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 - SPECIMEN. A. Left sentinel lymph node #1. B. Left breast stitch 12 o'clock. C. Left breast, Tail of Spence. D. Left breast, Nodule inferior skin flap - stitch 6 o'clock. E. Right breast double long 12 o'clock single long hard mass 10. b'clock. F. Palpable area right axilla. G. Sentinel node #2, right breast. REPORT REVISED ON. AT. CLINICAL NOTES. PRE-OP DIAGNOSIS: Bilateral breast carcinoma. FROZEN SECTION DIAGNOSIS. A) Lymph node, sentinel node left, excision: One lymph node. negative for metastatic carcinoma (0/1). FFS1, FFS2: Palpable area, right axilla, biopsy - Benign lymph. node. present. GFS: Sentinel node #2, right axilla, biopsy - One lymph node with. no evidence of metastasis. GROSS DESCRIPTION. A. Received fresh for frozen section labeled "left. sentinel lymph node #1" is an irregularly shaped fragment. of blue stained tissue that measures 1.3 x 0.6 x 0.4 cm. in. dimension. Tissue is entirely frozen. B. Received fresh, labeled "left breast stitch 12. o'clock". is a 26.0 cm. (medial to lateral) x 24.5 cm. (superior to. inferior) x 4.5 cm. (anterior to posterior) diffusely cauterized and. focally blue stained soft, lobulated tan gold-white portion of. fibroadipose tissue in keeping with breast designated as left per. requisition slip and container and oriented by a single suture as. stated previously. A 5.5 cm. (medial to lateral) X 2.3 cm. (superior. GROSS DESCRIPTION. to inferior) portion of dusky tan white skin with a central,. everted, 1.3 X 1.3 x 0.5 cm. nipple is present along the anterior. aspect. The deep margin is inked black and the specimen is. sectioned. There is a roughly spherical, 2.4 cm. clot-filled. biopsy. cavity within the lower inner quadrant. The cavity is present. within 1.2 cm. of the anterior surface (inked blue see block 2) and. 2.8 cm. of the inked deep margin (see block 1). Several. cylindrical. tan white firm structures are evident within the cavity. The. periphery of the cavity is fibrotic with diffuse chalky yellow fat. necrosis. Lateral to the cavity is an ill-defined focus of firm,. tan white fibrous tissue with dilated ductal structures (see blocks. 6 and 7) Within the center of the focus, there appears to be a. stellate 1.0 x 1.0 X 1.0 cm. rubbery tan white lesion which is 0.5. cm. from the inked deep margin (see blocks 7 and 8) - . The remaining. cut. surfaces throughout the specimen consists predominately of. glistening lobulated golden yellow adipose tissue with a moderate. amount of interspersed focally blue stained dense tan white fibrous. tissue. No additional mass lesions are identified. Representative. sections are submitted in fourteen blocks as labeled. RS-14. BLOCK SUMMARY: 1 - Biopsy cavity to inked deep margin; 2 - biopsy. cavity to anterior surface; 3-5 - biopsy cavity to adjacent. parenchyma; 6 - firm area lateral to biopsy cavity; 7-8 - apparent. lesion lateral to biopsy cavity to inked deep margin; 9 - random. upper outer quadrant; 10 - upper inner quadrant; 11 - lower inner. quadrant; 12 - lower outer quadrant; 13 - junction of the four. quadrant; 14 - nipple. C. Received fresh, labeled "tail of Spence", is a 5 X 4 X. 1.6. cm. portion of soft, lobulated golden-yellow adipose. tissue. Three soft tan-pink-gold tissues, in keeping with lymph. nodes, measuring up to 1.5 cm. in greatest dimension, are. recovered. The lymphoid tissues are entirely submitted in three blocks, as. GROSS DESCRIPTION. labeled. RS-3. BLOCK SUMMARY: 1 - One whole presumptive node; 2,3 - one bisected. presumptive node per cassette. D. Received fresh, labeled "nodule inferior skin flap -. stitch 6 o'clock", is a 3.8 cm. (9 to 3 o'clock) x 0.9 cm. (12 to 6 o'clock) wrinkled tan-white skin ellipse, with a suture. along one aspect, as stated previously. The 12 'clock half is. inked blue and the 6 o'clock half is inked black. There is a. stellate, rubbery, 0.6 X 0.6 x 0.6 cm. tan-white nodular lesion. within the 9 o'clock half of the specimen, which appears to extend. to within less than 0. cm. of the inked 12 o'clock surface. The. specimen is entirely submitted in a sequential manner from 3 to 9. "clock in four blocks (nodule block 3). E. Received fresh, labeled "right breast double long 12. o'clock, single long hard mass 10 o'clock" is 27.0. cm. (medial to lateral) x 23.5 cm. (superior to inferior) X 4.5. cm. (anterior to posterior) diffusely cauterized and focally blue. stained soft, lobulated tan gold-white portion of fibroadipose. tissue in keeping with breast designated as right per requisition. slip and container and oriented by double suture as stated. previously. A 4. 4 cm. (medial to lateral) X 2.5 cm. (superior to. inferior) dusky tan white skin ellipse with a central, everted, 1.0. x 1. 0 X 0.6 cm. nipple is present along the anterior aspect. A. second single suture is present at approximately 9-10 o'clock. The. intact deep margin is inked black and the specimen is sectioned. There is a moderately well circumscribed, 5.0 cm. (superior to. inferior) X 3.4 cm. (medial to lateral) x 3.0 cm. (anterior to. posterior) auti-loculated slightly firm cystic structure subjacent. to the aforementioned single suture at the junction of the upper. and. lower outer quadrants. The cyst focally extends to within 0.3 cm. of the inked deep margin (see blocks 1 and 2) and is 1.5 cm. from. GROSS DESCRIPTION. the anterior surface (subsequently inked blue) . A portion of the. cystic focus and a portion of normal parenchyma are submitted for. tissue procurement as requested. The cut surfaces throughout the. remainder of the specimen consists predominately of glistening. lobulated golden yellow adipose tissue with a moderate amount of. interspersed diffusely cystic tan white fibrous tissue. No mass. lesion or additional abnormalities are identified. Representative. sections are submitted in 16 blocks as labeled. RS-16. BLOCK SUMMARY: 1-2 - Cystic structure to inked deep margin; 3-4 -. cystic structure to inked anterior margin; 5-10 - representative. cystic structure to surrounding parenchyma including firm area. sequentially from lateral to medial; 11 - random upper outer. quadrant; 12 - upper inner quadrant; 13 - lower inner quadrant; 14. lower outer quadrant; 15 - junction of the four quadrants; 16 -. nipple. F. Container F is labeled with the patient's name,. medical. record number and "palpable area right axilla". The. specimen consists of a single fragment of fatty tissue measuring 2. X. 1.5. x 1 cm. AS-1. Blocks FS1 and FS2. G. Container G is labeled. "sentinel node #2 right axilla". The specimen consists of. a. single lymph node measuring 0.8 X 0.5 X 0.5 cm. ASF, GFF, bisected. This case is being handled by Dr. MICROSCOPIC DESCRIPTION. B. Left Breast. Invasive carcinoma: Histologic type: Ductal. Histologic grade: II. MICROSCOPIC DESCRIPTION. Overall grade: 6/9. Architectural score: 2. Nuclear score: 2. Mitotic score: 2. Greatest dimension (pT) : No less than 1.5 cm (adjacent to. biopsy. cavity). Specimen margins: Negative. Vessel invasion: No definitive invasion identified. Calcification : Present. Nipple (Paget's) : Negative. Invasion of skin or chest wall: Negative. Ductal carcinoma in situ: Histologic pattern: Cribriform and solid. Nuclear grade: 3. Central necrosis: Present. % DCIS of total tumor (if mixed) : 20%. Specimen margins: DCIS is 3 mm from deep margin (two small. foci). Calcification : Present. Description of non-tumorous breast: Small papillomas; fibrocystic. changes with microcalcifications. Comments: Previous core biopsy. reviewed. Carcinoma. is lateral to prior biopsy site. Prognostic markers: See core biopsy report,. D. "Left breast, Nodule inferior skin flap". Invasive Carcinoma. Histologic type: Ductal. Histologic grade: II. Overall grade: 6/9. Architectural score: 2. MICROSCOPIC DESCRIPTION. Nuclear score: 3. Mitotic score. 1. Greatest dimension (pT) : 7 mm. Specimen margins: 1.5 mm from resection margin (several areas). Vessel invasion: Negative. Calcification Present. Comments: Skin not directly involved by carcinoma. Focal duct. present containing necrotic debris and calcification, without. definitive ductal carcinoma in-situ identified. Breast Prognostic Marker Report (Part D). Estrogen receptor. 80%. Progesterone receptor:. 0%. Her2/neu by IHC: 0-1+. Interpretation. Estrogen receptor: Positive. Progesterone receptor. Negative. Her2/neu by IHC: Negative. Part E. Right breast. Ductal carcinoma in situ: Outer breast. Histologic pattern: Solid, papillary and micropapillary. Nuclear grade: 2. Central necrosis: Absent. Tumor size (if pure in situ) : 5 cm. Specimen margins: DCIS is focally 2 mm from deep margin and 3. mm. from anterior margin. MICROSCOPIC DESCRIPTION. Calcification Present. Comments: Fibrocystic changes are intermixed within this. complex. mass lesion, the majority of which is composed of ducts involved. by carcinoma in-situ. Invasive carcinoma is not identified. (p63 performed to evaluate) Portions of case also reviewed. by Dr. Nipple: large ducts of nipple involved by ductal carcinoma. in-situ. Breast Prognostic Marker Report (Part E). Estrogen receptor: 100%. Progesterone receptor:.. 0%. Interpretation. Estrogen receptor: Positive. Progesterone receptor. Negative. Prognostic markers were done by mmunohistochemical stain on. paraffin sections from 10% neutral buffered formalin fixed tissue. using. antibodies on a Benchmark automated. stainer. The Her2/neu antibody is clone 4B5 and has been approved by the FDA. as an aid in the assessment of breast cancer patients for whom. Herceptin treatment is considered. This laboratory meets the test validation and quality assurance. requirements of the ASCO/CAP guidelines for Her2 testing for. carcinoma of the breast (Arch Pathol Lab Med 2007;131:18-43) - . MICROSCOPIC DESCRIPTION. [A few of the antibodies used in our laboratory may be classified. as. analyte specific reagents. These antibodies are monitored and. controlled in our laboratory and their performance for in vitro. diagnosis is well described in the medical literature. They have. not been cleared or approved by the FDA. ]. 4x6, 3, 14x3, 15, 20x2, 25x5. REPORT REVISED ON. AT. DIAGNOSIS. A. Left breast, sentinel lymph node #1, biopsy: One negative lymph node (0/1). B. Breast, left, mastectomy: Invasive ductal carcinoma, grade II, size no less than 1.5. cm., with associated ductal carcinoma in-situ, grade 3, with. necrosis. C. Lymph node, Tail of Spence, left breast, regional resection: Three negative lymph nodes (0/3). D. Breast, left, inferior skin flap nodule, excisional biopsy: Invasive ductal carcinoma, grade II, 7 mm., close to. excisional margin. E. Breast, right, mastectomy: Ductal carcinoma in-situ, grade 2, involving 5 cm area and. large ducts of nipple. No invasive carcinoma identified. F. Lymph node, right axilla, biopsy: One negative lymph node (0/1) . G. Sentinel lymph node #2, right axilla, biopsy: One negative lymph node (0/1). REPORT REVISED ON. AT. DIAGNOSIS. MD (Electronic Signature). REVISED REPORT -. Clarification of specimen identification.

expanded version (tokens=3380) : 
 Histological classification: 
- Left breast, sentinel lymph node #1: Negative lymph node (0/1)
- Left breast, mastectomy: Invasive ductal carcinoma, grade II, size no less than 1.5 cm, with associated ductal carcinoma in-situ, grade 3, with necrosis
- Lymph node, Tail of Spence, left breast, regional resection: Three negative lymph nodes (0/3)
- Left breast, inferior skin flap nodule, excisional biopsy: Invasive ductal carcinoma, grade II, 7 mm, close to excisional margin
- Right breast, mastectomy: Ductal carcinoma in-situ, grade 2, involves a 5 cm area and large ducts of nipple. No invasive carcinoma identified
- Lymph node, right axilla, biopsy: One negative lymph node (0/1)
- Sentinel lymph node #2, right axilla, biopsy: One negative lymph node (0/1)

Subtypes: 
- Left breast, mastectomy: Invasive ductal carcinoma
- Left breast, inferior skin flap nodule: Invasive ductal carcinoma
- Right breast, mastectomy: Ductal carcinoma in-situ

Description of necrosis: 
- Left breast, mastectomy: Necrosis present in the associated ductal carcinoma in-situ
- Left breast, inferior skin flap nodule: Focal duct present containing necrotic debris without

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=3556) : 
 Left breast mastectomy: Invasive ductal carcinoma, grade II, with associated ductal carcinoma in-situ, grade 3, and necrosis. Lymphovascular invasion not mentioned. Calcification present. Estrogen receptor positive, progesterone receptor negative, Her2/neu negative. Left breast inferior skin flap nodule excisional biopsy: Invasive ductal carcinoma, grade II, 7 mm size. Right breast mastectomy: Ductal carcinoma in-situ involving 5 cm area and nipple ducts. No invasive carcinoma identified. Lymph node biopsies: All negative for metastasis (0/1).

