Breast ductal carcinoma in-situ (DCIS)

Your VNPI Calculation Worksheet

Remember that the calculations will be summed into a single number which can then place your case into one of three treatment groups: CBS only, CBS plus XRT, or mastectomy. It is HUGELY important for you to keep in mind that this does not constitute a treatment command or final decision. It simply gives one line of evidence, a statistics-based basis for considering your options as you discuss them with your doctors.

TUMOR SIZE

By whatever measure, the following are the criteria for assignment of size points (such were originally assigned from the pathology tissue studies):
bulletequal to or less than 1.5cm...............1 point
bulletfrom 1.6 cm. to 4.0 cm.........................2 points
bulletequal to or greater than 4.1 cm.......3 points

YOUR CANCER'S NUCLEAR GRADE:
bullettumor nuclei have diffuse chromatin, absent/inapparent nucleoli and average no larger than 1 to 1.5 RBC diameters:
nuclear grade 1 (one point)
bullettumor nuclei have coarse chromatin, present but infrequent nucleoli and average no larger than 1.5 to 2.0 RBC diameters:
nuclear grade 2 (two points)
bullettumor nuclei have vesicular chromatin, frequent nucleoli and average larger than two RBC diameters:
nuclear grade 3 (three points)
THINNEST SURGICAL MARGIN:
bulletclosest/thinnest measured margin is equal to or greater than 1.0 cm............1 point
bulletclosest/thinnest measured margin is between 0.1-0.9 cm.................2 points
bulletclosest/thinnest measured margin is less than 0.1 cm....................3 points
Age:
bullet61 or older............1 point
bullet40-60.................2 points
bullet39 or younger....................3 points
Non-beta-weighted VNPI CALCULATION FORMULA:
VNPI SCORE= tumor-size [_____pts] plus nuclear [_____pts]
plus margin [_____pts] plus age [___pts]=_____total VNPI points

VNPI DECISION GROUPS [here]

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(posted 17 Dec. 2000; latest update 13 January 2004)


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