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 - SPECIMENS: A. SLN #1 RIGHT AXILLA. B. SLN #2 RIGHT AXILLA. C. SLN #3 RIGHT AXILLA. D. RIGHT BREAST. E. RIGHT AXILLARY CONTENTS LEVELS 1-2. F. ADDITIONAL RIGHT BREAST TISSUE. G. ADDITIONAL INFERIOR MARGIN. SPECIMEN(S): A. SLN #1 RIGHT AXILLA. B. SLN #2 RIGHT AXILLA. C. SLN #3 RIGHT AXILLA. D. RIGHT BREAST. E. RIGHT AXILLARY CONTENTS LEVELS 1-2. F. ADDITIONAL RIGHT BREAST TISSUE. G. ADDITIONAL INFERIOR MARGIN. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TPA-sentinel lymph node #1 right axilla: Positive for carcinoma {Dr. consulted} called by Dr. to Dr. at. GROSS DESCRIPTION: A. SLN #1 RIGHT AXILLA. Received fresh is one lymph node measuring 0.8 x 0.7 x 0.2 cm. One touch prep is performed. Lymph. node is submitted entirely in cassettes A1-A3. B. SLN#2 RIGHT AXILLA. Received fresh is a lymph node measuring 1 X 0.6 X 0.4 cm. Submitted in cassette B1. C. SLN#3 RIGHT AXILLA. Received fresh is a piece of yellow-tan soft tissue measuring 3.2 X 1.5 x 0.3 cm. One possible lymph. node is identified measuring 0.1-cm. Lymph node is submitted in cassette C1. D. RIGHT BREAST. Received fresh is an oriented 205g, 15 x 13 x 4.5 cm mastectomy with 4.5 x 3 cm tan skin ellipse, 1.5. cm everted nipple. Superior anterior margin is inked yellow, inferior anterior margin blue, the deep. margin black. The specimen is serially sectioned from lateral to medial revealing the following: 1) A granular tan irregular mass (lesion #1} measuring 4.5 X 2.7 x 1.5 cm in the mid to upper inner. quadrant. It is 1 cm from the deep margin and abuts the anterior/superior margin. 2) A1x0.8x0.7 cm granular pink-tan area {lesion #2} that is 2 cm inferior to lesion #1. 3) 0.5 cm possible biopsy site in upper outer quadrant that is 1.5 cm lateral to lesion #1 and is 2.7 cm. from the deep margin. Representatively submitted as follows: D1-D2: lesion #1 including anterior/superior margin. D3-D4: complete cross-section extending from anterior/superior to deep, lesion #1. D5: lesion #1 including deep margin. D6: lesion #2 and tissue connecting to lesion #1. D7: lesion #2 and skin. D8: tissue extending from lesion #1 to possible biopsy site. D9-D11: possible biopsy site. D12: granular tissue from superior anterior margin. D13: upper inner quadrant. D14: lower inner quadrant. D15: lower outer quadrant. D16: upper outer quadrant. D17-D18: nipple. D19-D20: soft tissue from axillary tail. E. RIGHT AXILLARY CONTENTS LEVELS 1-2. Received in formalin are multiple tan pink soft tissue fragments aggregating to 5x: 3 x 2cm. Dissection. reveals 17 possible lymph nodes ranging from 0.2 x 0.2 x 0.2cm to 2.0 x 2.0 X 1.5cm. Entirely. submitted: E1: 5 lymph nodes. E2: 4 lymph nodes. E3: 4 lymph nodes. E4: 2 lymph nodes. E5: 1 lymph node serially sectioned. E6: 1 lymph node serially sectioned. E7-E8: additional axillary tissue. E9-E13: remainder of tissue. F. ADDITIONAL RIGHT BREAST TISSUE. Received in formalin is an 8g unoriented aggregate of tan pink fibrofatty tissue 5.0 x 4.0 X 2.0cm. The. specimen is inked Black and serially sectioned to reveal grossly unremarkable breast parenchyma. Toto. F1-F9. G. ADDITIONAL INFERIOR MARGIN. Stitch at new true margin. Received in formalin is a 28g oriented tan pink fragment of fibrofatty tissue 11.0 X 5.0 X 1.5cm. The new. true margin is inked Black and the specimen is serially sectioned to reveal grossly unremarkable breast. parenchyma. Toto G1-G27. SUMMARY OF MMUNOHISTOCHEMISTRY/SPECIAL STAINS. Material: Block A1. Population: Tumor Cells. Stain/Marker:Result: Comment: CYTOKERATIN AE1/3. Positive. Material: Block A2. Population: Tumor Cells. Stain/Marker:Result: Comment: CYTOKERATIN AE1/3. Negative. Material: Block A3. Population: Tumor Cells. Stain/Marker:Result: Comment: CYTOKERATIN AE1/3. Positive. The interpretation of the above immunohistochemistry stain or stains is guided by published results in. the medical literature, provided package information from the manufacturer and by internal review of. staining performance and assay validation within the Immunohistochemistry Laboratory of The use of. one or more reagents in the above tests is regulated as an analyte specific reagent (ASR). These tests. were developed and their performance characteristic determined by the Department of Pathology. Laboratory at. They have not been cleared or approved by the U.S. Food and Drug Administration. The FDA has determined that such clearance or approval is not necessary. Special stains and/or immunohistochemical stains were performed with appropriately stained positive. and negative controls. DIAGNOSIS: A. SENTINEL LYMPH NODE #1, RIGHT AXILLA, BIOPSY: - MICROMETASTATIC CARCINOMA TO ONE LYMPH NODE, WITH NO. EXTRANODAL EXTENSION (1/1) (SEE NOTE). NOTE: There are two foci of micrometastasis, each measuring less than 1 mm in size. A cytokeratin. AE1/3 stain was performed that highlights the micrometastases and also shows a few scattered. cytokeratin positive cells in the parenchyma. B. SENTINEL LYMPH NODE #2, RIGHT AXILLA, BIOPSY: - ONE LYMPH NODE, NO TUMOR SEEN (0/1). C. SENTINEL LYMPH NODE #3, RIGHT AXILLA, BIOPSY: - ONE LYMPH NODE, NO TUMOR SEEN (0/1). D. BREAST, RIGHT) MASTECTOMY: - MULTICENTRIC INVASIVE DUCTAL CARCINOMA, MODERATELY. DIFFERENTIATED (SBR GRADE 2) (SEE NOTE). - TUMOR MEASURES 1.2 CM IN GREATEST DIMENSION. - INVASIVE CARCINOMA IS WITHIN 1 MM OF THE ANTERIOR MARGIN. IN THE UPPER INNER QUADRANT. EXTENSIVE DUCTAL CARCINOMA IN SITU (DCIS), CRIBRIFORM, SOLID. AND MICROPAPILLARY TYPES, NUCLEAR GRADES 2 AND 3, WITH. NECROSIS AND MICROCALCIFICATIONS, INVOLVING LOBULES. DCIS IS PRESENT AT THE ANTERIOR MARGIN IN THE UPPER INNER. QUADRANT. - DCIS INVOLVES LACTIFEROUS DUCTS. - SKIN AND NIPPLE, NO TUMOR SEEN. NOTE: In the upper outer quadrant, a biopsy site is noted with adjacent DCIS. Near the biopsy site, a 2. mm focus of invasive ductal carcinoma is seen. In the upper inner quadrant, there is invasive ductal. carcinoma with DCIS, with the largest focus of invasion measuring 1.2 cm and with at least one other. focus of invasion that measures 0.1 cm. The DCIS in the upper inner quadrant is mass forming and. spans at least 4 cm in greatest dimension. E. AXILLARY CONTENTS, RIGHT, LEVELS 1-2, DISSECTION: - 13 LYMPH NODES, NO TUMOR SEEN (0/13). F. BREAST, RIGHT, ADDITIONAL TISSUE, EXCISION: - DUCTAL CARCINOMA IN SITU, PRESENT AT INKED ASPECT (SEE NOTE). NOTE: There is a 3 millimeter focus of DCIS. The tissue was not oriented but was inked entirely black. and DCIS is present at the inked aspect. G. BREAST, RIGHT, ADDITIONAL INFERIOR MARGIN, EXCISION: - FOCAL COLUMNAR CELL CHANGE WITH CYTOLOGIC ATYPIA. (FLAT EPITHELIAL ATYPIA). - NO EVIDENCE OF CARCINOMA. SYNOPTIC REPORT - BREAST. Specimen Type: Mastectomy. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: Yes. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 1.2cm. Tumor Site: Upper outer quadrant. Upper inner quadrant. Margins: Negative. Distance from closest margin: Less than 0.1cm. anterior. Tubular Score: 3. Nuclear Grade: 2. Mitotic Score: 1. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Absent. Vascular/Lymphatic Invasion: Present. Extent: Focal. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node and axillary dissection. Lymph node status: Positive 1 / 16. Micrometastases: Non-neoplastic areas: columnar cell change with flat epithelial atypia. DCIS present. Margins involved by DCIS: anterior. DCIS Quantity: Estimate 75%. DCIS Type: Solid. Cribriform. Micropapillary. DCIS Location: Both associated and separate from invasive tumor mass. Nuclear grade: High. Necrosis: Present. Location of CA++: DCIS. ER/PR/HER2 Results. ER: Positive. PR: Positive. HER2: by FISH. Pathological staging (pTN): pT 1c N 1mi. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimen: Surgical Excision. Block Number: D2. Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 10%. Fish Ordered: Yes, on Date. METHODOLOGY: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Her2 analysis was performed using the FDA approved Dako HercepTest (TM) test kit (. i using rabbit anti-human HER2. This assay was not modified. External kit-slides. provided by the manufacturer (cell lines with high, low and negative HER2 protein expression) and in-. house known HER2 amplified control tissue were evaluated along with the test tissue. Adequate, well. preserved, clear-cut invasive carcinoma was identified for HER2 evaluation. Interpretation of the HER2. immunohistochemical stain is guided by published results in the medical literature, information provided. by the reagent manufacturer and by internal review of staining performance. This assay has been validated according to the 2007 joint recommendations and guidelines from. ASCO and CAP and from the NCCN HER2 testing in Breast Cancer Task Force. The Pathology. Department takes full responsibility for this test's performance. CLINICAL HISTORY: -year-old female with abnormal screening mammogram of right breast at right upper outer quadrant. Needle biopsy showed invasive ductal carcinoma. Patient then had MRI which showed enhancement of. upper outer quadrant and upper inner quadrant; anteriorly there was enhancement 2 cm from clip and. close to nipple. PET, CT and bone scan show no evidence of metastatic disease. Invasive ductal. carcinoma SBR grade 2, ER positive, PR positive, Her2/neu negative. Tumor size 0.4 cm, also with high. grade DCIS solid and cribriform with necrosis and extension to lobules. PRE-OPERATIVE DIAGNOSIS: Right Breast Cancer. ADDENDUM: PathVysion HER-2 DNA Probe Kit. Analytical Interpretation of Results: HER-2 NOT AMPLIFIED. Clinical Interpretation of results. Amplification of the HER-2 gene was evaluated with interphase fluorescence in-situ. hybridization (FISH) on formalin-fixed paraffin embedded tissue sections using a chromosome. 17 centromeric probe and a HER-2 probe that spans the entire HER-2 gene in the Pathology. Core Facility by Dr.. A majority of tumors cells displayed 2 chromosome 17. signals and 2 HER-2 signals, with a HER-2/CEP 17 Ratio </=2.0, consistent with no. amplification of the HER2/neu gene. Block used A1. Source of case: RPCI. Tissue fixation. formalin-fixed tissue. Outside Case No:NA. Tissue source. breast Results interpreted: HER2/CEP17 ratio: 1.05. This ratio is derived by dividing the total number of LSI HER-2/neu signals by the total number of. CEP17 signals in at least 20 interphase nuclei with nonoverlapping nuclei in the neoplastic. mammary epithelial cells. Cells with no signals or with signals of only one color are disregarded. Method of ratio enumeration: manual count. Limitations. The Vysis PathVysion Kit is not intended for use to screen for or diagnose breast cancer. It is. intended to be used as an adjunct to other prognostic factors currently used to predict disease-free. and overall survival in stage II, node-positive breast cancer patients. In making decisions regarding. adjuvant CAF treatment, all other available clinical information should also be taken into. consideration, such as tumor size, number of involved lymph nodes, and steroid receptor status. treatment decision for stage II, node-positive breast cancer patients should be based on HER-. 2/neu. gene amplification status alone. Overview of this test. FDA APPROVED REAGENT. PathVysion HER-2 DNA Probe Kit is FDA approved for selection of. patients for whom Herceptin® therapy is being considered. These tests were performed in the. under the direction. of Dr.. The results of these studies should always be interpreted in the context of the. clinical, morphological, and immunophenotypic diagnosis. ONCOTYPE DX BREAST CANCER ASSAY. RESULTS: Recurrence Score: 16. CLINICAL EXPERIENCE: Patients with a recurrence score of: 16 in the clinical validation study. had an average rate of Distant Recurrence at 10 years of 10%. ER Score: 10.1 Positive. PR Score: 7.7 Positive. Her2 Score: 9.8 Negative. Interpretation: ER. Negative < 6.5. Positive >= 6.5. PR. Negative < 5.5. Positive >= 5.5. Her2 Negative <10.7 Positive 11.5 Equivocal = 10.7 - 11.4. See separate. report for further information. Inc. Microscopic/Diagnostic Dictation:, M.D., Pathologist, i. Final Review: M.D., Pathologist,. Final Review:, M.D., Pathologist,. Final:, M.D., Pathologist,. Addendum:., Pathologist,. Addendum Final: Pathologist,. Addendum:., Pathologist,. Addendum Final:., Pathologist,.

expanded version (tokens=3879) : 
 Based on the breast pathology report, here is the requested information:

1. Histological Classification:
- Sentinel lymph node #1, right axilla: Micrometastatic carcinoma to one lymph node (1/1)
- Sentinel lymph node #2, right axilla: No tumor seen (0/1)
- Sentinel lymph node #3, right axilla: No tumor seen (0/1)
- Right breast mastectomy: Multicentric invasive ductal carcinoma, moderately differentiated (SBR grade 2)
- Additional right breast tissue: Ductal carcinoma in situ (DCIS)
- Additional inferior margin: Focal columnar cell change with cytoxic atypia (flat epithelial atypia), no evidence of carcinoma

2. Description of DCIS:
- Extensive DCIS involving lobules
- Cribiform, solid, and micropapillary types
- Nuclear grades 2 and 3
- Necrosis and microcalcifications present
- DCIS present at the anterior margin in the upper inner quadrant
- DCIS spans at least 4 cm in greatest dimension in the upper inner quadrant
- Biopsy site noted with adjacent DCIS in the upper outer quadrant

3. Necrosis:
- Necrosis present in DCIS

4. Tumor Infiltrating Lymphocytes:
- No mention of tumor infiltrating lymphocytes in the report

5. Histological Grade:
- Multicentric invasive ductal 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=4075) : 
 Report:
1. Micrometastatic carcinoma in one lymph node in the right axilla (1/1).
2. No tumor seen in sentinel lymph nodes #2 and #3 (0/1).
3. Multicentric moderately differentiated invasive ductal carcinoma in the right breast.
4. Ductal carcinoma in situ (DCIS) with necrosis and microcalcifications.
5. Focal columnar cell change with cytoxic atypia at the additional inferior margin, no carcinoma seen.
6. Estrogen receptor (ER) and progesterone receptor (PR) positive.
7. Human epidermal growth factor receptor 2 (HER2) negative.
8. Oncotype DX recurrence score: 16,

