Criteria

University of Southern California (USC)/Van Nuys prognostic index for ductal carcinoma in situ (DCIS)[72]

The Van Nuys classification system incorporates nuclear grade and necrosis into a pathology score of high nuclear grade, non-high grade with necrosis, and non-high grade without necrosis. The pathology score is then combined with margin size, tumour size, and age for prognostic classification. A low score is 4-6, intermediate score is 7-9, and high score is 10-12.

Size (score):

  • <15 mm (1)

  • 16-40 mm (2)

  • >41 mm (3).

Margin (score):

  • >10 mm (1)

  • 1-9 mm (2)

  • <1 mm (3).

Age (score):

  • >61 years (1)

  • 40-61 years (2)

  • <39 years (3).

Pathological classification (score):

  • NG1 non-high grade without necrosis (1)

  • NG2 non-high grade with necrosis (2)

  • NG3 high grade (3).

Gail model of breast cancer risk assessment[73]

Combines the number of previous breast biopsies, presence of atypical hyperplasia in any previous breast biopsy specimen, reproductive history (age at the start of menstruation and age at the first live birth of a child), and history of breast cancer among first-degree relatives (mother, sisters, daughters) to estimate risk of developing invasive breast cancer over specific periods of time. Applies to women aged 35-74 years. Not accurate in the setting of prior DCIS, lobular carcinoma in situ (LCIS), or invasive breast cancer.

Claus (CASH) model of breast cancer risk assessment[73]

Genetic models were adapted to age-specific familial recurrence data. Less commonly used in practice than the Gail model, but better at factoring in second-degree relatives and lobular neoplasia.

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