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, Diagnosis: A: Lymph node, right sentinel #1, removal. - Metastatic carcinoma present in one of one sentinel lymph nodes (1/1). Size of largest metastatic focus: Estimated at greater than 2.0 cm (see comment). Extracapsular extension: Present. B: Lymph node, right axillary palpable, biopsy. - Metastatic carcinoma present in three of three non-sentinel lymph node (3/3). Size of largest metastatic foci in each node: 9 mm; 4 mm; 0.22 mm. Extracapsular extension: Present. - Lymphovascular space invasion is identified in perinodal adipose tissue. C: Breast, right posterior margin, biopsy. Skeletal muscle and adipose tissue without diagnostic histopathologic change. - No carcinoma in situ and no invasive carcinoma identified. D: Breast, right, total mastectomy. Tumor type: Infiltrating ductal carcinoma. Nottingham combined histologic grade: 1. Tubule formation score: 2. Nuclear Pleomorphism Score: 2. Mitotic count score: 1. Focality of tumor: Muiltifocal and multicentric. Tumor size (greatest dimension): 3.7 cm (gross measurement, see comment). Lymphovascular invasion: Present. In Situ Component: Present. Situ Component type/Architecture pattern: Ductal carcinoma in situ, solid and cribriform types. In Situ Component nuclear grade: Intermediate grade (nuclear grade 2). In Situ Component necrosis: Comedo-type necrosis is present. In Situ Component extent/size: Ductal carcinoma in situ comprises approximately 20% of the tumor volume. A precise. span for the DCIS cannot be determined, however, DCIS is present in seven of eighteen tissue sections evaluated. predominantly in the vicinity of the invasive ductal carcinoma. Extensive intraductal component: Not identified. Nipple involvement: Not identified. Skin involvement: Not identified. Margin status: Invasive component: Negative. Invasive carcinoma is greater than 5 mm from all margins. In Situ component: Negative. DCIS is greater than 5 mm from all margins. Axillary lymph nodes (see also parts A, B, and F): Total number with metastasis: 14 (includes two lymph nodes with micrometastases). Total number examined: 23. Size of largest metastasis: estimated at greater than 2.0 cm (part A). Extracapsular extension: Present. Microcalcifications: Focally present in association with ductal carcinoma in situ and with columnar cell change. Other findings: - Atypical lobular hyperplasia. - Flat epithelial atypia. - Sclerosing adenosis. - Apocrine cysts and apocrine metaplasia. - Fibrosis and hemorrhage in keeping with prior biopsy site. - Skin without diagnostic histopathologic change. AJCC PATHOLOGIC TNM STAGE: pT2(m) pN3a. Note: This pathologic stage assessment is based on information available at the time of this report, and is subject to. change pending clinical review and additional information. E: Lymph node, right Level 3 axillary, removal. - Metastatic carcinoma present in two of two lymph nodes (2/2). Size of largest metastatic foci: 6 mm; 5 mm. Extracapsular extension: Not definitively identified. F: Lymph node, right axillary Level 1 and 2, regional node dissection. - Metastatic carcinoma present in eight of seventeen lymph nodes (8/17). Size of largest metastatic focus: 12 mm. Extracapsular extension: Present. Note: In one lymph node, the metastatic focus measures only 0.2 mm (micrometastasis). - Lymphovascular space invasion is present. Comment: (Ithough the gross description mentions Mass A and Mass B, histologic sections of intervening tissue shows patchy. involvement by ductal carcinoma in situ and invasive ductal carcinoma. Mass A and Mass B are therefore regarded as a. single mass with a largest measurement of 3.7 cm (stage pT2). Multiple additional smaller foci of invasive carcinoma are. present, which are greater than grossly distinct from the large mass, including one nodule of invasive carcinoma. identified in a separate (lower outer) quadrant (multifocal and multicentric disease). Intraoperative Consult Diagnosis: A frozen section was requested by Dr. FSA1: Sentinel lymph node #1, right axilla, sentinel node biopsy. - Positive for metastatic carcinoma. Frozen Section Pathologist: Clinical History: with right breast IDC, well differentiated, undergoing lumpectomy with axillary node dissection. Gross Description: Received are six appropriately labeled containers. Container A is additionally labeled "right sentinel node #1." It holds a 6 X 3 X 1.4 cm fragment of red/tan fibrofatty tissue. containing a 5 X 1.5 x 1.3 cm lymph node candidate from which two representative sections are frozen as FSA1. The. remaining lymph node tissue is submitted in blocks A1-A4. Fat remains in formalin. Container B is additionally labeled "right axillary palpable node." It holds a 4.5 x 4.0 X 1.2 cm red/tan fibrofatty tissue. fragment containing three lymph node candidates measuring 3.5 x 3.0 x 1.0 cm, 0.6 cm and 0.4 cm. The two smaller. lymph node candidates are submitted in block B1. The largest lymph node candidate is sectioned and submitted in. blocks B2 and B3. Fat remains in formalin. Container C is additionally labeled "right posterior margin, clip posterior." It holds a 1.8 X 1.5 X 1.3 cm markedly. cauterized fragment of yellow/gray fibromuscular tissue and fat. There is a clip present on one surface which is. inked blue and the opposite surface is inked black. The specimen is sectioned and entirely submitted in blocks C1-C2,. Container D is additionally labeled "right total mastectomy, stitch marks axillary tail.". Specimen fixation: formalin. Time in fixative: 9 hours. Type of mastectomy: total mastectomy. Weight of specimen: 900 grams. Size of specimen: 26.6 X 21.2 x 6.3 cm. Orientation of specimen: Anterior=blue, posterior=black, axillary tail=yellow. Skin ellipse dimensions: 22.6 x 9.1 cm. Nipple/areola: 1.7/5.0 cm. Axillary tail: submitted separately. Biopsy site: not identified. Discrete Mass(es): present. Number of discrete masses: two (designated A and B). Size of mass (es)/biopsy site: Mass A: 1.8 x 1.3 x 1.1 cm. Mass B: 1.1 x 1.1 x 0.6 cm. Location of mass(es): Mass A: upper outer quadrant. Mass B: The mass is located 1.8 cm posterior and inferior to the lateral edge of Mass A. Distance of mass/biopsy site from surgical margin: Mass A: The mass is located 3.3 cm from the black inked deep margin,. 1.5 cm from the closest blue inked soft tissue margin, 11 cm from the medial margin, and 10 cm from the lateral margin. Mass B: The mass is located 0.8 cm from the black inked posterior margin, 4 cm from the closest blue. inked anterior margin. Gross involvement of skin or fascia/muscle by tumor: absent. Description of remaining breast: composed of dense and nodular white/tan fibroconnective tissue encompassing the. mass; this is most prominent in the central/subareolar portion of the breast where there is dense blue dye staining. The breast tissue between Mass A and Mass B is firm and hemorrhagic with fat necrosis. Sections are. taken of the intervening parenchyma (D3 and D4). If Mass A and Mass 8 are contiguous, the overall measurements of. the lesion would be 3.7 x 3.1 x 3.0 cm. Other remarkable features: There is a small amount of soft tissue hemorrhage and fat necrosis along the superior lateral. edge of the mass. Multiple 0.3 0.4 cm firm nodules are identified radiating from the main mass towards the. medial aspect of the breast. These are extensively sampled. Tissue submitted for special investigations: tumor and normal are given to. Block Summary: (Inking: anterior=blue, posterior=black and axillary tail=yellow). D1 - nipple, serially sectioned. 02 - areola, en face. D3-D4 - intervening section of breast tissue between Mass A and Mass B. D5 - Mass A in relationship to closest blue inked superior anterior margin. D6 - Mass B in relationship to black inked deep margin. D7 - central section of Mass A. D8 - small nodule anterior to edge of Mass A. D9 - second smaller nodule anterior to medial edge of Mass A. D10 - smaller nodule, approximately 2.5 cm medial to edge of Mass A. D11 - small nodule, lower inner quadrant. D12 - nodule along inferior edge of specimen. D13 - small nodule approximately 2 cm medial and posterior to edge of Mass A. D14 - upper inner quadrant. D15 - lower inner quadrant. D16 - upper outer quadrant. D17 - lower outer quadrant. D18 - small nodule, 2.1 cm from edge of Mass A along anterior/superior blue inked edge. Container E is additionally labeled "right Level 3 axillary node." It holds a 4.2 x 2.2 x 0.6 cm unoriented fragment of. yellow/tan fibrofatty tissue containing two lymph node candidates up to 1.3 cm in greatest dimension. Block Summary: E1 - one lymph node candidate, bisected. E2 - one lymph node candidate, bisected. Fat remains in formalin. Container F is additionally labeled "right axillary node dissection, Levels 1 and 2." It holds an unoriented 12.4 x 5.3 x 2.0. cm aggregate of fat which is dissected for lymph node candidates. Multiple lymph node candidates measuring up. to 1.9 cm in greatest dimension are identified. Block summary: F1 - four lymph node candidates. F2 - four lymph node candidates. F3 - three lymph node candidates. F4 - one bisected lymph node candidate. F5 - one bisected lymph node candidate. F6 - one bisected lymph node candidate. F7 - one bisected lymph node candidate. F8 - one lymph node candidate, sectioned. 9 - one lymph node candidate (largest), sectioned. Light Microscopy: Light microscopic examination is performed by Dr. Attending Pathologist: I have personally conducted the evaluation of the above specimens and have. rendered the above diagnosis(es).

expanded version (tokens=2788) : 
 Histological classification: The breast pathology report shows that the patient has infiltrating ductal carcinoma with intermediate grade (nuclear grade 2) and a significant ductal carcinoma in situ (DCIS) component. The subtype is Luminal A.

Subtype: LumA.

Description of necrosis: Comedo-type necrosis is present in the DCIS component.

Tumor infiltrating lymphocytes: There is no mention of tumor infiltrating lymphocytes in the report.

Histological grade: The Nottingham combined histologic grade of invasive ductal carcinoma is 1, based on tubule formation, nuclear pleomorphism, and mitotic count scores.

Nuclear grade: The nuclear grade of the DCIS component is intermediate (nuclear grade 2).

Lymphovascular invasion: Present in both the right posterior margin biopsy and the total mastectomy specimens.

Calcification: Microcalcifications are focally present in association with ductal carcinoma in situ and with columnar cell change.

Receptor status: The report does not mention the receptor status.

IHC and ancillary testing results: There is no mention of IHC or ancillary testing results in the report.

Other findings: Atypical lobular hyperplasia, flat epithelial atypia, sclerosing adenosis, apocrine cysts, and apocrine metaplasia are present. The lymph node involvement is evident, with metastatic carcinoma present in the right sentinel and axillary lymph nodes.

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=2940) : 
 Patient with Luminal A subtype infiltrating ductal carcinoma with intermediate-grade DCIS component. Necrosis and lymphovascular invasion present. Nottingham combined histologic grade is 1. Microcalcifications focally present. Atypical lobular hyperplasia, flat epithelial atypia, sclerosing adenosis, apocrine cysts/metaplasia present. Lymph node involvement evident, metastatic carcinoma in sentinel and axillary nodes. No information regarding receptor status or IHC/ancillary testing available.

