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 - Sex: F. Laboratory Patient Report. Print Date/Time. Histopathological Examination. Complete: Pre-op Diagnosis : Left Breast Cancer. Specimens. : breast, left inferior skin. Breast, left. Lymph Node, Left Axillary. Lymph Node, Sentinel Left Axilla. Breast, left, inferior margin. Frozen Diagnosis : Block#. : A-1. Re-Ex?. FS-Diag. : No carcinoma identified. Comment. : none. : GROSS EXAMINATION: A. The specimen is received fresh in a container labeled. with the name of the patient and labeled as breast, left. inferior skin. Tissue: Triangular excision. Size: 0.9 x 0.9 cm. Deep: 0. 3 cm. Sutures: No. Inked No. The specimen is entirely submitted for frozen section in one. block. FROZEN SECTION DIAGNOSIS: No carcinoma identified. B. The specimen is received fresh in a container labeled. with the name of the patient and identified as breast,. left. The specimen consists of a mastectomy measuring en. bloc 19.5 x 15 x 6 cm and weighs 604 grams. There is an. anterior ellipse of skin measuring 14 x 7 cm. Medially. located on the ellipse of skin is a 5 cm areolar complex. with everted nipple. Sections of nipple areola are sampled. in block 1. 2 cm lateral to the areola is a 0.9 cm red-tan. papule which is submitted in block 2. The superficial. superior margin is inked orange and the superficial inferior. margin is inked green. The deep margin is inked blue and. THIS CONFIDENTIAL AND PRIVILEGED DOCUMENT/INFORMATION IS PROTECTED BY. FEDERAL AND STATE LAW. UNAUTHORIZED DISCLOSURE, DISSEMINATION. OR DUPLICATION IS PROHIBITED. Path # : of 4. Visit # : the specimen sectioned, showing a red-tan oval mass in the. lateral aspect of the breast. This mass measures 7 cm. greatest dimension. It grossly extends to within 0.5 cm of. the superior margin of resection which is submitted in block. 3, 0. cm of the inferior margin of resection which is. submitted in block 4, and 1 cm of the deep margin of. resection which is submitted in block 5. Additional sections. of the mass are submitted in blocks 6-9. The remaining. breast is composed of yellow lobulated adipose tissue. admixed with islands of gray-white rubbery tissue. The. breast is divided into four quadrants, upper inner, lower. inner, upper outer and lower outer and sampled in blocks. 10-13 respectively. No axillary tissue is present and no. lymph nodes are identified. Formalin fixation time is 32 hours. Ischemic time: 30 minutes. C. The specimen is received in formalin in a container. labeled with the name of the patient and labeled as lymph. node, left axillary. The specimen consists of an oval piece. of tan-pink and yellow soft tissue which measures 2. 1 x 1.8. x 1 cm. The specimen is sectioned and entirely submitted in. three blocks. D. The specimen is received in formalin in a container. labeled with the name of the patient and identified as lymph. node, sentinel left axilla. Pieces: 1. Specimen Size: 2.2 x 1.4 x 1. 1 cm. No. of Nodes: 1. Size of Nodes: 2.2 cm. The specimen is sectioned and entirely submitted in three. blocks. E. The specimen is received in formalin in a container. labeled with the name of the patient and identified as. additional left breast tissue, inferior margin. Size: 14 x 6 x 2.5 cm. Shape: Flattened oval. Spec Board: No. Radiograph: No. Sutures: Yes; short superior, long lateral. Inked: Anterior-Green, Posterior-Blue, Superior-Orange,. Inferior-Yellow, Medial-Red, Lateral- Black. Sectioning shows no discrete masses. Sections are submitted as follows : Full thickness superior. to inferior sections 1-6 with the remaining margins. submitted as follows: anterior 7, posterior 8, medial 9,. lateral 10. Formalin fixation time is approximately 30 hours. Ischemic time: Unknown. DIAGNOSIS BASED ON GROSS AND MICROSCOPIC EXAMINATION: A. Skin, left inferior breast, biopsy: - Skin with minimal patchy nonspecific chronic inflammation. - No maliqnancy identified. THIS CONFIDENTIAL AND PRIVILEGED DOCUMENT/INFORMATION IS PROTECTED BY. FEDERAL AND STATE LAW. UNAUTHORIZED DISCLOSURE, DISSEMINATION. OR DUPLICATION IS PROHIBITED. Path # : of 4. Visit # : B. Breast, left, mastectomy : - Invasive metaplastic carcinoma, grade 3 (3+3+3) 7 cm in. greatest dimension, present within 3mm (0.3 cm) of superior. margin, 5mm (0.5 cm) of inferior margin, and 10mm (1 cm) of. deep margin. - Invasive carcinoma invades dermis and is associated with. overlying epidermal ulceration. - Background nonproliferative fibrocystic including stromal. fibrosis, apocrine metaplasia, microcystic formation, and. duct ectasia. - See cancer CASA summary checklist. C. Lymph node, left axillary, biopsy: - One benign lymph node, negative for metastatic carcinoma. (0/1). - See cancer case summary checklist. D. Sentinel lymph node, left, biopsy: - One benign lymph node, negative for metastatic carcinoma. (0/1) . - See cancer case summary checklist. E. Breast, left, re-excision of inferior margin: - Benign breast tissue with nonproliferative fibrocystic. changes including apocrine metaplasia, stromal fibrosis, and. microcyst formation. - No malignancy identified. - The margins are examined microscopically and are. histologically unremarkable. - See cancer case summary checklist. CANCER CASE SUMMARY CHECKLIST. SPECIMEN: Total breast (including nipple and skin). PROCEDURE: Total mastectomy. LYMPH NODE SAMPLING: Sentinel lymph nodes and axillary lymph. node biopsy. SPECIMEN INTEGRITY: Multiple designated specimens (main. excision and identified margin). SPECIMEN LATERALITY: Left. TUMOR SITE (Invasive Carcinoma) : Upper and lower outer. quadrants. TUMOR SIZE: Size of Largest Invasive Carcinoma: 7 cm (70. mm) in greatest dimension. TUMOR FOCALITY: Single focus of invasive carcinoma. MACROSCOPIC AND MICROSCOPIC EXTENT OF TUMOR: - Skin: Invasive carcinoma directly invades into the dermis. with associated skin ulceration. - Nipple: DCIS does not involve the nipple epidermis. Skeletal Muscle: No skeletal muscle is present. DUCTAL CARCINOMA IN SITU (DCIS) : No DCIS is present. LOBULAR CARCINOMA IN SITU (LCIS) Not identified. HISTOLOGIC TYPE OF INVASIVE CARCINOMA: Invasive metaplastic. THIS CONFIDENTIAL AND PRIVILEGED DOCUMENT/INFORMATION IS PROTECTED BY. FEDERAL AND STATE LAW. UNAUTHORIZED DISCLOSURE, DISSEMINATION. OR DUPLICATION IS PROHIBITED. carcinoma. HISTOLOGIC GRADE: NOTTINGHAM HISTOLOGIC SCORE: - Glandular (Acinar)/Tubular Differentiation. 3. - Nuclear Pleomorphism: 3. - Mitotic Count: 3. Number of mitoses per 10 high-power fields: 30. Diameter or microscope field: 0.55 mm. - Overall Grade: Grade 3 (score of 9). MARGINS: - Margins uninvolved by invasive carcinoma. - Distance of invasive carcinoma to closest margin = 3 mm. (0.1 cm), superior. - All other margins greater than 1 cm from invasive. carcinoma (including specimens A and E). LYMPH-VASCULAR INVASION: Not identified. Dermal Lymph-Vascular Invasion: Not identified. LYMPH NODES: Number of sentinel lymph nodes examined: 1. Total number of lymph nodes examined (sentinel and. nonsentinel) : 2. Number of lymph nodes with macrometastases (>0.2 cm) : 0. Number of lymph nodes with micrometastases (>0.2 mm to. 0.2 cm and/or >200 cells): 0. Number of lymph nodes with isolated tumor cells (0.2 mm and. <200 cells) : 0. Size of largest metastatic deposit: Not applicable. Extranodal Extension: Not applicable. Method of Evaluation of Sentinel Lymph Nodes: H&E, 1 level. PATHOLOGIC STAGING (pTNM) : - Primary Tumor (Invasive Carcinoma). (pT) : pT4b (skin. ulceration). - Regional Lymph Nodes (pN) : pNO (no regional lymph node. metastasis identified histologically). - Distant Metastasis (M) : Not applicable. ANCILLARY STUDIES: Estrogen Receptor: - Performed on another specimen. - Results: No immunoreactive tumor cells present. Progesterone Receptor: - Performed on another specimen. - Results: No immunoreactive tumor cells present. HER2/neu Immunoperoxidase Studies: - Performed on another specimen. - Results: Negative (score 0). Fluorescence In Situ Hybridization (FISH) for HER2/neu: - Not performed. Intradepartmental consultation obtained. M.D., Pathologist. Flantrnninallv Signed by: MD. THIS CONFIDENTIAL AND PRIVILEGED DOCUMENT/INFORMATION IS PROTECTED BY. FEDERAL AND STATE LAW. UNAUTHORIZED DISCLOSURE, DISSEMINATION. OR DUPLICATION IS PROHIBITED. of 4.

expanded version (tokens=2634) : 
 Histological classification: 
- Invasive metaplastic carcinoma, grade 3 
- No DCIS or LCIS identified

Necrosis: 
- None reported

Tumor infiltrating lymphocytes: 
- Not identified

Histological grade and nuclear grade: 
- Nottingham histologic score: 9 (grade 3)
- Glandular (Acinar)/Tubular Differentiation: 3 
- Nuclear Pleomorphism: 3 
- Mitotic Count: 3 (Number of mitoses per 10 high-power fields: 30)

Lymphovascular invasion: 
- Not identified

Calcification: 
- Not mentioned

Receptor status:
- Estrogen receptor and progesterone receptor: No immunoreactive tumor cells present.
- HER2/neu: Negative (score 0)

Ancillary testing results: 
- Fluorescence In Situ Hybridization (FISH) for HER2/neu: Not performed.
- Number of lymph nodes with macrometastases (>0.2 cm): 0 
- Number of lymph nodes with micrometastases (>0.2 mm to 0.2 cm and/or >200 cells): 0 
- Number of lymph nodes with isolated tumor cells (0.2 mm and <200 cells): 0 
- Method of Evaluation of Sentinel Lymph Nodes: H&E, 1 level

Overall, the report indicates a diagnosis of invasive metaplastic carcinoma

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=2792) : 
 Histopathological examination of a left breast cancer specimen showed invasive metaplastic carcinoma, grade 3, with no tumor infiltrating lymphocytes or lymphovascular invasion. Hormone receptor status was negative for estrogen receptor and progesterone receptor, and HER2/neu was negative (score 0). Lymph nodes were negative for macrometastases, micrometastases and isolated tumor cells. Sentinel lymph nodes were evaluated by H&E with one level. No ductal carcinoma in situ or lobular carcinoma in situ was identified.

