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. SLN #1. B. SLN #2. C. SENTINEL NODE #3 LEFT AXILLA. D. LEFT BREAST AND LOWER AXILLA TAIL. SPECIMEN(S): A. SLN #1. B. SLN #2. C. SENTINEL NODE #3 LEFT AXILLA. D. LEFT BREAST AND LOWER AXILLA TAIL. GROSS DESCRIPTION: A. SLN #1. Received fresh are two tan pink lymph nodes 0.9 x 0.6 x 0.5cm and 0.5 x 0.4 x 0 2cm. The specimen is serially. sectioned and two touch preps are taken. A1: 1 lymph node. A2: 1 lymph node. B. SLN #2. Received fresh is a tan pink lymph node 0.6 x 0.4 x 0.3cm. The specimen is serially sectioned and a touch prep is. taken. Toto B1. C. SLN #3 LEFT AXILLA. Received fresh is a tan pink lymph node 1.1 x 0.9 x 0.6cm. The specimen is serially sectioned and a touch prep is. taken. Toto C1. D. LEFT BREAST AND LOWER AXILLA-Stitch in axilla. Received fresh is an oriented 1314g, 30 x 28 x 6cm mastectomy with 15 x 6cm tan pink skin ellipse, 1.2 cm centrally. located, partially raised nipple and 1.5 cm areolar rim. The specimen is inked as follows: Anterior/Superior-Blue,. Anterior/Inferior-Orange, Posterior-Black. The specimen is serially sectioned from medial to lateral into 12 slices,. slice 1 being most medial, slice 12 being most lateral. The nipple is located in slice 7. The cut surfaces reveal a gray. white ill defined firm mass 3.5 x 2.8 x 2cm, 1.8cm from the deep margin located in slices 4, 5, 6 and 7. The area. surrounding the mass is remarkable for fibrosis and possible fat necrosis. The lower axillary tail is 6 x 5 x 3cm. Dissection reveals 4 possible lymph nodes ranging from 0.5 x 0.5 x 0.5cm to 0.8 x 0.8 x 0.5cm. A portion of. the. specimen is submitted for tissue procurement. Representative sections are submitted as follows: D1: nipple slice 7. D2: base of nipple slice 7. D3: UIQ area next to mass slice 3. D4-D5: mass bisected UIQ slice 4. D6: anterior margin UIQ slice 4. D7: deep margin UIQ slice 4. D8: mass UIQ slice 5. D9: deep margin UIQ slice 5. D10: skin slice 5. D11-D12: mass UIQ slice 6. D13: deep margin UIQ slice 6. D14: LIQ slice 6. D15-D16: mass bisected UC slice 7. D17: deep margin UC slice 7. D18: LC with inferior margin slice 7. D19: UOQ next to mass slice 8. D20: LOQ slice 8. D21: 2 lymph nodes. D22: 2 lymph nodes. D23-D26: lower axillary tissue. DIAGNOSIS: A. SENTINEL LYMPH NODE #1, LEFT BREAST, BIOPSY: - TWO LYMPH NODES, NEGATIVE FOR CARCINOMA (0/2). B. SENTINEL LYMPH NODE #2, LEFT BREAST, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR CARCINOMA (0/1). C. SENTINEL LYMPH NODE #3, LEFT BREAST, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR CARCINOMA (0/1). D. BREAST, LEFT, MASTECTOMY: - INVASIVE DUCTAL CARCINOMA, MODERATELY DIFFERENTIATED. (SBR GRADE 2), WITH MICROPAPILLARY FEATURES (SEE NOTE). - TUMOR MEASURES 3.5 CM IN GREATEST DIMENSION. - MARGINS, NEGATIVE FOR CARCINOMA. - DUCTAL CARCINOMA IN SITU, CRIBRIFORM AND SOLID TYPES,. NUCLEAR GRADE 2, WITH NECROSIS AND MICROCALCIFICATIONS. MINOR COMPONENT. - PREVIOUS BIOPSY SITE CHANGES PRESENT. - SKIN AND NIPPLE, NEGATIVE FOR CARCINOMA. - THREE LYMPH NODES, NEGATIVE FOR CARCINOMA (0/3). NOTE: A CD31 immunostain has been ordered to rule out lymphvascular invasion and ER, PR, and Her FISH has. been ordered. Those results will be reported in an addendum. SYNOPTIC REPORT - BREAST. Specimen Type: Mastectomy. Needle Localization: Laterality: Left. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 3.5cm. Tumor Site: Upper inner quadrant. Margins: Negative. Distance from closest margin: Greater than 1cm. deep. Tubular Score: 3. Nuclear Grade: 2. Mitotic Score: 2. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Absent. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Negative 0/7. DCIS present. Margins uninvolved by DCIS. DCIS Quantity: Estimate 5%. DCIS Type: Solid. Cribriform. DCIS Location: Associated with invasive tumor. Nuclear grade: Intermediate. Necrosis: Present. Location of CA++: DCIS. Pathological staging (pTN): pT 2N0. CLINICAL HISTORY: year old with multifocal Invasive Cancer in Upper Inner Quadrant of Left Breast. PRE-OPERATIVE DIAGNOSIS: Left Breast Cancer. INTRAOPERATIVE CONSULTATION: TPA/TPB/TPC: Negative for tumor. Diagnosis called to Dr. at. y Dr. ADDENDUM: SUMMARY OF MMUNOHISTOCHEMISTRY/SPECIAL STAINS. Material: Block D12. Population: Tumor Cells. Stain/Marker: Comment: CD31. Negative Shows no evidence of lymphvascular invasion. 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. 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. 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. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Surgical Excision. Block Number: D11. ER: Positive Allred Score: 8 = Proportion Score 5 + Intensity Score 3. PR: Positive Allred Score: 4 = Proportion Score 2 + Intensity Score. 2. 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: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Immunohistochemistrv was performed using the mouse anti-human ER (ER 1D5, 1:100) and PR (PGR 136, 1:100). provided by Dako (. following the manufacturer S instructions. This assay was not modified. Interpretation of the ER/PR immunohistocnemical stain is guided by published results in the medical literature,. information provided by the reagent manufacturer and by internal review of staining performance. 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. by Dr. A majority of tumors cells displayed extensive polysomy 17. with 4 to 6 chromosome 17 signals and 2 to 3 HER-2 signals, with a HER-2/CEP 17 Ratio </=2.0,. consistent with no amplification of the HER2/neu gene. Block used. D11. Source of case: Tissue fixation formalin-fixed tissue Outside Case No: NA. Tissue source breast Results interpreted: yes. HER2/CEP17 ratio: 1.29. 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. No. 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. Microscopic/Diagnostic Dictation: Pathologist. Final Review: Pathologist. Final: Pathologist,. Addendum: Pathologist,. Addendum Final: Pathologist. Addendum: Pathologist,. Addendum Final: Pathol.

expanded version (tokens=2918) : 
 1. Histological Classification: The breast pathology report indicates that the patient has Luminal A subtype of invasive ductal carcinoma. The breast mass is moderately differentiated (SBR Grade 2) with micropapillary features, and measures 3.5 cm in size. 

2. Necrosis: The ductal carcinoma in situ (DCIS) component, which is found in the specimen, is of the solid and cribriform type with nuclear grade 2, and necrosis present. 

3. Tumor Infiltrating Lymphocytes: There is no mention of tumor infiltrating lymphocytes (TILs) in the report. 

4. Histological Grade: The breast mass is moderately differentiated (SBR Grade 2), and the DCIS component is of nuclear grade 2. 

5. Nuclear Grade: The Nuclear grade of the invasive mass is reported as grade 2, and the DCIS component is also of Nuclear grade 2. 

6. Lymphovascular Invasion: CD31 immunostain ordered to rule out lymphovascular invasion. The results of this test are not reported in the pathology report. 

7. Calcification: Microcalcifications were identified within the DCIS component.

8. Receptor Status: The receptors status of the tumor is positive for estrogen (ER+) and progesterone (PR+) with an Allred score of 8 and 4 out of 8, respectively. 

9. Immunohistochemistry

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=3087) : 
 Breast pathology report states Luminal A subtype of invasive ductal carcinoma, moderately differentiated (SBR Grade 2) measuring 3.5 cm, and DCIS with solid and cribriform type, nuclear grade 2. ER+ (Allred score of 8) and PR+ (score of 4/8). Absence of tumor infiltrating lymphocytes and lymphovascular invasion. CD31 immunostain ordered for lymphovascular invasion not reported. Microcalcifications noted within the DCIS component and negative HER-2 result. Three negative lymph nodes out of seven sampled.

