PUBLIC LIBRARY / SCORE

Van Nuys Prognostic Index (USC/VNPI)

Estimates DCIS local recurrence risk after breast-conserving surgery and guides choice among excision alone, excision with radiotherapy and mastectomy.

Calculate with transparency

Check the population, units and version. The result shows the formula or classification; it does not make an automatic treatment decision.

Preparing the form…

Check the method
Enter the data
Check the result

Method · Limits of application

USC/VNPI/Silverstein 2003: 4 factors including age, total 4–12; not 3-factor VNPI

USC/VNPI 2003 was studied in pure DCIS treated with breast-conserving surgery and adds age to the three previous factors. It is not the original three-factor index and must not be automatically applied to invasive carcinoma. Treatment suggestions reflect the described evidence base and require clinical assessment and contemporary evidence.

Conditions of use

Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.

Documented parameters

DCIS size
Smallest clear margin
Pathological classification
Age

4/4 reference cases checked. Numerical tests are not clinical validation.

Sources and documentation

Documented formula

Transcribed from the source or a recorded revision; this is not a clinical recommendation.

Sum of 4 factors, each 1–3 points: size, closest margin, pathological classification (nuclear grade and comedo necrosis) and age. Total 4–12.

References

Silverstein MJ. The University of Southern California/Van Nuys prognostic index for ductal carcinoma in situ of the breast. Am J Surg, 2003.

Identifier: indice-de-van-nuys

Original clinical content: Brazilian Portuguese.

Method version

USC/VNPI/Silverstein 2003: 4 factors including age, total 4–12; not 3-factor VNPI

indice-de-van-nuys@native-2026-10-03+6869d54ae95f

Source for the active edition

The bibliographic edition identifies the source. By itself, it proves neither full conformity of the formula nor clinical approval.

Synthetic cases checked (4)

Synthetic cases for checking the implementation, with no patient data.

Case 1

reference-001

Inputs

DCIS size: ≤ 15 mm
Smallest clear margin: ≥ 10 mm
Pathological classification: Not high-grade, without necrosis
Age: > 60 years

{
  "tam": "1",
  "margem": "1",
  "pato": "1",
  "idade": "1"
}

Expected result

{
  "score": 4,
  "level": "low"
}

Actual result

{
  "score": 4
}

Case 2

reference-002

Inputs

DCIS size: 16 to 40 mm
Smallest clear margin: 1 to 9 mm
Pathological classification: Not high-grade, with necrosis
Age: > 60 years

{
  "tam": "2",
  "margem": "2",
  "pato": "2",
  "idade": "1"
}

Expected result

{
  "score": 7,
  "level": "mid"
}

Actual result

{
  "score": 7
}

Case 3

reference-003

Inputs

DCIS size: ≥ 41 mm
Smallest clear margin: < 1 mm
Pathological classification: High-grade (with or without necrosis)
Age: 40 to 60 years

{
  "tam": "3",
  "margem": "3",
  "pato": "3",
  "idade": "2"
}

Expected result

{
  "score": 11,
  "level": "high"
}

Actual result

{
  "score": 11
}

Case 4

reference-004

Inputs

DCIS size: 16 to 40 mm
Smallest clear margin: < 1 mm
Pathological classification: High-grade (with or without necrosis)
Age: 40 to 60 years

{
  "tam": "2",
  "margem": "3",
  "pato": "3",
  "idade": "2"
}

Expected result

{
  "score": 10,
  "level": "high"
}

Actual result

{
  "score": 10
}

Code and reproducibility

This tool’s code on GitHub

Download code and tests

Sources, version and reproduction instructions

The code tests are technical checks. Clinical approval and professional translation review are recorded separately.

Relationship with cancer research

Specific oncological application

A model for ductal carcinoma in situ of the breast. Historical stratification does not represent an automatic treatment indication.

Applications: Survival and quality of life