title: Comparison of Nottingham Prognostic Index and Adjuvant Online prognostic tools in young women with breast cancer: review of a single-institution experience.
abstract: OBJECTIVE
  Accurately predicting the prognosis of young patients with breast cancer (<40 years) is uncertain since the literature suggests they have a higher mortality and that age is an independent risk factor. In this cohort study we considered two prognostic tools; Nottingham Prognostic Index and Adjuvant Online (Adjuvant!), in a group of young patients, comparing their predicted prognosis with their actual survival.
  
  
  METHODS
  North East England
  
  
  METHODS
  Data was prospectively collected from the breast unit at a Hospital in Grimsby between January 1998 and December 2007. A cohort of 102 young patients with primary breast cancer was identified and actual survival data was recorded. The Nottingham Prognostic Index and Adjuvant! scores were calculated and used to estimate 10-year survival probabilities. Pearson's correlation coefficient was used to demonstrate the association between the Nottingham Prognostic Index and Adjuvant! scores. A constant yearly hazard rate was assumed to generate 10-year cumulative survival curves using the Nottingham Prognostic Index and Adjuvant! predictions.
  
  
  RESULTS
  Actual 10-year survival for the 92 patients who underwent potentially curative surgery for invasive cancer was 77.2% (CI 68.6% to 85.8%). There was no significant difference between the actual survival and the Nottingham Prognostic Index and Adjuvant! 10-year estimated survival, which was 77.3% (CI 74.4% to 80.2%) and 82.1% (CI 79.1% to 85.1%), respectively. The Nottingham Prognostic Index and Adjuvant! results demonstrated strong correlation and both predicted cumulative survival curves accurately reflected the actual survival in young patients.
  
  
  CONCLUSIONS
  The Nottingham Prognostic Index and Adjuvant! are widely used to predict survival in patients with breast cancer. In this study no statistically significant difference was shown between the predicted prognosis and actual survival of a group of young patients with breast cancer.
authors: Breast Care Unit, Pink Rose Suite, Diana Princess of Wales Hospital, Grimsby, UK UCL Medical School, Royal Free Hospital, London, UK.
authors: Benjamin Joseph
authors: http://orcid.org/0000-0001-6100-3975
authors: BJ
authors: Hearne
authors: Design Trials and Statistics Section, School of Health and Related Research, University of Sheffield, Sheffield, UK.
authors: M Dawn
authors: MD
authors: Teare
authors: Breast Care Unit, Pink Rose Suite, Diana Princess of Wales Hospital, Grimsby, UK.
authors: Mohammad
authors: M
authors: Butt
authors: Breast Care Unit, Pink Rose Suite, Diana Princess of Wales Hospital, Grimsby, UK.
authors: Leslie
authors: L
authors: Donaldson
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000601:surgery; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D016019:Survival Analysis
keywords: Adjuvant Online; Breast cancer; Nottingham Prognostic Index; Prognosis; Young Age
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