Breast Cancer Recurrence Risk Worksheet

About the Breast Cancer Recurrence Risk Worksheet

Breast cancer recurrence review is one part of pathology interpretation, especially when tumor size, grade, lymph node status, ER/PR/HER2 pattern, and Ki-67 need to be summarized in one place. This page brings those standard factors together so the broad context is easier to read as educational background.

This worksheet groups the case into broad 5-year and 10-year recurrence-context bands based on standard prognostic factors. It classifies the tumor into broad molecular subtypes (Luminal A, Luminal B, HER2-enriched, Triple Negative), computes a Nottingham Prognostic Index-like score, and shows where genomic assays are commonly referenced in the literature. Validated tools such as Oncotype DX, MammaPrint, PREDICT, and CTS5 add information that this worksheet does not reproduce.

This page should be used as background only. It does not replace validated prognostic models, full pathology review, or clinician interpretation.

When This Page Helps

This worksheet provides broad recurrence-context bands, subtype summary, and assay context that can help organize pathology factors before a clinical discussion. It is most useful as background only, not as a stand-alone prognosis tool.

How to Use the Inputs

1. Enter the patient age at diagnosis.
2. Enter the tumor size in centimeters (largest pathological dimension).
3. Select histologic grade, lymph node status, ER, PR, HER2, and Ki-67 level.
4. Review broad recurrence-context bands, molecular subtype, and NPI-like score.
5. Use the genomic assay table as context for which assays are commonly discussed in similar cases.
6. Use presets to explore different tumor profiles.

Example Calculation

Tips & Best Practices

• Always use pathological tumor size (from surgical specimen), not clinical/imaging size.
• Ki-67 is most useful for distinguishing Luminal A from Luminal B in ER+/HER2- cancers.
• Genomic assays are most commonly referenced in selected ER+/HER2- cases, but this page does not calculate them.
• Late recurrence remains part of the background context for ER-positive disease, which is why the 10-year band is shown.
• Triple-negative patterns often carry higher early recurrence risk than late recurrence risk in broad cohort data.

What This Worksheet Summarizes

This page combines familiar clinicopathologic factors such as tumor size, grade, nodal status, receptor pattern, and Ki-67 into one simplified recurrence worksheet. That can be useful for educational review, but it is still only a rough summary of a much more detailed pathology and outcomes discussion.

Why Molecular Subtypes Matter

Broad subtype labels such as Luminal A, Luminal B, HER2-enriched, and Triple Negative reflect recurring patterns in receptor status and proliferation. They help explain why tumors with similar size can still behave differently, even before formal genomic testing is considered.

Limits of Simplified Risk Estimates

Validated recurrence tools and genomic assays incorporate data that this worksheet does not. That is why the output here should be read as background context only rather than as an individualized prognosis or a management answer.

Frequently Asked Questions

• What is the Oncotype DX Recurrence Score?

  Oncotype DX is a 21-gene assay that produces a recurrence score for selected ER+/HER2- breast cancers. This page does not calculate that score; it only notes that genomic assays are commonly part of recurrence-risk discussions in certain pathology profiles.

• What is the difference between Luminal A and Luminal B?

  Luminal A usually refers to an ER-positive, HER2-negative, lower-proliferation pattern, while Luminal B generally refers to an ER-positive pattern with higher proliferation, lower PR expression, or HER2 positivity. This page uses receptor status and Ki-67 as a simplified approximation of those subtype groupings.

• Why is triple-negative breast cancer often described as higher early risk?

  Triple-negative tumors are often higher grade and more proliferative, which is why recurrence risk is often concentrated in the earlier years after diagnosis. This page uses that broad pattern only as educational context.

• Do ER-positive cancers have late recurrence?

  Yes. ER-positive cancers can have meaningful recurrence risk beyond 5 years, which is why the 10-year band remains relevant on this worksheet. The actual late-recurrence picture is more nuanced than this simplified model can capture.

• What is the Nottingham Prognostic Index (NPI)?

  The NPI combines tumor size, lymph node status, and histologic grade: NPI = (0.2 × size in cm) + grade (1-3) + lymph node score (1-3). This page shows an NPI-like value as one more way to summarize the pathology profile.

• Does this page replace genomic testing or validated prognostic tools?

  No. This page is only a simplified educational worksheet. It does not replace genomic assay results, validated prognostic models, pathology review, or clinician interpretation.