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. SENTINEL LYMPH NODE #3 LEFT AXILLA. D. SENTINEL LYMPH NODE #4 LEFT AXILLA. E. LEFT BREAST. F. ADDITIONAL SKIN UPPER SUPERIOR FLAP. G. RIGHT BREAST. SPECIMEN(S): A. SENTINEL LYMPH NODE #1 LEFT AXILLA. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. SENTINEL LYMPH NODE #3 LEFT AXILLA. D. SENTINEL LYMPH NODE #4 LEFT AXILLA. E. LEFT BREAST. F. ADDITIONAL SKIN UPPER SUPERIOR FLAP. G. RIGHT BREAST. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TPA-TPD: sentinel nodes #1-#4, left axilla: All negative for tumor cells on touch prep, called to Dr. at. by Dr. GROSS DESCRIPTION: A. SENTINEL LYMPH NODE #1 LEFT AXILLA. Received fresh labeled with the patient's identification of a fragment of beige tan soft tissue measuring 1. x. 1 x 0.3 cm. Touch preparations are performed. The entire specimen is submitted in cassette A1. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. Received fresh labeled with the patient's identification of a fragment of beige tan soft tissue measuring 1. x 1 x 0.3 cm. Touch preparations are performed. The entire specimen is submitted in cassette B1 and. B2. C. SENTINEL LYMPH NODE # 3 LEFT AXILLA. Received fresh labeled with the patient's identification are two possible lymph nodes measuring 0.5 x. 0.5 x 0.2 cm each. Both lymph nodes are entirely submitted separately in C1 and C2. D. SENTINEL LYMPH NODE # 4 LEFT AXILLA. Received fresh labeled with the patient's identification of a fragment of beige tan soft tissue measuring. 0.7 x 0.7 x 0.5 cm. Touch preparations are performed. The entire specimen is submitted in cassette. D1. E. LEFT BREAST. Received fresh labeled with the patient's identification and designated "Part E., left breast" is an. orientated 399g, 18 x 17 x 3 cm mastectomy specimen with a 5.2 x 3.3 cm skin ellipse, and 1.2cm. everted nipple. Ink code: Anterior/superior-blue, anterior/inferior-orange, posterior-black. Specimen is. serially sectioned into 9 slices from medial to lateral with nipple in slice 3 revealing a 3.5 x 3.1 x 2 cm. firm beige spiculated mass at the 12 o'clock position (slices 5-7) closest to the anterior margin at 0.9cm. and located 2.2cm from the deep margin. Tissue is procured. Representatively submitted: E1: Perpendicular sections, nipple. E2: Bisected nipple base. E3: Sections of skin. E4: Tumor, slice 5. E5-E8: Tumor, slice 6. E9: Overlying deep margin, slice 6. E10: Tumor, slice 7. E11: Tumor and closest anterior margin, slice 7. E12: Additional tumor, slice 7. E13: Upper outer quadrant. E14: Lower outer quadrant. E15: Upper inner quadrant. E16: Lower inner quadrant. F. ADDITIONAL SKIN UPPER SUPERIOR FLAP. Received in formalin in a container labeled with the patient's identification is a brown tan crescent. shaped excision of skin measuring 6.1 x 2.5 x 0.3 cm. A suture designates superior. The specimen. is. inked as follows: Superior-blue, inferior-orange, deep-black. The surface of the skin demonstrates no. obvious gross abnormality. The specimen is serially sectioned from medial to lateral and submitted. entirely for microscopic evaluation. Cassettes are submitted as follows: F1: Medial tip. F2-F6: Serial sections. F7: Lateral tip. G. RIGHT BREAST. Received fresh labeled with the patient's identification and "Right Breast-Stitch marks axillary tail" is an. oriented 339g, 23 x 14 x 3cm simple mastectomy with 5 x 3cm tan pink skin ellipse, and a 1.3cm. centrally located, raised nipple. Ink Code: Anterior-Superior: Blue, Anterior-Inferior: Orange, Posterior: Black. The specimen is serially sectioned from lateral to medial into 15 slices. The nipple is located in. slice 12. The cut surfaces reveal a blue dome cyst 0.8 x 0.4cm in the LC of slice 12, more than 1cm. from the closest deep margin. No lesions are grossly identified. Representative sections are submitted. as follows: G1: nipple slice 12. G2: skin slice 12. G3: UOQ slice 8. G4: UOQ slice 9. G5: LOQ slice 7. G6: LOQ slice 10. G7: blue dome cyst LC slice 12. G8: LC with inferior margin slice 12. G9: UC slice 12. G10: UIQ slice 13. G11: UIQ slice 14. G12: LIQ slice 13. G13: LIQ slice 14. DIAGNOSIS: A. SENTINEL LYMPH NODE #1, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NO TUMOR SEEN (0/1). B. SENTINEL LYMPH NODE #2, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NO TUMOR SEEN (0/1). C. SENTINEL LYMPH NODE #3, LEFT AXILLA, BIOPSY: - TWO LYMPH NODES, NO TUMOR SEEN (0/2). D. SENTINEL LYMPH NODE #4, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NO TUMOR SEEN (0/1). E. BREAST, LEFT, MASTECTOMY: - INVASIVE DUCTAL CARCINOMA, POORLY DIFFERENTIATED. (SBR GRADE 3) (SEE NOTE). - TUMOR MEASURES 3.5 CM IN GREATEST DIMENSION. - MARGINS, FREE OF TUMOR. - DUCTAL CARCINOMA IN SITU (DCIS), SOLID TYPE, NUCLEAR GRADE 3,. WITH NECROSIS, MICROCALCIFICATIONS AND ASSOCIATED. LYMPHOID INFILTRATE. - SKIN AND NIPPLE, NO TUMOR SEEN. NOTE: Biomarkers and lymphvascular invasion status will be reported in an addendum. F. SKIN, UPPER SUPERIOR FLAP, EXCISION: - BASAL CELL CARCINOMA, SUPERFICIAL TYPE (SEE NOTE). - MARGINS, FREE OF TUMOR. NOTE: The basal cell carcinoma is focally 2 mm from the superior margin. G. BREAST, RIGHT, PROPHYLACTIC MASTECTOMY: - SMALL FIBROADENOMA, PSEUDOLACTATIONAL CHANGE, APOCRINE. METAPLASIA, STROMAL FIBROSIS, AND MICROCALCIFICATIONS. - BENIGN SKIN AND NIPPLE. SYNOPTIC REPORT - BREAST. Specimen Type: Mastectomy. Needle Localization: No. Laterality: Left. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 3.5cm. Tumor Site: 12:00. Margins: Negative. Distance from closest margin: 0.5cm. anterior superior. Tubular Score: 3. Nuclear Grade: 3. Mitotic Score: 3. Modified Scarff Bloom Richardson Grade: 3. Necrosis: Present. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Negative 0/5. DCIS present. Margins uninvolved by DCIS : 0.5cm from anterior superior margin. DCIS Quantity: Estimate 40%. DCIS Type: Solid. DCIS Location: Associated with invasive tumor. Nuclear grade: High. Necrosis: Present. Location of CA++: DCIS. Pathological staging (pTN): pT 2N0. CLINICAL HISTORY: None given. PRE-OPERATIVE DIAGNOSIS: None given. ADDENDUM: NOTE: A CD31 stain was performed on block E6 and is negative, showing no evidence of. lymphvascular invasion. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Surgical Excision. Block Number: E10. 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 Dakc. bllowing 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. Specimen: Surgical Excision. Block Number: E10. Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 15%. 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. C. 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. int 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 E10. Source of case: Tissue fixation. formalin-fixed tissue. Outside Case No: NA. Tissue source. breast Results interpreted: 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. Microscopic/Diagnostic Dictation: Pathologist, 1. Final Review: Pathologist,. Final Review: Pathologist,. Final: Pathologist, r. Addendum: Pathologiat. Addendum Final: Pathologist,. Addendum: Pathologist,. Addendum Final: Pathologist.

expanded version (tokens=3533) : 
 Histological classification: 
- Left breast: Invasive ductal carcinoma, poorly differentiated (SBR Grade 3)
- Left breast: Ductal carcinoma in situ (DCIS), solid type, nuclear grade 3, with necrosis, microcalcifications, and associated lymphoid infiltrate
- Right breast: Fibroadenoma, pseudolactational change, apocrine metaplasia, stromal fibrosis, and microcalcifications
- Skin upper superior flap: Basal cell carcinoma, superficial type

Necrosis: Present in both invasive ductal carcinoma and DCIS in the left breast

Tumor infiltrating lymphocytes: Associated with DCIS in the left breast

Histological grade: SBR Grade 3 for invasive ductal carcinoma in the left breast

Nuclear grade: Grade 3 for invasive ductal carcinoma and DCIS in the left breast

Lymphovascular invasion: Not mentioned explicitly in the provided report

Calcification: Present in DCIS in the left breast

Receptor status:
- ER (Estrogen receptor): Negative (Allred Score 0)
- PR (Progesterone receptor): Negative (Allred Score 0)
- HER2 (Human epidermal growth factor receptor 2): Equivocal (2+) with 15% tumor staining. Additional testing (FISH) ordered to confirm HER2 status.

IHC and ancillary testing results:
- CD31 stain on block E6 (

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=3695) : 
 Breast Pathology Report: 
Left breast: Invasive ductal carcinoma (poorly differentiated, SBR Grade 3), with associated ductal carcinoma in situ (DCIS) (solid type, nuclear grade 3, necrosis, microcalcifications, and lymphoid infiltrate). Right breast: Fibroadenoma with pseudolactational change. Skin upper superior flap: Basal cell carcinoma (superficial type). Receptor status: ER-negative, PR-negative. HER2 status equivocal; further testing ordered. No lymphovascular invasion mentioned.

