Question:
Van Nuys prognostic index is not based on:
Van Nuys prognostic index is not based on:
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Remember VNPI scores size, age, grade and margin - hormone-receptor markers are not part of it.
Updated On: Jun 23, 2026
- Age
- Microcalcification
- Size
- ER status
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The Correct Option is D
Solution and Explanation
Step 1: The Van Nuys Prognostic Index (VNPI) is a scoring system used to guide management of ductal carcinoma in situ (DCIS) of the breast. It predicts the risk of local recurrence after breast-conserving surgery.
Step 2: The original VNPI is built on three parameters, each scored 1 to 3: tumour size, width of the surgical resection margin, and the pathological (nuclear) grade with or without comedonecrosis. The modified VNPI adds patient age as a fourth parameter.
Step 3: So the recognised inputs are age, size, margin status and grade. Microcalcification and the type of DCIS are descriptive features of DCIS but feature in the broader Van Nuys classification of the disease, not as scored numerical parameters of the prognostic index in the way the answer choices are framed.
Step 4: Estrogen receptor (ER) status is a prognostic and predictive marker for invasive breast cancer and guides endocrine therapy, but it is NOT a component of the Van Nuys Prognostic Index. Hence the correct answer is ER status.
Age (a), microcalcification (b) and size (c) are all linked to the Van Nuys system, making ER status (d) the parameter the index is not based on.
Step 2: The original VNPI is built on three parameters, each scored 1 to 3: tumour size, width of the surgical resection margin, and the pathological (nuclear) grade with or without comedonecrosis. The modified VNPI adds patient age as a fourth parameter.
Step 3: So the recognised inputs are age, size, margin status and grade. Microcalcification and the type of DCIS are descriptive features of DCIS but feature in the broader Van Nuys classification of the disease, not as scored numerical parameters of the prognostic index in the way the answer choices are framed.
Step 4: Estrogen receptor (ER) status is a prognostic and predictive marker for invasive breast cancer and guides endocrine therapy, but it is NOT a component of the Van Nuys Prognostic Index. Hence the correct answer is ER status.
Age (a), microcalcification (b) and size (c) are all linked to the Van Nuys system, making ER status (d) the parameter the index is not based on.
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