Assessment of clinical & morphological prognostic features on mastectomy specimen

Abstract

Objective: To assess clinical and morphological prognostic features of breast cancer, to evaluate and determine the prognostic usefulness of Nottingham prognostic index(NPI) and its components. Methods: A prospective and retrospective study was conducted on 123 consecutive modified radical mastectomy specimens received in our department during period from January 2013 to June 2014 (retrospective and prospective study). We evaluated the significance of the various prognostic features like age, stage at diagnosis, histopathological grade, and number of axillary lymph nodes retrieved and involved. The Nottingham Prognostic Index was also calculated Results: The age range was 20- 75 years with a mean (±SD) of 49 ±11.5 years. Infiltrating duct carcinoma NOS (IDC NOS) was the most common type of carcinoma breast seen in 86.2% and BR Grade 2 was seen in 85.7% patients. Maximum number of cases (95.12%) had TNM stage II (47.15% ) and III (47.97%). Majority of cases i.e.47% were classified under poor prognostic group with NPI Score more than 5.41 Conclusion: Based on the findings of the present study it may be concluded that assessment of tumor size, histological grade and lymph node involvement along with NPI Score are important determinants of breast carcinoma prognostication and should be incorporated in planning therapy of patients with breast carcinoma. The Nottingham grading system when adequately carried out provide a simple, non-expensive, accurate and validated method for assessing patients prognosis.