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 Basal, Gender: F. Provider Group : Date of Service: Date Received: FINAL SURGICAL PATHOLOGY REPORT. Diagnosis: LEFT BREAST, MODIFIED RADICAL MASTECTOMY: - Invasive ductal carcinoma, Nottingham grade 3. - Tumor size: 2.7 cm in diameter. Ductal carcinoma in situ (DCIS), high nuclear grade, solid type,. present at periphery of invasive carcinoma. - No comedo necrosis or calcifications present. - DCIS comprises less than 10% of tumor volume. - Mastectomy margins are free of tumor. - Carcinoma is at least 1.5 cm from the superior-superficial margin,. and is at least 2 cm from all other margins. - Ten axillary lymph nodes, no tumor present (0/10). - Papilloma, inferior-central breast, measuring at least 0.9 cm in diameter. - Fibroadenoma, 0.8 cm, lower outer quadrant. PATHOLOGIC TUMOR STAGING SYNOPSIS: Type and grade (invasive): Invasive ductal carcinoma, Nottingham grade 3. Type and grade (in situ): DCIS, high nuclear grade. Primary tumor: pT2. Regional lymph nodes: pNO. Distant metastasis: Not applicable. Pathologic stage: IIA. Lymphovascular invasion: Not identified. Margin status: Negative. COMMENT: The invasive carcinoma has features suggestive of the basal-like. phenotype. In support of this, the tumor was found to be positive for CK5/6 (previous. core needle biopsy). Although the tumor was not reported as "triple negative", the. estrogen receptor as only positive in 5% of tumor cells (biomarker studies performed. on previous core needle biopsy; see synoptic report for additional details). Printed: This report continues. Acct No. -. Pathology - Page 1/6. 1 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. Intradepartmental consultation: Dr. concurs with the diagnosis. of invasive ductal carcinoma. Invasive Breast Cancer Tumor Staging Information. AJCC Cancer Staging Handbook, 7th Ed., and CAP Protocol (revised June 2012). Previous pathology specimens: Printed: This report continues (FINAL). Acct No. Pathology - Page 2/6. be 2 Doc# 1. SPECIMEN IDENTIFICATION. Procedure/specimen type: Modified radical mastectomy. Laterality: Lelt. Lymph node sampling: Lymph node dissection. INVASIVE CARCINOMA TUMOR CHARACTERISTICS. Histologic type: Invasive ductal carcinoma. Tumor site: 12:00. Tumor size: 2.7 cm,. Tumor focality: Single focus of invasive carcinoma. Histologic grade (Nottingham Score): Nottingham score 3 of 3. Tubule formation: 3 of 3,. Nuclear pleomorphism: 3 of 3. Mitotic rate: 3 of 3. Lymphovascular invasion: Not identified. Macroscopic and microscopic extent of tumor: No skin or chest wall invasion is identified. DUCTAL CARCINOMA IN SITU (DCIS): High-grade, comprises less than 5% of tumor. MARGINS. Invasive carcinoma: Negative, at least 1.5 cm from deep margin, at. least 2 cm from all other margins. Ductal carcinoma in situ: At least 2 cm from all margins. LYMPH NODES. Total lymph nodes examined. 10. Number of lymph nodes involved. 0. PATHOLOGIC STAGING: Primary Tumor (pT): pT2. Regional lymph nodes (pN): pNO. Distant metastasis (pM): Not applicable. AJCC Stage: IIA. ANCILLARY STUDIES: performed on core needle. biopsy). Estrogen receptor: 5% positive cells, moderate intensity. Progesterone receptor: 0% positive cells. HER2: IHC score 1+. Ki-67: 60% positive cells. Printed: This report continues (FINAL). Pathology - Page 3/6. Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. Source of Specimen: Breast total mastectomy;Left. Clinical History/Operative Dx: Malignant neoplasm of breast, left. Gross Description: Single specimen designated as left breast mastectomy, stitch is lateral, with axillary dissection. Initially. received in the fresh state for possible Oncogenotyping studies, is a 728 gram left modified radical. mastectomy, 31.8 cm medial to lateral (including axillary extension), 19,7 cm superior-inferior, and 4.0 cm. posterior-anterior. The overlying ellipse of wrinkled, tan-brown skin is 16.9 x 10.2 cm with a paracentral,. darkened brow areola, 3.8 cm in diameter and prominent nipple, 1.3 cm in diameter. A double black. suture marks the lateral apex of the skin. Included within the container is an unoriented, crescent-shaped. strip of wrinkled. tan-brown skin, 19.5 x 1.8 X 1.0 cm. The tentative outer edge of this skin - peripheral. margin is marked blue and the remaining surgical margins are marked yellow. The surgical margins of the. mastectomy are differentially inked as follows: Superior superficial: Blue,. Inferior superficial: Orange,. Posterior; Black. The breast is serially sectioned perpendicularly through the medial-lateral long axis (slab 1 assigned at. the base of the axillary extension of fat) to reveal a well-circumscribed, light tan, centrally softened tumor. mass measuring upwards of 2.7 x 2.5 x 2.5 cm (slabs 4-6, from lateral). The tumor is grossly placed 1.5 cm. from the superior superficial, 1.3 cm deep to the skin, 2.3 cm from the deep surgical margin, 3.5 cm from. the most lateral extension of breast (not including axillary extension), greater than 6.0 cm from the inferior. superficial surgical margin, and greater than 6.0 cm from the most medial extension of breast. A. radiologic insert is not appreciated. Case F. Printed: This report continues. (FINAL). Acct No. Nam. Pathology - Page 4/6. 1 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. Examination of the lower outer quadrant reveals a poorly defined nodular area of density upwards of 1.5 X. 0.8 cm, approximately 3.0 cm inferior to the primary lesion (A11-A12) and 2.3 cm from the adjacent. inferior superficial surgical margin. The mid inferior breast demonstrates suspicious nodular induration. within 1.2 cm of the deep, and 1.0 cm of the inferior superficial surgical margins (A13-A14), respectively,. The lower inner quadrant demonstrates a 0.8 cm focus of similar suspicion, within 0,8 cm of the deep. surgical margin (A15). No additional nodularity is appreciated. Examination of the axillary extension of fat reveals eleven lymph node candidates ranging from .25 cm. to 2,5 X 1.2: x 1.0 cm in greatest dimension. The lymph node candidacy is submitted/represented for. microscopic evaluation. Sectioning through the separate crescent-shaped strip of skin reveals glistening, yellow-tan lobular fat. without grossly unusual changes suggestive of invasive/residual tumor, Representative sections are. submitted. Cassette summary: A1) nipple,. A2) medial and lateral extension of skin,. A3) upper outer quadrant, slab 2. adjacent to tumor,. A4-A6) upper outer quadrant, tumor-superior superficial surgical margin, and skin relationship,. A7) deep margin adjacent to tumor,. A8) bulk of tumor, represented,. A9) upper outer quadrant, slab 7, adjacent to tumor,. A10) lower outer quadrant, slab 2,. A11) lower outer quadrant, ill-defined nodular density, 3.5 cm inferior to primary tumor, represented,. A12) lower outer quadrant, inferior superficial, adjacent to ill-defined density,. A13-A14) inferior central breast, slab 7, suspicious changes, including deep and inferior surgical margins,. contiguous sections,. A15) lower inner quadrant, slab 9, suspicious induration, deep margin relationship,. A16) upper inner quadrant, slab 8,. A17) full thickness cross-sections of seperate skin, mid length,. A18-A19) additional representation of length of skin, tentative outer margin en face, three pieces,. A20) two small lymph node candidates,. A21) two small lymph node candidates,. A22) two lymph node candidates, bisected, one marked orange,. A23) single lymph node candidate, serially sectioned,. A24) single lymph node candidate, serially sectioned. A25) longest lymph node candidate, serially sectioned and entirely submitted,. A26-A27) large lymph node candidate, serially sectioned and entirely submitted,. A28-A29) large lymph node candidate, serially sectioned and entirely submitted. Cuse #: Printed: This report continues. cct No. Pathology - Page 5/6. 5 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. Microscopic Description: Microscopic sections have been examined. The microscopic findings are reflected in the diagnosis. rendered. Printed: END or REPORT (FINAL). .cct No. atient Name. Pathology - Page 6/6. ige. 6 Doc# 1.

expanded version (tokens=2356) : 
 Histological classification:
- Invasive ductal carcinoma, Nottingham grade 3
- Ductal carcinoma in situ (DCIS), high nuclear grade, solid type

Subtype: Basal-like

Description of necrosis: No comedo necrosis or calcifications present

Tumor infiltrating lymphocytes: No mention

Histological grade: Nottingham score 3 out of 3

Nuclear grade: High nuclear grade

Lymphovascular invasion: Not identified

Calcification: Not present

Receptor status: 
- Estrogen receptor: 5% positive cells with moderate intensity
- Progesterone receptor: 0% positive cells 
- HER2: IHC score 1+
- Ki-67: 60% positive cells

Ancillary testing results: 
- Tumor was found to be positive for CK5/6 (previous core needle biopsy)

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=2524) : 
 Left breast modified radical mastectomy revealed invasive ductal carcinoma, Nottingham grade 3 with subtype basal, and ductal carcinoma in situ (DCIS) present at the periphery, with high nuclear grade and solid type. No necrosis, lymphovascular invasion or tumor infiltrating lymphocytes identified. Estrogen receptor status was positive in 5% of tumor cells with moderate intensity while progesterone receptor was negative. HER2 was IHC score 1+ and Ki-67 positive in 60% of cells. Tumor was CK5/6 positive. Pathologic stage IIA.

