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, DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE. Date Coll: SPECIMEN. A. Left axillary sentinel node #1. B. Left breast stitch marks long lateral, short superior. C. Intraop lymph node left axilla. D. Right breast tissue long stitch lateral, short stitch superior. E. Left axillary content. CLINICAL NOTES. PRE-OP DIAGNOSIS: Left breast carcinoma. POST-OP DIAGNOSIS: Left breast carcinoma. CLINICAL HISTORY: Left breast carcinoma. FROZEN SECTION DIAGNOSIS. A - Two lymph nodes negative for metastatic disease. Amended diagnosis - Upon re-appraisal, the smaller node. contains. a focus of carcinoma consistent with lobular origin. GROSS DESCRIPTION. A. The specimen is received fresh for frozen section. labeled "left axillary sentinel node #1". It consists of. a. portion of hemorrhagic adipose tissue measuring 3.5 X 2.4 x 0.9 cm. On section it is fatty and slightly indurated consistent with nodal. tissue. One such node measures 3.2 x 1.8 x 0.6 cm. A second smaller. node is present measuring 0.6 cm. by 0.5 X 0.5 cm. The larger node. is bisected and all submitted for frozen section as FS1 and FS2. The smaller node is bisected and all submitted as FS3. B. Received fresh, labeled "left breast" is an 18.1 u. cm. (medial to lateral) X 15.5 cm. (superior to inferior) x. 5.0 cm. (anterior to posterior) diffusely cauterized soft, lobulated. tan gold-white portion of fibroadipose tissue in keeping with. breast. designated as left per requisition slip and container and oriented. by two sutures as stated previously. There is a 9. cm. (medial to. lateral) X 3.8 cm. (superior to inferior) wrinkled white skin. ellipse. with an eccentric, flattened, 1.2 x 1. 1 cm. nipple along the. anterior aspect. A well healed and retracted 1 cm. cicatrix is. present along the skin surface corresponding to the lower outer. quadrant. The anterior surface surrounding the lateral portion. of. the skin ellipse is inked blue, the intact deep margin is inked. black and the specimen is sectioned. There is a poorly defined,. stellate, 5.5 cm. (medial to lateral) x 4.0 cm. (superior to. inferior). x 2.2 (anterior to posterior) oblique rubbery tan white tumor mass,. extending from the lower outer quadrant centrally to the junction. of the four quadrants. A portion of tumor and a portion of normal. parenchyma are submitted for tissue procurement as requested. The. tumor focally extends to within 1.2 cm. of the inked deep margin and. 1.1 cm. from the anterior/skir surface. The parenchyma throughout. the remainder of the specimen consists predominently of glistening. lobulated golden yellow adipose tissue with a minimal amount of. interspersed delicate tan white fibrous tissue. No additional mass. lesion or abnormality is identified. Representative sections are. submitted in twelve blocks as labeled. RS-12. BLOCK SUMMARY: 1,2 - Tumor to inked deep margin; 3,4 - tumor to. overlying skin ellipse/anterior surface of the specimen;. tumor. to adjacent parenchyma; 8 - random upper outer quadrant; 9 - upper. inner quadrant; 10 - lower inner quadrant; 11 - lower outer. quadrant; 12 - nipple. C. Received fresh, labeled "intraop lymph node left. axilla". is 1 cm. in greatest dimension slightly rubbery white. pink. tissue in keeping with lymph node with a moderate amount of. associated adipose tissue. The specimen is bisected and entirely. submitted in one block. AS-1. D. Received fresh, labeled "right breast tissue" is. a. diffusely cauterized and slightly fragmented, 8.6. cm. (medial to lateral) X 6.4 cm. (anterior to posterior) x 3.4. cm. (superior to inferior) soft, lobulated tan gold-white portion of. fibroadipose tissue, with two sutures as stated previously. The. margins are inked as follows: superior blue, inferior black,. anterior green, and posterior orange. The specimen is sectioned. from medial to lateral. There is a 6.5 cm. (medial to lateral) x. 4.2. cm. (anterior to posterior) X 1.0 cm. (superior to inferior) vacant. biopsy cavity occupying the majority of the specimen. The cavity. is. focally contiguous with the anterior, posterior, and superior inked. margins. No residual lesion or abnormality is noted grossly. The. cut surfaces throughout the specimen consist predominately of. mildly. congested glistening lobulated golden yellow adipose tissue with a. scant amount of interspersed delicate tan white fibrous tissue. Representative sections are submitted in a sequential manner from. medial to lateral in ten blocks as labeled. RS-10. BLOCK SUMMARY: 1 - Perpendicular sections entire medial margin cap;. J - sequential sections; 10 - representative perpendicular. sections lateral margin cap. E. Received fresh, labeled "left axillary content" is an. unoriented, 6.5 x 5.8 x 1.8 cm. portion of soft, lobulated. golden yellow adipose tissue. Several soft to slightly rubbery. pale. tan tissues in keeping with lymph nodes measuring up to 1.8 cm. in. greatest dimension are recovered. The lymphoid tissues are. entirely. submitted in three blocks as labeled. RS-3. BLOCK SUMMARY: 1 - Eight whole lymph nodes; 2 - five whole lymph. nodes; 3 - one bisected lymph node. MICROSCOPIC DESCRIPTION. A. Two lymph nodes are examined in their entirety at. multiple levels. The smaller contains a 3 mm. metastasis. with minimal extra-capsular extension, ,. B. The previously biopsied large tumor is an infiltrating. lobular carcinoma. In one 2 mm. area (block #6 within the. main tumor) , there is a focus of invasive ductal carcinoma which is. nuclear grade 1 (architectural score 1, nuclear score 2, mitotic. score 1) . In addition, in blocks 4 and 5 there is in situ tumor. which, with the help of E-Cadherin stain, proves to be ductal. carcinoma in situ, nuclear grade 2. Please see the template below. Invasive carcinoma: Histologic type: Infiltrating lobular carcinoma with single. small focus of associated infiltrating ductal carcinoma. Histologic grade: The invasive lobular carcinoma is moderately. differentiated. Overall grade: [ Last Name (un) 1] SBR grade 2. Architectural score: 3. Nuclear score: 2. Mitotic score: 1. Greatest dimension (pT) : The tumor measures 5.5 cm., pT3. Specimen margins: Negative. Vessel invasion Suspicious for lymphatic invasion. Perineural. invasion is noted. Calcification: Negative. Nipple (Paget's) : No Paget's disease of the nipple is present. Major lactiferous ducts, however, contain lobular neoplasia in. situ, supported by stain for E-Cadherin. There is also a 1.5. mm. of invasive lobular carcinoma within the subareolar tissue,. supported by stains for P63 and E-Cadherin. Invasion of skin or chest wall: Negative. Ductal carcinoma in situ (supported by stain for E cadherin) : Histologic pattern: Solid. Nuclear grade: 2. Central necrosis: Negative. : DCIS of total tumor (if mixed) : The DCIS appears to be. separate from the invasive lobular carcinoma. Extensive intraductal component (present/absent) : Absent. Specimen margins: Negative. Calcification: Negative. Description of non-tumorous breast: Fibrocystic changes are also. present, including cysts, apocrine metaplasia, a 3 mm. fibroadenoma. and rare calcification. Comments: E-Cadherin on block #5 supports the diagnosis of ductal. carcinoma in situ. Lymph nodes: Number of positive nodes of total: As per parts A, C and E,. there are 16 1 mmnh nodes. one of which contains metastatic. carcinoma, l. Size of largest metastasis: 3 mm. Extracapsular extension (present/absent) : Present. pN: 1A. Distant metastasis (pM) : Cannot be assessed. Prognostic markers: Please see. C. A single lymph node is present. Negative for. metastatic. disease, 0/1. D. This portion of tissue contains biopsy site changes. In. situ tumor is noted in blocks 1 through 7. With the. assistance of stains for E-Cadherin on all of these blocks, it is. apparent that the tumor in blocks. ] and 5 is lobular. carcinoma in. situ. The tumor in blocks 4, 6 and 7 prove to be ductal carcinoma. in situ. Also, in block 7, there is a 1.1 mm. focus of invasive. tumor which proves to be of ductal origin. Please see the template. below for the details regarding the ductal tumor. Invasive Carcinoma: Histologic type Infiltrating ductal carcinoma. Histologic grade: Moderately differentiated. Overall grade: Last Name (un) 1] SBR grade 2. Architectural score: 3. Nuclear score: 2. Mitotic score: 1. Greatest dimension (pT) : The tumor measures 1.1 mm., pTla. Specimen margins: Invasive tumor is less than 1 mm from the. inferior margin. Vessel invasion : Negative. Calcification: Negative. Ductal carcinoma in situ: Histologic pattern: Solid and cribriform. Nuclear grade: 2. Central necrosis: Negative. DCIS of total tumor (if mixed) : The invasive component is very. minor relative to the in situ component. Extensive intraductal component (present/absent) : Present. Specimen margins: DCIS less than 1 mm. from the inferior margin. Calcification: Negative. Description of non-tumorous breast: Cysts and apocrine metaplasias. present. Comments: In addition to the invasive and in situ ductal. carcinoma,. there are foci of lobular carcinoma in situ. Prognostic markers: Cold ischemia time too long for accurate. marker. studies. E. Thirteen lymph nodes are present, all negative for. metastatic disease, 0/13. This is supported by negative. keratin stains on blocks 1 through 3. [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 [Last Name. (un) 2]. diagnosis is well described in the medical literature. They have. not been cleared or approved by the FDA. ]. 14, 15x2, 4x5, 20x12, PGRI 3260F. DIAGNOSIS. A. Left axillary sentinel node #1, excision -. Two lymph nodes, one of which contains metastatic carcinoma,. B.(Left) breast, mastectomy -. Large (5.5 cm. ) infiltrating lobular carcinoma, minor. associated component of invasive ductal carcinoma. Ductal. carcinoma in situ also present. A second minute focus of. invasive lobular carcinoma is present in the sub-areolar. tissue. All margins are negative for tumor. C. Intraoperative lymph node left axilla, excision -. Single lymph node negative for metastatic disease, 0/1. D. Right breast tissue, excision -. Breast tissue with biopsy site changes, lobular carcinoma in. situ, ductal carcinoma in situ and invasive ductal carcinoma,. SBR grade 2. The invasive ductal. carcinoma and ductal. carcinoma in situ are. less than 1 mm. from the inferior margin. Hormone receptor. studies cannot accurately be performed on the invasive ductal. carcinoma. E. Left axillary contents, dissection -. Thirteen lymph nodes all negative for metastatic disease,. 0/13.

expanded version (tokens=3142) : 
 Here are the key points extracted from the breast pathology report:

- Histological Classification: 
   - Invasive Carcinoma: 
      - Histologic Type: Infiltrating lobular carcinoma with a small focus of associated infiltrating ductal carcinoma.
      - Histologic Grade: Moderately differentiated (SBR grade 2).
      - Nuclear Grade: 2
      - Mitotic Score: 1
   - Ductal Carcinoma in Situ (DCIS):
      - Histologic Pattern: Solid and cribriform
      - Nuclear Grade: 2

- Necrosis: No mention of necrosis.

- Tumor Infiltrating Lymphocytes: No specific mention of tumor infiltrating lymphocytes.

- Histological Grade: Invasive lobular carcinoma is moderately differentiated (SBR grade 2).

- Lymphovascular Invasion: Suspicious for lymphatic invasion. No specific mention of vascular invasion.

- Calcification: Negative for calcification.

- Receptor Status: Hormone receptor studies cannot be accurately performed on the invasive ductal carcinoma.

- IHC and Ancillary Testing Results: E-Cadherin stain supports the diagnosis of ductal carcinoma in situ. Stains for P63 and E-Cadherin support the presence of invasive lobular carcinoma within the subareolar tissue.

- Other findings: Fibrocystic changes, including cysts, apocrine metaplasia, a 3mm fibroadenoma,

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=3306) : 
 Left breast pathology report: Infiltrating lobular carcinoma (moderately differentiated), with a small focus of infiltrating ductal carcinoma. Ductal carcinoma in situ (solid and cribriform) also detected. Lymphovascular invasion is suspected. No necrosis or calcification present. Hormone receptor status not accurately determined for invasive ductal carcinoma. No specific mention of tumor-infiltrating lymphocytes. Thirteen axillary lymph nodes negative for metastatic disease (0/13). Fibrocystic changes observed, including cysts and apocrine metaplasia.


