
• maximum score: over 7
Prognostic Index
Prognosis
Annual Mortality Rate (in 1980's)
< 3.4
good
3%
3.4 to 5.399
moderate
7%
>= 5.4
poor
30%
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