Criteria
University of Southern California (USC)/Van Nuys prognostic index for ductal carcinoma in situ (DCIS)[104]
The Van Nuys classification system incorporates nuclear grade and necrosis into a pathology score of high nuclear grade, non-high grade with necrosis, and non-high grade without necrosis. The pathology score is then combined with margin size, tumour size, and age for prognostic classification. A low score is 4-6, intermediate score is 7-9, and high score is 10-12.
Size (score):
<15 mm (1)
16-40 mm (2)
>41 mm (3)
Margin (score):
>10 mm (1)
1-9 mm (2)
<1 mm (3)
Age (score):
>61 years (1)
40-61 years (2)
<39 years (3)
Pathological classification (score):
NG1 non-high grade without necrosis (1)
NG2 non-high grade with necrosis (2)
NG3 high grade (3)
Gail model of breast cancer risk assessment[105]
The National Cancer Institute’s Breast Cancer Risk Assessment Tool (BCRAT; also known as the Gail model) determines breast cancer risk based on:[54] National Cancer Institute: breast cancer risk assessment tool Opens in new window
Current age
Age at first menstrual period
Age at first live birth
Number of first-degree relatives with breast cancer
Number of breast biopsies
Presence atypical hyperplasia
Applies to women aged 35-85 years. Not accurate in women with a previous history of ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), or invasive breast cancer. Risk may be underestimated in: those with BRCA1 or BRCA2 mutation; those with a strong family history of breast cancer; those with a family history of ovarian cancer in the maternal or paternal family lineage; non-white individuals; and those with atypical hyperplasia.
Use of this content is subject to our disclaimer