Breast Cancer Recurrence Risk Calculator
Estimate 5-year local breast cancer recurrence risk from tumor grade, lymph node status, and lymphovascular invasion.
What Is the O'Rourke Recurrence Index?
The O'Rourke 1994 index estimates 5-year local breast cancer recurrence after simple mastectomy using three pathology findings: tumor grade, lymph node status, and lymphovascular invasion (LVI). It helps frame discussions about chest wall surveillance and adjuvant radiation. Pair it with the Breast Cancer Risk Calculator for baseline invasive risk, or the BMI Calculator for lifestyle follow-up.
Scoring System
Each factor contributes points that map to a published 5-year local recurrence percentage:
- Grade I = 6, Grade II = 12, Grade III = 18
- Node negative = 6, node positive = 12
- LVI absent = 4, LVI present = 8
Example: Grade II, node positive, LVI present scores 32 points and corresponds to a 33% 5-year local recurrence risk.
Risk Bands
- Low: below 10%
- Moderate: 10% to below 16%
- High: 16% to below 30%
- Very high: 30% or higher
Frequently Asked Questions
What does local recurrence mean?
Local recurrence is cancer returning in the chest wall or mastectomy skin flaps, distinct from regional or distant metastasis.
Does a high score guarantee recurrence?
No. The index reports population-level risk from a 1994 surgical cohort without modern systemic therapy or radiation. Individual outcomes vary.
Why can node-positive disease with LVI show different risks?
The O'Rourke table uses direct lookup values from the original study. Some combinations share the same score but always map to the same published percentage.
What is lymphovascular invasion?
LVI means tumor cells were seen inside small lymphatic or blood vessels on pathology review. Present LVI generally raises recurrence risk.
Should I use this instead of genomic assays?
No. Oncotype DX and similar tests estimate distant recurrence biology. This tool addresses local chest wall recurrence only.
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