prompt1 : extract information from  breast pathology report. List the histological classification, i.e. type of cancer or DCIS, subtype, description of any necrosis, any mention of tumor infiltrating lymphocytes,  histological grade, nuclear grade,  lymphovascular invasion, calcification, receptor status, IHC and any other ancillary testing results.  List out and expand the main points.
prompt2 : The report is - Subtype LumA, Specimen #: (Age: )F Race: WHITE. SPECIMEN: A: LEFT BREAST B: RIGHT BREAST. C: LEFT AXILLARY SENTINEL NODE. D: RIGHT AXILLARY SENTINEL NODE. E: RIGHT AXILLARY NON SENTINEL NODE. FINAL DIAGNOSIS: A. BREAST, LEFT, SIMPLE MASTECTOMY: - SKIN WITH NO SIGNIFICANT PATHOLOGIC CHANGES. BREAST TISSUE WITH FIBROCYSTIC CHANGES TO INCLUDE APOCRINE METAPLASIA. AND MICROCYST FORMATION. - NEGATIVE FOR MALIGNANCY. B. BREAST, RIGHT, SIMPLE MASTECTOMY: - TUMOR TYPE: INVASIVE LOBULAR CARCINOMA, MULTICENTRIC (SEE COMMENT) . TUMOR #1: - TUMOR TYPE: INVASIVE LOBULAR CARCINOMA, LOW NUCLEAR GRADE. - NOTTINGHAM GRADE: I/III. - NOTTINGHAM SCORE: 5/9. (Tubules= 3, Nuclei= 1, Mitoses= 1; mitotic count 1 per 10 HPF at. 40x power). - TUMOR LOCATION: LOWER OUTER QUADRANT. TUMOR SIZE (GREATEST DIMENSION) : 1.0 CM (MEASURED GROSSLY). - ADDITIONAL DIMENSIONS: 1.0 X 0.5 CM. - TUMOR NECROSIS: NONE IDENTIFIED. - MICROCALCIFICATIONS: NONE IDENTIFIED. VENOUS / LYMPHATIC INVASION: NONE IDENTIFIED. - MARGINS: TUMOR INVOLVES INKED SUPERFICIAL MARGIN (B2) . - INTRADUCTAL COMPONENT: NONE IDENTIFIED. LYMPH NODES FOUR (4) OF FOUR POSITIVE FOR TUMOR BY H&E (SEE PARTS D. AND E). - NIPPLE INVOLVEMENT: NOT IDENTIFIED. - SKIN INVOLVEMENT: NOT IDENTIFIED. TUMOR #2: - TUMOR TYPE: INVASIVE LOBULAR CARCINOMA, LOW NUCLEAR GRADE. - NOTTINGHAM GRADE: I/III. - NOTTINGHAM SCORE: 5/9. (Tubules= 3, Nuclei= 1, Mitoses= 1; mitotic count 2 per 10 HPF at. Specimen # : FINAL DIAGNOSIS (continued) : 40x power). - TUMOR LOCATION: UPPER MIDDLE. - TUMOR SIZE (GREATEST DIMENSION) : 1.0 CM (MEASURED GROSSLY) (SEE. COMMENT) . - ADDITIONAL DIMENSIONS: 1.0 X 0.5 CM. - TUMOR NECROSIS: NONE IDENTIFIED. MICROCALCIFICATIONS: PRESENT, ASSOCIATED WITH LOBULAR CARCINOMA IN. SITU (B3). - VENOUS / LYMPHATIC INVASION: NONE IDENTIFIED. - MARGINS : TUMOR <0.1 CM FROM INKED SUPERFICIAL MARGIN (B3). - INTRADUCTAL COMPONENT : NONE IDENTIFIED. - LYMPH NODES: SEE ABOVE. - NIPPLE INVOLVEMENT: NOT IDENTIFIED. - SKIN INVOLVEMENT: NOT IDENTIFIED. - ESTROGEN RECEPTORS: POSITIVE (PER. - PROGESTERONE RECEPTORS: POSITIVE (PER. - HER 2 NEU by IHC: 1+ (NEGATIVE) (PER. - PATHOLOGIC STAGE: pT1c N2 MX (AJCC, 6th ED) (SEE COMMENT). - ADDITIONAL PATHOLOGIC CHANGES: - LOBULAR CARCINOMA IN SITU. - ACELLULAR FOREIGN MATERIAL AND BIOPSY SITE CHANGES (SEE COMMENT) . - FIBROCYSTIC CHANGES TO INCLUDE APOCRINE METAPLASIA AND MICROCYST. FORMATION. - MAMMARY DUCT ECTASIA. C. SENTINEL LYMPH NODE, LEFT AXILLA, EXCISIONAL BIOPSY: - THREE (3) BENIGN LYMPH NODES BY CONVENTIONAL H&E AND. IMMUNOHISTOCHEMICAL STAINING. D. SENTINEL LYMPH NODES, RIGHT AXILLA, EXCISIONAL BIOPSY. - THREE (3) LYMPH NODES POSITIVE FOR CARCINOMA BY CONVENTIONAL H&E AND. IMMUNOHISTOCHEMICAL STAINING. E. NON-SENTINEL LYMPH NODE, RIGHT AXILLA, EXCISIONAL BIOPSY: - ONE (1) LYMPH NODE POSITIVE FOR CARCINOMA WITH EXTRACAPSULAR. EXTENSION BY H&E STAINING. Comment: There are two separate tumors in the right breast mastectomy. specimen. Since these tumors are separated by 4. cm and are located in. different quadrants the designation "multicentric" is used. Both tumors. are histologically similar. The acellular marker material present in the. specimen is associated with the upper middle tumor (tumor #2) . There are. isolated tumor cells present in a section adjacent to the upper middle. Specimen #: FINAL DIAGNOSIS (continued) : tumor (tumor #2, slide B4) making the exact determination of tumor size. difficult. The largest dimension measured of the tumor is 1.2 cm from the. previous biopsy specimen (S08- - i! making the tumor stage Tlc. The. histologic appearance along with the presence of lobular carcinoma in situ. and the immunohistochemical characterization of the previous biopsy. support the diagnosis of invasive lobular carcinoma. CLINICAL DIAGNOSIS AND HISTORY: year-old female with right breast mass birads four on. mammogram, ultrasound guided biopsy, invasive lobular carcinoma. Bilateral simple mastectomy, skin biopsy, with immediate reconstruction. PRE-OPERATIVE DIAGNOSIS: Right breast cancer. GROSS DESCRIPTION: A. Received fresh, labeled with the patient's name,. designated "LEFT BREAST TISSUE WITH MARKINGS" is a mastectomy specimen. oriented with a short stitch superior, long stitch lateral, and double. stitch "down". The specimen measures 17.0 cm medial to lateral, 16 cm. superior to inferior, and 3.5 cm anterior to posterior. The lightly. pigmented superficial skin ellipse measures 10.0 x 3.0 cm and displays a. 1.0 cm centrally located everted nipple free of discharge. No scar is. identified. The deep margin is inked black. Serial sections reveal. predominantly lobulated, yellow-tan, adipose tissue admixed with evenly. distributed, tan-white, fibrous tissue comprising approximately 20% of the. cut surface. On palpation, no discreet mass or lesion is identified. No. lymph nodes are identified. Cassette Summary : A1: Skin. A2: Upper outer quadrant. A3: Upper inner quadrant. A4: Lower inner quadrant. A5: Lower outer quadrant. A6: Central. A7: Nipple. A8: Upper outer quadrant. Specimen #: GROSS DESCRIPTION (continued) : A9: Upper inner quadrant. A10: Lower inner quadrant. All: Lower outer quadrant . Matched sections of A1 through A6 are submitted in. for CBCP protocol. B. Received fresh, labeled with the patient's name,. designated "RIGHT BREAST TISSUE WITH MARKINGS" is a mastectomy specimen. oriented with a short stitch superior, and a long stitch lateral. The. specimen measures 7.0 cm superior to inferior, 17.0 cm medial to lateral,. and 3.5 cm anterior to posterior. The lightly pigmented superficial skin. ellipse measures 10.0 x 3.0 cm and displays a 1.0 cm centrally located,. everted nipple free of discharge. No scar is identified. The deep margin. is inked black, and the superficial surface is partially inked blue. Serial sections reveal a 1.0 x 1.0 x 0.5 cm well defined, tan-white mass. in. the. upper mid breast, abutting the blue inked superficial surface, and. coming to within 4.0 cm of the deep margin. Also identified is a second,. poorly defined mass in the lower outer quadrant measuring approximately. 1.0 x 1.0 x 0.5 cm. The lower outer quadrant mass abuts the blue inked. superficial surface, and is located 4.5 cm from the deep margin. The. masses are separated by a distance of approximately 4.5 cm. The remainder. of the specimen is predominantly composed of lobulated, yellow-tan,. adipose tissue admixed with approximately 20% slightly dense, fibrous. tissue. No additional lesions are identified. No lymph nodes are. identified. Cassette Summary : B1: Skin. B2 Lower outer quadrant mass. B3 : Upper mid mass. B4: Adjacent normal (to B3) . B5: Upper outer quadrant. B6: Lower outer quadrant. B7: Lower inner quadrant. B8: Upper inner quadrant. B9: Nipple. B10: Lower outer quadrant mass. B11: Deep margin of lower outer quadrant mass. B12-B13: Upper mid mass. B14: Deep margin of upper mid mass. C. Received in formalin, labeled with the patient's name,. D, designated "LEFT AXILLARY SENTINEL NODE" is a 5.5 x 4.5 x. cm. irregularly shaped, lobulated fragment of tan-yellow, adipose. Sectioning. Specimen #: GROSS DESCRIPTION (continued) : reveals three possible lymph nodes ranging in size from 1.0 x 0.6 x 0.3 cm. to 1.2 x 1.0 X 0.6 cm. The lymph nodes are bisected, and submitted in. cassettes C1 through C3. D. Received in formalin, labeled with the patient's name,. D, designated "RIGHT SENTINEL NODE" is a tan-yellow, lobulated,. irregularly shaped fragment of adipose tissue measuring 5.5 x 3.0 X 0.5 cm. in diameter. Examination reveals three possible lymph nodes ranging in. size from 0.2 x 0.2 x 0.2 cm to 2.3 x 1.6 x 1.0 cm. Cassette Summary. D1-D2: First possible lymph node. D3: Second possible lymph node. D4: Third possible lymph node. E. Received fresh for intraoperative consultation, labeled with the. patient's name,. designated "RIGHT AXILLARY TISSUE, NON. SENTINEL NODE" is a 4.0 x 3.5 x 2.0 cm irregular portion of yellow-tan,. soft tissue. Sectioning reveals a single, 1.5 x 1.0 x 0.5 cm lymph node. The cut surface is tan-white, suspicious for involvement by lesion. The. lymph node is bisected, and submitted in cassette E1. A matched section. of E1 is submitted in. ior CBCP protocol. Time in formalin for specimen A: 79 hours. Time in formalin for specimen B: 81 hours.

expanded version (tokens=2874) : 
 Histological classification:

- Left breast tissue: Fibrocystic changes to include apocrine metaplasia and microcyst formation. Negative for malignancy.
- Right breast tissue: Invasive lobular carcinoma, multifocal/multicentric (two separate tumors present), low nuclear grade, Nottingham grade I/III. Positive for estrogen and progesterone receptors. HER2-negative (1+ by IHC). Lobular carcinoma in situ identified. Lymphovascular invasion and calcification were not identified. Margin status: tumor involves inked superficial margin (B2) and tumor <0.1 cm from inked superficial margin (B3).
- Left axillary sentinel node and three lymph nodes from the right axilla were removed.

Subtype: Luminal A.

Subtype LumA is a type of breast cancer that tests positive for hormone receptors (estrogen receptor and/or progesterone receptor-positive), but negative for HER2 expression. It is usually slow-growing and has a favorable prognosis.

Subtype LumA was not explicitly mentioned in the report, but it can be inferred from the hormone receptor and HER2 status of the tumor.

Subtype, subtype LumA is positive for estrogen and progesterone receptors and negative for HER2 (1+ by IHC).

Necrosis: None identified in both tumors.

Tumor infiltrating lymphocytes: Not mentioned.

Histological grade: Nottingham grade I/III (low nuclear grade).

Nuclear grade: Low.



prompt : Please generate a succinct report in 75 words from the above information. Exclude any filler words or sentences. If something is not mentioned or specified, exclude it from the report. Low verbosity.

final output (tokens=3019) : 
 This is a report for a woman who underwent bilateral mastectomy due to concerns of right breast cancer. Subtype LumA was identified for the diagnosed invasive lobular carcinoma, which was multifocal/multicentric. The Nottingham grading system determined its grade as I/III with low nuclear grading. The tumor was positive for estrogen and progesterone receptors while negative for HER2. No necrosis or lymphovascular invasion was identified in any of the tumors, while margins were involved.

