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, SPECIMENS: A. SENTINEL LYMPH NODE #1 LEFT AXILLA. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. LEFT BREAST. D. SENTINEL LYMPH NODE #1 RIGHT AXILLA. E. RIGHT BREAST. SPECIMEN(S). A. SENTINEL LYMPH NODE #1 LEFT AXILLA. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. LEFT BREAST. D. SENTINEL LYMPH NODE #1 RIGHT AXILLA. E. RIGHT BREAST. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TPA, Sentinel lymph node #1, left axilla: Negative for carcinoma. TPB, Sentinel lymph node #2, left axilla: Negative for carcinoma. Diagnosis called at. by Dr. TPC, Sentinel lymph node #1, right axilla: negative for carcinoma. Diagnosis called at. by Dr. GROSS DESCRIPTION: A. SENTINEL LYMPH NODE #1 LEFT AXILLA. Received fresh labeled with the patient's identification and designated "sentinel lymph node number one left axilla" is. a fragment of fibroadipose tissue, 1.4 x 1 x 0.6 cm, consisting of one possible lymph node, 1.4 x 0.7 x 0.4 cm. Touch. preparation is performed. The entire lymph node is submitted, A1. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. Received fresh labeled with the patient's identification and designated "sentinel lymph node number two left axilla" is. a fragment of fibroadipose tissue, 2 x 1.4 x 0.8 cm, consisting of one possible lymph node, 2 x 0.9 x 0.5 cm. Touch. preparation is performed. The entire lymph node is submitted, B1. C. LEFT BREAST. Received fresh labeled with the patient's identification and designated "left breast" is an oriented (suture in axilla),. 573-g, 25 x 18 x 4.5 cm mastectomy specimen with 3.5 x 2 cm light tan skin ellipse, and 1.4-cm diameter everted. nipple. Ink code: Posterior-black, anterior/superior-blue, anterior/inferior-orange. The specimen is serially sectioned. from lateral to medial revealing a tan stellate mass in the UOQ (slices 3-4), 3 x 2.8 x 1.5 cm, located 0.2-cm from the. nearest anterior margin, and 2.2-cm from the deep margin. A smaller well defined nodule present in the posterior. UIQ is seen. A portion the specimen is submitted for tissue procurement. Representatively submitted: C1-C3: Nipple, C3 contains representative section of skin. C4: Mass with anterior margin, slice 3, UOQ. C5: Mass with anterior margin, slice 4, UOQ. C6-C7: Remainder of mass, slice 4, UOQ. C8: Deep margin, slice 4, UOQ. C9: Additional section, UOQ, slice 5. C10: Representative section, LOQ, slice 5. C11-C12: Representative sections, UIQ, slices 7-8, respectively. C13: Representative section, LIQ, slice 7. C14-C15: nodule in posterior UIQ. D. SENTINEL LYMPH NODE #1 RIGHT AXILLA. Received fresh labeled with matching patient identifiers is a piece of adipose tissue 3.4 x 3 x 1.1 cm containing two. lymph nodes, the smaller is 0.5 cm in diameter, larger one measures 2.4 x 0.8 x 0.8 cm. Touch preps are performed. the specimen is submitted entirely/separately in cassettes D1-D2. E. RIGHT BREAST. Received fresh labeled with the patient's identification and "right breast" is an oriented 454 g, 19 x 16 x 3 cm. mastectomy with 3 x 3 cm skin ellipse and 1.8 cm everted nipple. Ink code: Anterior/superior-blue, anterior/inferior-. orange, posterior-black. Specimen is serially sectioned into 9 slices from medial to the lateral with nipple in slice 4. revealing 4 lesions. 1- 1.3 x 0.8 x 0.5 cm firm tan mass located in slics 5-6 in the upper outer quadrant; 2.7 cm from the deep margin and. 0.2 cm from the anterior margin. 2-. 1.2 x 0.9 x 0.8 cm firm tan stellate mass with central area of hemorrhage located in the upper mid-quadrant; 2.5. cm from the deep margin, 1.8 cm from the anterior margin, 1.4 cm the medial to lesion #1, and 1.8 cm. posterior/superior from nipple. 3- 0.6 x 0.3 x 0.3 cm firm tan nodule located in the upper inner quadrant; 1.2 cm from the deep margin, 0.9 cm from. the anterior margin and 3.2 cm medial to lesion #2. 4- 0.6 x 0.4 x 0.2 cm firm tan nodule located in the lower inner quadrant; 1.2 cm from the deep margin, 0.6 cm from. the anterior margin, and 6.2 cm inferior to lesion #1. Representatively submitted. E1: slice 1, upper inner. E2-E3: slice 2, lesion #3(posterior to anterior). E4: slice 3, tissue connecting lesion #3 and #2. E5-E7: slice 4, lesion #2 submitted anterior to posterior. E8: slice 5, lesion #1. E9: slice, 6, lesion #1. E10: slice 7, upper outer (lateral to lesion #1). E11: slice 7, lower outer. E12: slice 6, lower outer. E13-E14: slice 5, lesion #4 (anterior to posterior). E15-E16: slice 5, tissue connecting lesions #1 and #4. E17: slice 3, lower inner. E18: slice 2, lower inner. E19-E21: nipple, perpendicular sections. E22: skin. DIAGNOSIS: A. LYMPH NODE, SENTINEL #1, LEFT AXILLA, EXCISION: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). B. LYMPH NODE, SENTINEL #2, LEFT AXILLA, EXCISION: - METASTATIC CARCINOMA TO ONE OF ONE LYMPH NODE (1/1), MEASURING 0.1-CM. (MICROMETASTASES) WITH NO EXTRANODAL EXTENSION, SEE NOTE. C. BREAST, LEFT, MASTECTOMY: - TWO FOCI OF INVASIVE DUCTAL CARCINOMA. - SBR GRADE 3, MEASURING 1.6-CM. - SBR GRADE 1, MEASURING 0.5-CM. - INTERMEDIATE NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU, SOLID TYPE WITH CENTRAL NECROSIS. AND MICROCALCIFICATIONS. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. - BIOPSY SITE CHANGES WITH FIBROSIS AND GRANULATION TISSUE. - SEE SYNOPTIC REPORT AND SEE NOTE. D. LYMPH NODE, SENTINEL #1, RIGHT AXILLA, EXCISION: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). E. BREAST, RIGHT, MASTECTOMY: - TWO FOCI OF INVASIVE DUCTAL CARCINOMA,. - SBR GRADE 3, MEASURING 1.1-CM. - SBR GRADE 2, MEASURING 0.6-CM. - INTERMEDIATE NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU, SOLID AND CRIBRIFORM TYPES. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. - BIOPSY SITE CHANGES WITH FIBROSIS. - FIBROADENOMA AND SCLEROSING ADENOSIS. - SEE SYNOPTIC REPORT AND SEE NOTE. NOTE: Left axillary sentinel lymph node #2 touch preparation is negative. Therefore, the false- negativity is due to. sampling error. The morphology of metastatic tumor is similar to the larger grade 3 tumor (see below). In the left mastectomy specimen, 2 nodules are grossly identified, larger nodule located in UOQ measuring 1.6 and is. of grade 3; and a smaller nodule, located in posterior UIQ, measuring 0.5-cm and is of grade 1. Breast biomarkers on. both nodules are pending. In the right mastectomy specimen, 4 nodules are grossly identified, one is fibroadenoma, one is sclerosing adenosis,. and the other two are separate foci of invasive ductal carcinoma. The largest invasive tumor measures 1.1-cm and it. is of grade 3. Breast biomarkers are as follows, ER negative, PR negative and HER-2/neu equivocal (2+, FISH. pending). The smaller nodule measures 0.6-cm and it is of grade 2. The breast biomarkers are as follows ER. positive, PR positive and HER-2/neu equivocal (2+, FISH pending). Also, the morphology of grade 3 tumors (right and left) is different. It seems that there are 4 different primary tumors,. 2 in each breast. SYNOPTIC REPORT - BREAST. Specimens Involved. Specimens: B: SENTINEL LYMPH NODE #2 LEFT AXILLA. C: LEFT BREAST. Specimen Type: Mastectomy. Needle Localization: Laterality: Left. Invasive Tumor: Present. Multifocality: Yes. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 1.6cm. Tumor Site: Upper outer quadrant. Upper inner quadrant. Margins: Negative. Tubular Score: 3. Nuclear Grade: 2. Mitotic Score: 3. Modified Scarff Bloom Richardson Grade: 3. Necrosis: Present. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Positive 1/2. Micrometastases: DCIS present. Margins uninvolved by DCIS. DCIS Quantity: Estimate 5%. DCIS Type: Solid. DCIS Location:Associated with invasive tumor. Nuclear grade: Intermediate. Necrosis: Present. ER/PR/HER2 Results. Performed on Case: see note. Pathological staging (pTN): pT 1c N 1mic. SYNOPTIC REPORT - BREAST. Specimens Involved. Specimens: D: SENTINEL LYMPH NODE #1 RIGHT AXILLA. E: RIGHT BREAST. Specimen Type: Mastectomy. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: Yes. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 1. 1cm. Margins: Negative. Tubular Score: 3. Nuclear Grade: 3. Mitotic Score: 2. Modified Scarff Bloom Richardson Grade: 3. Necrosis: Present. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Negative 0/1. DCIS present. Margins uninvolved by DCIS. DCIS Quantity: Estimate 2%. DCIS Type: Solid. Cribriform. DCIS Location: Associated with invasive tumor. Nuclear grade: Intermediate. Necrosis: Absent. ER/PR/HER2 Results. Performed on Case: see note. Pathological staging (pTN): pT 1c N O. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimens Involved. Specimens: E: RIGHT BREAST. Specimen: Surgical Excision. Block Number: E5, larger tumor. ER: Negative Allred Score: 0 = Proportion Score 0 + Intensity Score 0. PR: Negative Allred Score: 0 = Proportion Score 0 + Intensity Score 0. 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. Immunohistochemistry 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 immunohistochemical stain is guided by published results in the medical literature,. information provided by the reagent manufacturer and by internal review of staining performance. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimens Involved. Specimens: E: RIGHT BREAST. Specimen: Surgical Excision. Block Number: E5 larger tumor. 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 (Dako, Carpenteria, CA) 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. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimens Involved. Specimens: E: RIGHT BREAST. Specimen: Surgical Excision. Block Number: E13 smaller tumor. ER: Positive Allred Score: 8 = Proportion Score 5 +. 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: 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 immunohistochemical stain is guided by published results in the medical literature,. information provided by the reagent manufacturer and by internal review of staining performance. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimens Involved. Specimens: E: RIGHT BREAST. Specimen: Surgical Excision. Block Number: E13 larger tumor. Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 50%. Fish Ordered: Yes on Date. METHODOLOGY: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and nn longer than 24 hours. Her2 analysis. was performed using the FDA approved Dako HercepTest (TM) test kit. 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: Bilateral invasive breast carcinoma. PRE-OPERATIVE DIAGNOSIS: Same. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TPD, Sentinel lymph node #1, right axilla: negative for carcinoma. Diagnosis called at. .m. by Dr. ADDENDUM: Results for touch prep on specimen D was incorrectly designated in the Intraoperative Consultation Diagnosis above. as "TPC". Correct information is as follows: SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimens Involved. Specimens: C: LEFT BREAST. Specimen: Surgical Excision. Block Number: C4 larger tumor. ER: Negative Allred Score: o = Proportion Score 0 + Intensity Score 0. PR: Negative Alired Score: 0 = Proportion Score 0 + Intensity Score 0. 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. Immunohistochemistry 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 immunonistocnemical stain is guided by published results in the medical literature,. information provided by the reagent manufacturer and by internal review of staining performance. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimens Involved. Specimens: C: LEFT BREAST. Specimen: Surgical Excision. Block Number: C4 larger tumor. Interpretation: NEGATIVE. Intensity: 1+. % Tumor Staining: 5%. Fish Ordered: No. 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. 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. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimens Involved. Specimens: C: LEFT BREAST. Specimen: Surgical Excision. Block Number: C14 smaller tumor. ER: Positive Allred Score: 8 = Proportion Score 5 + 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: 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 immunohistochemical stain is guided by published results in the medical literature,. information provided by the reagent manufacturer and by internal review of staining performance. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimens Involved. Specimens: C: LEFT BREAST. Specimen: Surgical Excision. Block Number: C14 smaller tumor. 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 (Dako, Carpenteria, CA) 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. 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 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. E5. Source of case: Tissue fixation formalin-fixed tissue Outside Case No: NA. Tissue source breast Results interpreted: yes. HER2/CEP17 ratio: 1.03. 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. 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 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. E13. Source of case: Tissue fixation formalin-fixed tissue Outside Case No: NA. Tissue source breast Results interpreted: yes. HER2/CEP17 ratio: 0.91. 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. 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 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. C14. Source of case: Tissue fixation formalin-fixed tissue Outside. NA. Tissue source breast Results interpreted: yes. HER2/CEP17 ratio: 0.94. 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: Final Review: Pathologist,. Final Review: Pathologist,. Final: Pathologist,. Addendum Reviev. autologist. Addendum Final: Pathologist,. Addendum: Pathologist,. Addendum Final: M.D., Pathologist, -. Addendum: Pathologist,. Addendum Final: Pathologist,. Addendum: Pathologist,. Addendum Final: Pathologist.

expanded version (tokens=7351) : 
 Main points from the breast pathology report:

1. Histological classification: Invasive ductal carcinoma, NOS (8500/3)
   - Left breast: Two foci of invasive ductal carcinoma, SBR grade 3 measuring 1.6 cm and SBR grade 1 measuring 0.5 cm.
   - Right breast: Two foci of invasive ductal carcinoma, grade 3 measuring 1.1 cm and grade 2 measuring 0.6 cm.

2. Subtype: Basal

3. Description of necrosis: Central necrosis observed in ductal carcinoma in situ (DCIS) in the left breast.

4. Tumor infiltrating lymphocytes: Not mentioned in the report.

5. Histological grade: SBR grade 3 in both breasts.

6. Nuclear grade: Intermediate nuclear grade for DCIS in the left breast.

7. Lymphovascular invasion: None identified.

8. Calcification: Microcalcifications present in DCIS in the left breast.

9. Receptor status and IHC results:
   - Left breast: ER/PR negative, HER2 negative (HER-2 immunohistochemical stain equivocal).
   - Right breast: ER/PR positive, HER2 negative (HER-2 immunohistochemical stain equivocal).

10. Ancillary testing results:
    - ER/PR results for the left breast: Both negative (Allred score 0).
    - HER2 results

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=7511) : 
 Breast Pathology Report: Left breast had SBR grade 3 invasive ductal carcinoma measuring 1.6cm and grade 1 carcinoma measuring 0.5cm. Central necrosis observed in DCIS. ER/PR negative, HER2 negative (equivocal). Right breast had grade 3 invasive ductal carcinoma measuring 1.1cm and grade 2 carcinoma measuring 0.6cm. ER/PR positive, HER2 negative (equivocal). No lymphovascular invasion identified. Microcalcifications present in DCIS of left breast.


