What is the Van Nuys Prognostic Index (VNPI) Scoring System for ductal carcinoma in situ (DCIS)?

Updated: May 24, 2018
  • Author: Peter Abdelmessieh, DO, MSc; Chief Editor: Marie Catherine Lee, MD, FACS  more...
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Answer

Answer

The Van Nuys Prognostic Index [1] is an attempt to objectively determine the aggressiveness of DCIS and the probability that local recurrence will occur after breast-conserving therapy (surgery). See Table 1, below.

Table 1 The Van Nuys Prognostic Index (VNPI) Scoring System (Open Table in a new window)

Score*

1

2

3

Size

< 15 mm

16-40 mm

>41 mm

Margins

>10 mm

1-9 mm

< 1 mm

Pathologic

Classification

Non–high grade without necrosis (nuclear grade 1 and 2)

Non–high grade with necrosis (nuclear grade 1 and 2)

High grade with or without necrosis (nuclear grade 3)

*Scores for tumor size, surgical margin, and pathologic classification are added to produce a total VNPI score of 3 to 9, with increasing scores representing a progressively worse prognosis.


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