Correlation between Nottingham Prognostic Index and Adjuvant! Online Prognostic tools in patients with early-stage breast cancer in Mid-Western ireland

Background: Prognostic tools are widely used in the practice of oncology and have been developed to help stratify patients into specific risk-related grouping. We sought to apply tool such tools used for patients with early-stage breast cancer (EBC) and correlate them to actual outcomes. Methods: A retrospective analysis was designed to include EBC cases seen at the Mid-Western Regional Hospital from January 1, 2002, to December 31, 2002. Information was derived from the patients' records, and indices were derived from prognostic tools. Information was analyzed using descriptive statistics and chi-square or Fisher exact test. Results: A total of 77 patients were found, with a median age of 52.2 years. A median overall survival (OS) of 84 months was observed. The majority presented with moderately differentiated estrogen receptor positive invasive ductal carcinoma and lymph node involvement (60%). Sixty-four percent of patients underwent mastectomy as opposed to breast conservation. Adjuvant cytotoxic chemotherapy uptake was 61%, which was comparable to the proportion of node positive disease. The Nottingham Prognostic Index and Adjuvant! Online (AO) tools were both correlated with actual survival, with the AO showing better correlation. Conclusions: This report underscores that these predicting tools were both underestimations consistent with the actual OS and highlights the importance of further work in validating these tools within our own population.