Question:medium
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: Recall what VNPI is for. It is a numeric tool for DCIS that tells the surgeon whether wide excision alone, excision plus radiotherapy, or mastectomy is the safest choice based on recurrence risk.
Step 2: Memorise the four-item modified score with the mnemonic $SAGM$: $S$ize, $A$ge, $G$rade (nuclear grade with/without necrosis), and $M$argin. Each is given 1, 2 or 3 points and the totals stratify patients into low, intermediate and high recurrence groups.
Step 3: Test each option against $SAGM$. Age matches $A$, size matches $S$. Microcalcification relates to the imaging and classification of DCIS and is associated with the Van Nuys descriptive system, so it cannot be the intended outlier here.
Step 4: Estrogen receptor status is a hormone-receptor marker that drives tamoxifen or aromatase-inhibitor therapy in invasive disease; it sits entirely outside the VNPI scoring framework. Therefore the index is not based on ER status.
\[\boxed{\text{ER status}}\]
Step 2: Memorise the four-item modified score with the mnemonic $SAGM$: $S$ize, $A$ge, $G$rade (nuclear grade with/without necrosis), and $M$argin. Each is given 1, 2 or 3 points and the totals stratify patients into low, intermediate and high recurrence groups.
Step 3: Test each option against $SAGM$. Age matches $A$, size matches $S$. Microcalcification relates to the imaging and classification of DCIS and is associated with the Van Nuys descriptive system, so it cannot be the intended outlier here.
Step 4: Estrogen receptor status is a hormone-receptor marker that drives tamoxifen or aromatase-inhibitor therapy in invasive disease; it sits entirely outside the VNPI scoring framework. Therefore the index is not based on ER status.
\[\boxed{\text{ER status}}\]
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