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 - Patient Location: Date of Service: Date Received: Room: Bed: A copy of this report will be faxed to: FINAL SURGICAL PATHOLOGY REPORT. Diagnosis: BREAST, RIGHT, MODIFIED RADICAL MASTECTOMY: - Invasive lobular carcinoma, grade 2. - Tumor size at least 65 mm, see comment. - Surgical margins negative. - Five of fourteen lymph nodes POSITIVE for carcinoma (5/14). Extracapsular extension identified. PATHOLOGIC TUMOR STAGING SYNOPSIS: Type and grade (invasive): Invasive lobular carcinoma, grade 2. Type and grade (in situ): Lobular carcinoma in situ. Primary tumor: pT3. Regional lymph nodes: pN2a (5/14 lymph nodes positive). Distant metastasis: pMX. Pathologic stage: IIIA. Lymphovascular invasion: Not identified. Margin status: R0, negative. COMMENT: The tumor size is measured at least 6.5 cm grossly, however, there is a. second tumor mass grossly noted that shows similar histology to the large tumor. mass grossly noted. On random sections between the two tumor masses, invasive. lobular carcinoma is seen, therefore, these masses are considered to be one large. tumor mass rather than two separate masses (overall gross estimate of 14 cm). Results discussed with Dr. Printed: This report continues. FINAL SURGICAL PATHOLOGY REPORT. Breast Invasive Tumor Staging Information. (AJCC Cancer Staging Handbook, 7th Ed, and CAP protocol, Oct 2009). This staging also incorporates: Previous biopsy: Breast profile: Other: N/A. Specimen type: Total breast including nipple and skin. Specimen procedure: Modified radical mastectomy. Lymph node sampling: Axillary dissection. Specimen integrity: Single intact specimen. Specimen laterality: Right. Specimen size (other than mastectomy): 2,220 grams, 28 X 23 X 6 cm. INVASIVE TUMOR FEATURES: Invasive tumor size: At least 65 mm. Invasive tumor site: Upper outer quadrant. Invasive tumor focality: Single focus of invasive carcinoma. Histologic type: Invasive lobular carcinoma. Total Nottingham Grade: Grade 2, cumulative score 6 of 9. Tubule formation: Less than 5% (3 of 3). Nuclear Pleomorphism: Intermediate (2 of 3). Mitotic count for Nottingham: Low (1 of 3). Mitotlc count: Two per ten high power field. Other Grading System: N/A. Lymphatic invasion: Not identified. MARGIN STATUS FOR INVASIVE COMPONENT: R0, negative. Distance of tumor from margins: Closet margin: Deep at 15 mm. Other margins: All other margins 15 mm or greater. DUCTAL CARCINOMA IN-SITU (DCIS): Not identified. LOBULAR CARCINOMA IN-SITU (LCIS): Present. Skin: Present, invades skin, no ulceration or. lymphovascular invasion. Nipple: Present, tumor invades nipple. Skeletal Muscle: Not identified. INVASIVE PATHOLOGIC TUMOR STAGING (pTNM). Primary tumor (pT): pT3. FINAL SURGICAL PATHOLOGY REPORT. Regional lymph nodes (pN): pN2a (5/14 lymph nodes POSITIVE). Distant metastasis (pM): pMX. Pathologic stage: IIIA. RECEPTOR STATUS AND HER2/NEU: Estrogen receptors: POSITIVE (95-100% positive cells, strong. intensity). Progesterone receptors: POSITIVE (90-100% positive cells, strong. intensity). Her2/neu: Negative (0, scale 0-3+). Kl-67 proliferative index: Low (2-5% positive cells). COMMENT: The biomarkers are combined from previous. cases and show a similar staining pattern. The. patient had two previous biopsies, however, on. the mastectomy specimen, there are two. identified masses, however, there is intervening. tumor cells and both tumor masses show a. similar histology, therefore, it's felt to represent. one large tumor mass. In addition to the five. macrometastases seen in the fourteen lymph. nodes, two additional lymph nodes show isolated. tumor cells (and are not included in the five. positive nodes). Additional pathologic findings: Apocrine metaplasia, atypical lobular. hyperplasia, usual ductal hyperplasia. MD,. Source of Specimen: Right Breast total mastectomy. Clinical History/Operative Dx: Right breast cancer. Gross Description: The specimen is labeled right breast modified radical mastectomy and is received without fixative. It. consists of a modified radical mastectomy which weighs 2,220 grams. Overall, the specimen measures 28. x 23 x 6 cm. There is an overlying broad ellipse of brown skin measuring 30 X 19.5 cm. Centrally and. slightly superiorly within the skin, there is a 7.5 cm areola and a protuberant 1.5 cm nipple. The. peripheral skin displays five sharply delineated dark brown, smooth, shiny papules. The anterior-superior. margin is inked blue, the anterior-inferior margin is inked green, and the posterior margin, which consists. of smooth facial tissue, is inked black. Axillary tissue is present with at stitch marking the axilla. The. axillary tail measures 10 x 5 X 2 cm. in the lower outer quadrant of the breast, there is palpably firm and. hemorrhagic breast parenchyma which is very poorly delineated. There is some bright yellow. discoloration of the associated fatty tissue. This area of firm fibrous parenchyma involves an area. Printed: This report continues. FINAL SURGICAL PATHOLOGY REPORT. measuring 6.5 cm from medial to lateral, 5.5 cm from superior to inferior, and up to 3 cm from superficial. to deep. The fibrous tissue is 4 cm from the closest inferior margin, 12 cm from the closest superior margin,. 9 cm from the closest medial margin, and 11 cm from the closest lateral margin. It is 2.5 cm from the. closest deep margin, and 2 cm from the closest skin. Representative sections of this tissue are obtained for. research purposes. Further examination of the breast reveals scattered moderately dense, tan-white. fibrous parenchyma throughout all four quadrants. In the lower outer quadrant of the breast centrally, 5.5. cm lateral to the palpably firm breast tissue, there is an additional ill-defined 2 cm area of moderately. dense fibrous tissue with very focal bright yellow discoloration of the surrounding fat. This lower outer. quadrant fibrous parenchyma is 1.5 cm from the closest margin which is the deep margin. It is 5 cm from 1.8. the closest lateral margin, and greater than 5 cm from all other margins, except for the skin where it is. cm from the skin. There are multiple palpable firm nodes within the axillary portion of the dissection. Representative sections are submitted. Section summary: A1) nipple and tissue just deep to nipple,. A2) representative skin including small papules,. A3) sections from medial edge of palpably firm and fibrous tissue,. A4-A6) central sections of firm neoplastic tissue submitted from superior to inferior,. A7-A8) representative sections of lateral edge of fibrous tissue,. A9) representative section of fibrous tissue from far lateral lower outer quadrant,. A10) representative deep margin far lateral lower outer quadrant,. A11) representative deep margin central breast underlying palpably firm tissue,. A12) representative tissue from upper inner quadrant,. A13) representative tissue lower inner quadrant,. A14) representative tissue upper outer quadrant,. A15) representative sections of lower outer quadrant (in between palpable central tumor and far lateral. lower outer quadrant sections),. A16) representative sections of largest 2.7 cm node (grossly suspicious for tumor),. A17) single node, bivalved (grossly suspicious for tumor),. A18) single node, trisected (grossly suspicious),. A19) single node, trisected,. A20) two nodes, inked and bivalved, one possible node intact,. A21) one node, inked and bivalved, possible smaller nodes intact,. A22-A25) additional sections following reexamination for possible lymph nodes. Microscopic Description: Microscopic sections have been examined. The microscopic findings are reflected in the diagnosis. rendered. Immunohistochemistry was performed with adequate control for OSCAR keratin. REPRINT: Orig. printing on. Printed:

expanded version (tokens=2279) : 
 The breast pathology report describes a case of invasive lobular carcinoma, grade 2, with lobular carcinoma in situ. The tumor size is at least 65mm and is considered to be a single large mass rather than two separate masses. There is no necrosis present and tumor infiltrating lymphocytes are not mentioned. The histological grade is Nottingham grade 2 with a cumulative score of 6 out of 9. The nuclear grade is intermediate and the mitotic count is low with two per ten high power field. There is no lymphovascular invasion identified. The margin status is R0 negative, with the closest margin being deep at 15mm. There is no ductal carcinoma in-situ identified, but lobular carcinoma in-situ is present. The cancer has invaded the skin and nipple, and there is no mention of infiltration into skeletal muscle. The tumor is estrogen receptor positive with 95-100% positive cells and strong intensity, and progesterone receptor positive with 90-100% positive cells and strong intensity. HER2/neu is negative with a score of 0 on a scale of 0-3+. The Ki-67 proliferative index is low with 2-5% positive cells. The pathology staging is pT3 with pN2a (5/14 lymph nodes positive) and no distant metastasis identified. The overall pathologic stage is IIIA. Ancillary testing included OSCAR keratin immunohistochemistry testing. Other

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=2418) : 
 Breast pathology report reveals invasive lobular carcinoma, grade 2, and lobular carcinoma in-situ. Tumor is estrogen and progesterone receptor positive with low Ki-67 proliferative index and negative HER2/neu. Lymphovascular invasion is not identified. Margin status is R0 negative. Pathologic stage is IIIA with pT3 and regional lymph node metastasis (pN2a). No distant metastasis identified.

