This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
A case of carcinoma breast stage-IV TNM. Which of the factors is not included in staging? 
Select and explain. 
A. Satellite nodules, B. Inflammation, C. Nipple retraction, D. Skin ulceration
C: Nipple retraction
Answer: C: Nipple retraction 
Explanation: In Stage IV TNM of carcinoma of breast, malignancy has spread to chest wall, there is evidence of inflammation, satellite lesions and ulcerations.