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Neoadjuvant chemotherapy: see primary chemotherapy in chemotherapy entry.

Nipple discharge: obvious physiological causes are pregnancy and lactation. Under certain circumstances, massage and stimulation in 70% of premenopausal and 15% of postmenopausal women can induce spontaneous nipple discharge. Nipple discharge can also occur in duct ectasia (see entry) and periductal mastitis (see entry). All nipple discharge should be assessed. Single duct discharge and blood stained nipple discharge in particular require urgent attention. Blood stained nipple discharge is often related to a benign condition in the major ducts called duct papilloma, but can sometimes be a presenting feature of intraductal DCIS or invasive breast cancer (see entries).

Nottingham Prognostic Index: a scoring system to assess outcome from breast cancer based on tumour size, grade and lymph node status.

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