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Understanding and improving the prognosis of patients with a disease or health condition is a priority in clinical research and practice. More than 30 years ago, the Nottingham Prognostic Index (NPI) was proposed, has been sufficiently validated and also used in clinical practice. NPI is a widely accepted index to reflect metastatic behavior, growth rate, and genetic instability of breast cancer and to accurately predict survival patterns in accordingly stratified groups with follow up period after primary diagnosis of breast cancer.