Can Biomarkers Improve Ability of NPI in Risk Prediction? A Decision Tree Model Analysis

Abstract

Background: The Nottingham Prognostic Index (NPI) is widely-used in the UK for risk stratification of breast cancer patients. This paper aims to evaluate the ability of this index to detect patients with sufficiently low risk of recurrence that they could be spared harsh treatments, and to construct an enhanced prognostic rule that integrates biomarkers with clinical variables to achieve better risk stratification.