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, SPECIMENS: A. SENTINEL LYMPH NODE #1 LEFT AXILLA. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. SENTINEL LYMPH NODE #3 LEFT AXILLA. D. LEFT BREAST. E. RIGHT BREAST SKIN. SPECIMEN(S): A. SENTINEL LYMPH NODE #1 LEFT AXILLA. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. SENTINEL LYMPH NODE #3 LEFT AXILLA. D. LEFT BREAST. E. RIGHT BREAST SKIN. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TP A-C: Negative for tumor. By Dr., called to Dr. GROSS DESCRIPTION: A. SENTINEL LYMPH NODE #1 LEFT AXILLA. Received fresh labeled with patient name designated "A - sentinel lymph node #1 left axilla" is a. fragment of beige-tan possible lymphoid tissue measuring 1.1 X 0.9 x 0.3 cm. The specimen is serially. sectioned. Touch preps were performed. The entire specimen is submitted in cassette A1. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. Received fresh labeled with patient name designated "B - sentinel lymph node #2" is a fragment of. yellow-red fibroadipose tissue measuring 3.2 x 1.5 x 0.7 cm. One possible lymph node is identified. measuring 1.2 X 0.6 X 0.5 cm. The specimen is bisected. Touch preps were performed. The entire. lymph node is submitted in cassette B1. C. SENTINEL LYMPH NODE#3 LEFT AXILLA. Received fresh labeled with patient name designated "C - sentinel lymph node #3 left axilla" is a. fragment of beige-tan possible lymphoid tissue measuring 1.2 x 0.6 X 0.4 cm. The specimen is serially. sectioned, touch preps were performed. The entire specimen is submitted in cassettes C1. D./EET BREAST. Received fresh labeled with patient name designated "D - left breast" is a resected mastectomy. specimen weighing 676 grams and measuring 22.5 X 19 X 3 cm. The specimen is received with. orientation. A suture designates the axillary end of breast. The deep margin is inked black. The. overlying beige-tan ellipse of skin measures 14.5 X 4.2 cm. The light brown areola measures 3.5 cm. in. diameter. The everted nipple measures 1.1 cm in diameter. The specimen is serially sectioned from. medial to lateral. Cut section shows a firm beige-tan mass in the upper outer quadrant approaching. the. deep surgical margin at closest distance 1.3 cm and is located 5 cm from the axillary tail. The lesion. measures 3.6 X 3 x 2.2 cm. This lesion extends to the lower outer quadrant for about 2.5 X 1.5 cm. A. second possible lesion is noted in the upper outer quadrant superior to the first main mass approaching. the deep surgical margin at a distance of 2.5 cm. This area is located 5.2 cm from the first lesion and. measures 0.5 x 0.5 x 0.4 cm. A third possible subareolar is noted located 4.5 cm from the first main. mass in the upper outer quadrant. This third lesion measures 0.6 X 0.5 x 0.5 cm. A fourth possible. mass is located approximately 2.5 cm from the main mass in the upper outer quadrant and approaches. the deep margin at a distance of 2.2 cm. The fourth lesion measures 0.5 x 0.3 x 0.3 cm. The. remainder of the breast parenchyma shows multiple patchy fibrous firm tissue. A portion of the. specimen is submitted for tissue procurement. Representative sections are submitted as follows: D1-D3: the main mass in the upper outer quadrant with overlying deep margin. D4-D5: remainder of the main mass in the upper outer quadrant. D6: lesion #2 upper outer quadrant. D7: lesion #3 subareolar. D8: lesion #4 upper outer quadrant. D9-D10: additional firm fibrous tissue adjacent to main mass of lower outer quadrant. D11-D14: additional section lower outer quadrant. D15-D16: fibrous tissue central subareolar. D17-D18: representative sections upper inner quadrant. D19-D21: representative sections lower inner quadrant. D22: section of nipple. D23: representative sections of skin. D24-D28: multiple possible axillary lymph nodes. E. RIGHT BREAST TISSUE SKIN. Received in formalin in a container labeled with the patient name designated "e. right breast skin" is an. irregular fragment of beige-tan skin measuring 11.4 X 4.5 X 0.3 cm. The surface of the specimen is. unremarkable. A section shows unremarkable skin tissue. Representative sections are submitted in. cassettes E1-E3. DIAGNOSIS: A. SENTINEL LYMPH NODE #1, LEFT AXILLA, EXCISION: - ONE LYMPH NODE, NEGATIVE FOR TUMOR (0/1). B. SENTINEL LYMPH NODE #2, LEFT AXILLA, EXCISION: - ONE LYMPH NODE, NEGATIVE FOR TUMOR (0/1). C. SENTINEL LYMPH NODE #3, LEFT AXILLA, EXCISION: - ONE LYMPH NODE, NEGATIVE FOR TUMOR (0/1). D. LEFT)BREAST, MASTECTOMY: - INVASIVE DUCTAL CARCINOMA, MULTIFOCI, SBR GRADE II. - SIZE OF LARGEST TUMOR FOCUS MEASURING 6.1 X 4.5 CM. - DUCTAL CARCINOMA IN-SITU, CRIBRIFORM AND MICROPAPILLARY TYPES. - ATTACHED SKIN AND NIPPLE, NEGATIVE FOR TUMOR. - SURGICAL RESECTION MARGINS, NEGATIVE FOR TUMOR. - SEE TEMPLATE. SYNOPTIC REPORT - BREAST. Specimens Involved. Specimens: D: LEFT BREAST. Specimen Type: Mastectomy. Needle Localization: Laterality: Left. Invasive tumor: Present. Multifocality: Yes. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Specimen size: Size of Invasive focus 6.1cm. Additional dimensions: 4.5cm x 2.2cm. Tumor Site: Upper outer quadrant. Lower outer quadrant. Margins: Negative. Distance from closest margin: 1.3cm. Margin: deep. Tubular score: 2 (10-75% tubule). Nuclear grade: 2. Mitotic score (Olympus 40x): 2 (7-13/10. Modified Scarff Bloom Richardson Grade: Il (6-7 points). Necrosis: Present. Vascular/Lymphatic Invasion: Indeterminate. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Negative 0/3. Non-neoplastic areas: Fibrocystic disease, pseudoangiomatous stromal hyperplasia. DCIS present. DCIS Quantity: Estimate % 10. DCIS type: Cribriform. Micropapillary. DCIS location: Associated with invasive tumor. Nuclear grade: Intermediate. Necrosis: Absent. Location of CA++: Benign epithelium. Pathological staging (pTN): pT 3 N 0. Comment(s): See breast biomarker template. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimens Involved. Specimens: D: LEFT BREAST. SPECIMEN: Other. mastectomy. Block Number: D4. ER: Positive - Allred Score: 7 = Proportion score: 4 + Intensity Score 3. PR: Positive - Allred Score: 8 = Proportion Score 5 + Intensity Score 3. COMMENT: The Allred score for estrogen and progesterone receptors is calculated by adding the sum of the. proportion score (0 = no staining, 1 = <1% of cells staining, 2 = 1 - 10% of cells staining, 3 = 11-30%. of. cells staining, 4 = 31-60% of cells staining, 5 = >60% of cells staining) to the intensity score (1 = weak. intensity of staining, 2 = intermediate intensity of staining, 3 = strong intensity of staining), with a scoring. range from 0 to 8. ER/PR positive is defined as an Allred score of >2 and ER/PR negative is defined as an Allred score. of. less than or equal to 2. Methodology: Fixation Type and Length: Tissue was fixed in 10% neutral buffered formalin. ) for no less than 8 and no longer than 24 hours. Antibody and Assay Methodology: Mouse anti-human ER and PR,. Comment: This assay can be used to select invasive breast cancer patients for hormone therapy (1). ER and PR analysis was performed on this case by immunohistochemistry utilizing the ER (ER 1D5,. 1:100) and PR (PGR 136, 1:100) antibody provided by. following the manufacturer's instructions. listed in the package insert. This assay was not modified, and adherence to all instruction and. guidelines were strictly followed. Interpretation of the ER/PR immunohistochemical staining. characteristics is guided by published results in the medical literature (1), information provided by the. reagent manufacturer and by internal review of staining performance within the Pathology Department. 1. Harvey JM, et al. Estrogen receptor status by immunohistochemistry is superior to the ligand-binding. assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol. 17:1474-. 1481, 1999. CLINICAL HISTORY: None given. PRE-OPERATIVE DIAGNOSIS: Left breast ca. ADDENDUM: E. RIGHT BREAST SKIN, EXCISION: - FRAGMENT OF UNREMARKABLE SKIN, NEGATIVE FOR TUMOR. 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. I. 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 D4. Source of case: RPCI. Tissue fixation. formalin-fixed tissue. Outside Case No:NA. Tissue source. breast Results interpreted: HER2/CEP17 ratio: 1.21. 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 The results of these studies should always be interpreted in the context of the. clinical, morphological, and immunophenotypic diagnosis. Microscopic/Diagnostic Dictation:., Pathologist,. Microscopia/Diagnostic Dictation: Pathologist,. Microscopic/Diagnostic Dictation: Pathologist. Final Review: Pathologist,. Final: Pathologist,. Addendum: Pathologist,. Addendum Final: Pathologist, I. Addendum: Pathologist,. Addendum Review: Pathologist,. Addendum Final:., Pathologist, A. Addendum: Pathologist,. Addendum Final:., Patholugist,.

expanded version (tokens=3247) : 
 Based on the breast pathology report, here are the main points extracted:

1. Histological Classification:
   - Invasive Ductal Carcinoma (IDC)
   - Ductal Carcinoma In Situ (DCIS)
   - Subtypes: Cribriform and Micropapillary
   - Hormone receptor positive subtype (Luminal A)

2. Tumor Characteristics:
   - Size of largest tumor focus: 6.1 x 4.5 cm
   - Multifocal tumor
   - Histological grade: Grade II (SBR Grade II)
   - Nuclear grade: Intermediate (Grade 2)
   - Necrosis present

3. Lymph Node Involvement:
   - Sentinel lymph nodes removed and examined
   - No tumor identified in sentinel lymph nodes (0/3)

4. Lymphovascular Invasion:
   - Indeterminate status mentioned

5. Receptor Status:
   - Estrogen Receptor (ER): Positive (Allred Score: 7)
   - Progesterone Receptor (PR): Positive (Allred Score: 8)
   - HER2/neu: Not amplified

6. Calcification:
   - Benign epithelium location of Ca++

7. Other Ancillary Testing:
   - PathVysion HER-2 DNA Probe Kit used, indicating no amplification of HER2/neu gene

Please note that this is a summary and some details may have

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=3391) : 
 Breast Pathology Report: Subtype LumA, invasive ductal carcinoma (IDC) with multifocality, size 6.1 x 4.5 cm, SBR Grade II. No lymph node involvement (0/3). ER and PR positive, Allred Score 7 and 8 respectively. HER2 not amplified. Necrosis present. Indeterminate lymphovascular invasion status. Ca++ found in benign epithelium. No further ancillary testing performed.

