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 RIGHT AXILLA. B. RIGHT BREAST. C. ADDITIONAL ANTERIOR MARGIN. SPECIMEN(S): A. SLN #1 RIGHT AXILLA. B. RIGHT BREAST. C. ADDITIONAL ANTERIOR MARGIN. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TPA, Lymph node, sentinel, right axilla, biopsy: Negative for carcinoma. Part B, Right breast, Gross examination: Tumor is present at the anterior margin, and at least 0.2-cm. from posterior margin. Diagnoses called at. (A) anc. (B) by Dr. GROSS DESCRIPTION: A. SLN #1 RIGHT AXILLA. Received fresh labeled with the patient's patient and designated "sentinel lymph node number one right. axilla" is a fragment of lymphoid tissue measuring 1.9 X 1.2 x 0.8 cm. Touch preparation is performed. Entirely submitted, A1. B. RIGHT BREAST. Received fresh labeled with the patient's identification and designated "right breast" is a previously. inked, oriented, 13-g, 4 x 2.5 x 1.5 cm lumpectomy specimen. The short suture designates superior,. long-lateral. Ink code: Anterior-yellow, posterior-black, medial-green, lateral-red, superior-blue, inferior-. orange. The specimen is serially sectioned from medial to lateral into 6 slices revealing a firm tan. mass, 1.2 x 0.9 x 0.7 cm, located 0.1-cm from the nearest anterior margin. A portion of the specimen is. submitted for tissue procurement. The remainder of the specimen is entirely submitted: B1-B2: Perpendicular sections medial margin. B3-B4: Slice 2, B4 demonstrates mass. B5-B6: Slice 3, B6 demonstrates mass. B7-B8: Slice 4, B8 demonstrates mass. B9-B10: Slice 5, B10 demonstrating remainder of mass. B11-B12: Perpendicular sections lateral margin. C. ADDITIONAL ANTERIOR MARGIN. Received fresh labeled with the patient's identification and designated "additional anterior margin" are. two previously inked (black at final margin) fragments of adipose tissue together weighing 1 g and. measuring 2 x 1 x 0.3 cm in aggregate. The entire specimen is submitted, C1. DIAGNOSIS: A. LYMPH NODE, SENTINEL #1, RIGHT AXILLA, EXCISION: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). B. BREAST, RIGHT, WIDE LOCAL EXCISION: INVASIVE DUCTAL CARCINOMA, SBR GRADE 3 WITH FOCAL NECROSIS, MEASURING 1.2-CM. HIGH NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU, SOLID AND CRIBRIFORM TYPES WITH. CENTRAL NECROSIS, MICROCALCIFICATIONS, AND LOBULAR EXTENSION. INVASIVE TUMOR INVOLVES ANTERIOR SURGICAL RESECTION MARGIN (SEE PART C). BIOPSY SITE CHANGES WITH FIBROSIS. - SEE SYNOPTIC REPORT. C. BREAST, ADDITIONAL ANTERIOR MARGIN, EXCISION: - FATTY BREAST TISSUE, NO TUMOR SEEN. SYNOPTIC REPORT - BREAST. Specimen Type: Excision. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 1.2cm. Margins: Negative. Distance from closest margin: 0.3cm. inferior. 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: Negative 0 / 1. DCIS present. Margins uninvolved by DCIS. DCIS Quantity: Estimate 10%. DCIS Type: Solid. Cribriform. DCIS Location: Associated with invasive tumor. Nuclear grade: High. Necrosis: Present. Location of CA++: DCIS. Benign epithelium. ER/PR/HER2 Results. ER: Positive. PR: Positive. HER2: Pending. Performed on Case: Pathological staging (pTN): pT 1c N 0. Pathological staging is based on the AJCC Cancer Staging Manual, 7th Edition. CLINICAL HISTORY: None given. PRE-OPERATIVE DIAGNOSIS: None given. ADDENDUM: SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimen: Surgical Excision. Block Number: Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 30%. Fish Ordered: METHODOLOGY: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Her? 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. 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 HFR-2 probe that spans the entire HER-2 gene in the F. by Dr. A majority of tumors cells displayed moderate polysomy 17. with 2 to 4 chromosome 17 signals and 2 to 4 HER-2 signals, with a HER-2/CEP 17 Ratio </=2.0,. consistent with no amplification of the HER2/neu gene. Block used. Source of case: Tissue fixation. formalin-fixed tissue. Outside Case No:NA. Tissue source. breast Results interpreted: HER2/CEP17 ratio: 1.1. 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. 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: 18. CLINICAL EXPERIENCE: Patients with a recurrence score of: 18 in the clinical validation study. had an average rate of Distant Recurrence at 10 years of 11%. ER Score: 10.2 Positive. PR Score: 9.2 Positive. Her2 Score: 9.9 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. Microscopic/Diagnostic Dictation:,. Final Review: M.D., Pathologist. Final: M.D., Pathologist,. Addendum: M.D., Pathoiogist,. Addendum Final: M.D., Pathologist, (. Addendum:, M.D., Pathologist,. Addendum Final, M.D., Patholugiat,. Addendum, M.D., Pathologist. Addendum Final:, M.D., Pathologist,.

expanded version (tokens=2443) : 
 Histological classification: Invasive ductal carcinoma, Solid and Cribiform types with Central Necrosis, and Lobular Extension, DCIS, Subtype LumA. 

Necrosis: Focal Necrosis is present.

Tumor infiltrating lymphocytes: Not mentioned in the report.

Histological grade: SBR Grade 3.

Nuclear grade: High.

Lymphovascular invasion: None identified.

Calcification: Microcalcifications are present.

Receptor status: ER and PR positive.

IHC: Her2 is equivocal with an intensity score of 2+, % Tumor Staining of 30%. ONCOTYPE DX BREAST CANCER ASSAY shows Positive ER Score, Positive PR Score, and Negative Her2 Score.

Ancillary testing results: Sentinel lymph node #1 right axilla was negative for carcinoma, whereas the tumor was present at the anterior margin of the right breast. No tumor was seen in the additional anterior margin.

Pathological staging: pT 1c N 0 based on the AJCC Cancer Staging Manual, 7th Edition.

Overall, the patient has been diagnosed with LumA subtype Invasive ductal carcinoma. It has a high nuclear grade, SBR grade 3, with focal necrosis, and microcalcifications. No lymphovascular invasion was detected. The receptor status shows positive ER and PR, while Her2 is equivocal. The Oncotype DX breast cancer assay suggests a positive ER and PR

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=2607) : 
 The patient has a LumA subtype invasive ductal carcinoma with high nuclear grade and focal necrosis. Microcalcifications are present, but there is no lymphovascular invasion. ER and PR receptors are positive, while Her2 is equivocal. Oncotype DX breast cancer assay shows positive ER and PR scores. Sentinel Lymph Node from the right axilla is negative for carcinoma, whereas the tumor was present at the anterior margin of the right breast. Total Tumor Size is 1.2-cm, with no involvement of lymph nodes (pT1c N0).

