The University of Southern California/Van Nuys Prognostic Index for ductal carcinoma in situ (DCIS) is a modification of the Van Nuys Prognostic Index.
Change from original van Nuys prognostic index: addition of age
Parameters:
(1) age in years
(2) size in millimeters
(3) distance to margin in millimeters
(4) histologic grade (group) based on nuclear grade and the presence of necrosis
Parameter
Finding
Points
age
> 60 years
1
40 to 60
2
< 40 years
3
size
<= 15 mm
1
16 to 40 mm
2
> 40 mm
3
distance to margin
>= 10 mm
1
1 to 9 mm
2
< 1 mm
3
histologic grade
Grade 1 or 2 nuclei, no necrosis
1
Grade 1 or 2 nuclei, necrosis
2
Grade 3 nuclei
3
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 4
• maximum score: 12
• The higher the score the greater the risk and the greater the need for aggressive management.
Score
Margin
Treatment
4 to 6
nothing additional
7
>= 3 mm
nothing additional
7
< 3 mm
radiation
8
>= 3 mm
radiation
8
< 3 mm
mastectomy
9
>= 5 mm
radiation
9
< 5 mm
mastectomy
10 to 12
mastectomy
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