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The Nottingham prognostic index (NPI) is used to determine prognosis following surgery for breast cancer. [1] [2] Its value is calculated using three pathological criteria: the size of the tumour; the number of involved lymph nodes; and the grade of the tumour. [1] It is calculated to select patients for adjuvant treatment.
In one study, the lifetime risk of recurrence was 20% for smaller (<2 cm) tumors without lymph node metastasis. Larger tumors without lymph nodes had 38% risk of recurrence. Presence of lymph nodes in tumors of any size showed 62% and 86% risk of recurrence in patients with 1-3 and >4 positive lymph nodes, respectively.
Stages 1–3 are within the breast or regional lymph nodes. Stage 4 is a metastatic cancer. Metastatic breast cancer has a less favorable prognosis. Receptor status. Cells have receptors on their surface and in their cytoplasm and nucleus. Chemical messengers such as hormones bind to receptors, and this causes changes in the cell.
Nx: lymph nodes cannot be assessed; N0: no regional lymph nodes metastasis; N1: regional lymph node metastasis present; at some sites, tumor spread to closest or small number of regional lymph nodes; N2: tumor spread to an extent between N1 and N3 (N2 is not used at all sites) N3: tumor spread to more distant or numerous regional lymph nodes ...
Breast cancer can metastasize anywhere in body but primarily metastasizes to the bone, lungs, regional lymph nodes, liver and brain, with the most common site being the bone. [4] Treatment of metastatic breast cancer depends on location of the metastatic tumors and includes surgery, radiation, chemotherapy, biological, and hormonal therapy. [5]
The predictive value and prevalence of lymphovascular invasion is strongly dependent on the type of cancer. In other words, LVI in one type of cancer may be much less important than LVI in another type of cancer. Generally speaking, it is associated with lymph node metastases [2] [3] which themselves are predictive of a poorer prognosis. [4]
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