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, RUN DATE : RUN TIME : n Inquiry. RUN USER : LOC: U #. AGE/SX. ROOM: REG DR: BED: DIS : TLOC: SPEC # : COLL: TIME IN FORMALIN 77:14. hrs. CLINICAL INFORMATION: Pre-Op Diagnosis: Breast CA. Remarks. Specimen(s) : A. Left breast. C. B. Right Left sentinel breast and node axillary contents Carcinona, dactalinfiltrating NOS. MICROSCOPIC DIAGNOSIS. A. BREAST, LEFT. SIMPLE MASTECTOMY: INVASIVE GRADE 3 DUCTAL CARCINOMA WITH EXTENSIVE TUMOR NECROSIS AND ASSOCIATED. HIGH-GRADE DUCTAL CARCINOMA IN SITU (DCIS) WITH COMEDO NECROSIS. TUMOR MEASURES 1.8 CM IN GREATEST DIMENSION (pT1c). ONE (1) OF TWO (2) TAIL OF BREAST/LOW AXILLARY LYMPH NODES POSITIVE FOR. METASTATIC CARCINOMA MEASURING 7 MM IN EXTENT WITHOUT EXTRACAPSULAR EXTENSION. HEALING WOUND REACTION CONSISTENT WITH PREVIOUS NEEDLE BIOPSY. NO DEFINITIVE PERITUMORAL ANGIOLYMPHATIC INVASION IDENTIFIED. MARGINS NEGATIVE WITH CLOSEST MARGIN DEEP MEASURING 5 MM. ADDITIONAL PATHOLOGIC FINDINGS: NEUROFIBROMATOSIS. PROLIFERATIVE FIBROCYSTIC CHANGES. FIBROADENOMA (SMALL). B. LEFT AXILLARY SENTINEL LYMPH NODE. EXCISION: ONE (1) SENTINEL NODE NEGATIVE FOR METASTATIC CARCINOMA BY ROUTINE LIGHT. MICROSCOPY AND CYTOKERATIN (PANK+) IMMUNOSTAIN. TWO (2) NONSENTINEL LYMPH NODES NEGATIVE FOR METASTATIC CARCINOMA. C. BREAST, RIGHT, MODIFIED RADICAL MASTECTOMY: INVASIVE GRADE 3 DUCTAL CARCINOMA MEASURING 4 CM WITH EXTENSIVE TUMOR NECROSIS. (pT2). ASSOCIATED HIGH-GRADE DUCTAL CARCINOMA IN SITU (DCIS) WITH COMEDO NECROSIS: NOT. EXTENSIVE). TUMOR INVADES DERMIS WITHOUT ULCERATION. TUMOR DOES NOT INVADE DEEP SKELETAL MUSCLE. TWO (2) OF 12 AXILLARY LYMPH NODES POSITIVE FOR METASTATIC CARCINOMA WITH. EXTRANODAL CAPSULAR EXTENSION PRESENT AND FOCAL AREA SUSPICIOUS FOR PERINODAL. VENOUS INVASION. MARGINS NEGATIVE WITH CLOSEST MARGIN TO INVASIVE TUMOR SUPERIOR (2 MM) AND TO. DCIS MEDIAL (4 MM). ADDITIONAL PATHOLOGIC FINDINGS: 2.5 CM FIBROADENOMA. NEUROFIBROMATOSIS. RUN DATE. RUN TIME. Specimen Inquiry. RUN USER: SPEC #: (,Continued). MICROSCOPIC DIAGNOSIS. PROLIFERATIVE FIBROCYSTIC CHANGES. COMMENT(S). Bilateral poorly differentiated ductal carcinomas are present Both have positive axillary. lymph nodes with the positive left axillary node present in the tail of the breast region. of the simple mastectomy specimen. Of note is that the sentinel lymph node on the left. side was found to be negative for carcinoma. High-grade DCIS with comedo necrosis is. associated with both tumors. most prominent on the left side where in some areas it is. difficult to distinguish the in situ from the invasive component. The left breast. carcinoma is associated with numerous amorphous chunk-like microcalcifications. The previous core needle biopsy material from these tumors (. Left and. right) were evaluated with a breast prognostic panel . The carcinomas were. both. found to be weakly positive for estrogen receptor and with discordant findings with. regards to HER2/neu by immunohistochemical stain and FISH analysis. Due to the extensive. necrosis present on the previous core needle biopsy. both tumors are being further. evaluated for HER2/neu status. Às this case was received in the department such that. it. does not fall within the 6-48 hour time frame for formalin fixation and due to some. difficulty in sorting out the invasive component from the DCIS component in sections of the. left breast mass, the positive lymph node from the left breast with 5 hours of formalin. fixation and two sections of the tumor from the right breast (block C1 with 5 hours of. formalin fixation and block C5 with 77 hours of formalin fixation) are being further. evaluated for HER2/neu status by immunohistochemical stains and possible FISH. The. of these studies will be reported separately as an addendum. CAP Protocol for the Examination of Specimens From Patients With Invasive Carcinoma of the. Breast. Based on AJCC/UICC TNM. 7th edition. Specimen À - Left Breast Carcinoma. PROCEDURE. Total mastectomy. LYMPH NODE SAMPLING. Sentinel lymph nodes and lymph nodes presen t. within the breast specimen. LATERALITY: Left. HISTOLOGIC TYPE: Invasive ductal carcinoma (NOS). TUMOR SIZE. Greatest dimension : 1.8 cm. HISTOLOGIC GRADE (NOTTINGHAM) : Glandular Differentiation: Score 3. Nuclear Pleomorphism: Score 3. Mitotic Rate: Score 3. Overall Grade: Grade 3. TUMOR FOCALITY: Single focus of invasive carcinoma. DUCTAL CARCINOMA IN SITU: DCIS is present. MARGINS: Margins uninvolved by invasive carcinoma and. DCIS. RUN DATE: RUN TIME: Specimen Inquiry. RUN USER: SPEC #. COMMENT (s). Distance from closest margin 5 mm (deep). LYMPH NODES: Number of sentinel lymph nodes examined : 1. Total number of lymph nodes examined (sentinel. and nonsentinel) : 5. Number of sentinel lymph nodes with. macrometastases: 1. Number of lymph nodes with micrometastases. (>0.2 mm to 2 mm and/or >200 cells) : 0. Number of lymph nodes with isolated tumor. cells 110.2 mm and <200 cells) : 0. Number of lymph nodes without tumor cells. identified 4. PATHOLOGIC STAGING: Primary Tumor: pT1c. Regional Lymph Nodes: pN1a. Distant Metastasis: Not applicable. ANCILLARY STUDIES: ER: Positive (26% of tumor cells weak staining. intensity). PR: Negative. HER2 Immunoperoxidase Studies 2+. HER2 FISH: Not amplified. NOTE: Results are on previous core biopsy. material. Specimen C - Right Breast Carcinoma. PROCEDURE: Total mastectomy. LYMPH NODE SAMPLING: Axillary dissection. LATERALITY. Right. HISTOLOGIC TYPE: Invasive ductal carcinoma (NOS). TUMOR SIZE: Greatest dimension : 4 cm. HISTOLOGIC GRADE (NOTTINGHAM) : Glandular Differentiation: Score 3. Nuclear Pleomorphism: Score 3. Mitotic Rate: Score 3. Overall Grade: Grade 3. TUMOR FOCALITY. Single focus of invasive carcinoma. DUCTAL CARCINOMA IN SITU: DCIS is present. MICROSCOPIC EXTENT OF TUMOR : Skin: Invasive carcinoma directly invades into. the dermis without skin ulceration. MARGINS. Invasive carcinoma: Margins uninvolved by. invasive carcinoma. Distance from closest margin: 2 mm (superior). Ductal Carcinoma In Situ: Margins uninvolved. by DCIS. Distance from closest margin: 4 mm (medial). LYMPH NODES. Number of sentinel lymph nodes examined : 0. Total number of lymph nodes examined (sentinel. and nonsentinel) : 12. Number of sentinel lymph nodes with. macrometastases: 2. RUN DATE. RÜN TIME. Specimen Inquiry. RUN USER: SPEC #: COMMENT (S). Number of lymph nodes with. micrometastases (>0.2 mm to 2 mm and/or 200. cells) : 0. Number of lymph nodes with isolated tumor. cells (50.2 mm and <200 cells) : 0. Number of lymph nodes without tumor cells. identified 10. PATHOLOGIC STAGING: Primary Tumor: pT2. Regional Lymph Nodes: pN1a. Distant Metastasis: Not applicable. ANCILLARY STUDIES: ER: Positive ( %% of tumor cells) weak staining. intensity). PR: Negative. HER2 Immunoperoxidase Studies: Negative (1+). In Situ Hybridization: Amplified. Average Number of HER2 gene copies/cell: 5.9. Average Number of chromosomes 17/cell: 1.8. Note: Performed on core needle biopsy. GROSS DESCRIPTION: A. Received fresh for Tissue Banking. gross evaluation and "left breast" Received is. a 413 gram, 27.0 x 12.5 x 3.0 cm fibrofatty breast. The breast has an overlying 24.0 x 12.5. cm portion of brown/black skin. The skin has a central to slightly eccentric 5.5 x 4.5 cm. areola. and a somewhat central 1.5 cm nipple. The skin surface has multiple papules with no. scars or lesions identified The deep margin is predominantly smooth and is inked blue. The. breast is serially sectioned from medial to lateral to have a central/lateral 2.0 x 1.0 x. 1. cm indurated to centrally necrotic hemorrhagic to yellow appearing tumor mass. The. tumor mass is at least 18 cm from medial, is approximately 5 cm from lateral. is. approximately 5 cm from superior and 5 cm from inferior. The tumor is 0.2 cm from the deep. margin and the deep margin slides easily over the mass. Sections of tumor are sampled for. Tissue Banking. A large, 1.4 x 1.0 x 0.8 cm, nodular lymph node is identified in the. lateral most aspect of the breast tissue. Two additional smaller lymph nodes are present. À. section of the large lymph node is sampled for frozen section diagnosis The two smaller. nodes are 0. and 0.8 cm. The remainder of the breast tissue is diffusely fibrous with. fibrocystic change There is indurated fibrocystic change adjacent to the tumor and ranges. up to an additional 2. 0 cm. The white fibrous tissue makes up between 75 and 80% of the. parenchyma. There is diffuse ecchymotic hemorrhage lateral to the tumor predominant in the. lower/outer quadrant. The breast tissue is diffusely nodular, however. no additional. discrete tumor like mass is identified Representative sections are sampled to be submitted. following overnight fixation for a repeat of tumor markers. The remainder of the specimen. will be held for fixation. Representative sections are sampled as labeled in the following. cassettes: A1. frozen section residue. A2. remainder of the lymph node. A3. sliver of tumor. RUN DATE. RUN TIME: Specimen Inquiry. RUN USER: SPEC #: GROSS DESCRIPTION (Continued). All these sections will be submitted following overnight fixation The remainder. of. the. sections will be submitted following further fixation as labeled: A4-A5. sections of nipple. A6. en face areola sectioned. A7-A8. full cross sections of tumor to deep margin. A9. smaller lymph node submitted in toto. A10. area of indurated nodularity adjacent to tumor. A11. upper/outer quadrant sampled. A12. lower/outer quadrant sampled (quadrant most closely associated with. tumor). A13. upper/inner quadrant sampled. A14. lower/inner quadrant sampled. B. Part. B. is received in formalin. labeled with the patient's name and "left sentinel. node" Received is a 3.5 x 2.5 x 0. cm aggregate of yellow adipose The adipose is. sectioned to have three nodular lymph nodes which range from 0.5 cm to a linear 1.7 x. 0. 6. x. 0. 4. cm. The larger node has been designated in the OR as the sentinel node. Each node is. sectioned perpendicular to the long axis to be entirely submitted per sentinel lymph node. protocol with the sentinel node submitted in B1-B2 and the additional nodes submitted. separately B3-B4. C. Received fresh for Tissue Banking, labeled with the patient's name and "right breast. with axillary node contents" is a 445 gram. 23.0 x 13.0 x 3.0 cm fibrofatty breast. The. breast has an overlying 22.5 x 11.0 cm black/brown skin ellipse. The ellipse has multiple. raised papules across the surface and an eccentrically, medially located 6.0 x 5.0 cm. areola with a 1.3 cm mildly flattened nipple. No scars or lesions are identified on the. skin surface. The breast is received with a 9.0 x 4.5 x 3.0 cm axillary tail and the. specimen is consistent with a modified radical mastectomy specimen. The deep fascial plane. is smooth and somewhat irregular. The deep fascial plane will be inked blue and the breast. is serially sectioned from medial to lateral to have a medially located 4.0 x 3.7 x 3.0. cm. tumor mass. The mass is 0.5 cm from the nearest inked deep margin. There is a portion. that comes within 0.6 cm of superior, 0.8 cm of medial and is 0.4 cm from inferior at the. medial most tip of the breast specimen A second spherical 2.0 cm mass is located in the. upper/outer quadrant This mass is 0. cm from the deep margin and the deep margin slides. easily over the mass. The second mass is approximately 2.5 cm from superior. is 12.5 cm. inferior, is 15 cm from medial and 8 cm from lateral. Further sectioning of the large mass. shows it to focally extend to the superior peripheral margin. The remainder of the breast. parenchyma has diffuse dense white fibrous tissue with diffuse fibrocystic change The. fibrous tissue makes up between 80 and 90% of the parenchyma. No additional discrete tumor. like masses are identified. The axillary tail is sectioned to have multiple nodular lymph. nodes. The nodes include tumor replaced nodes and range up to a positive. 4.8 x 2.5 x 2.5. cm, lymph node. The large lymph node appears to have necrosis in the center, similar to. the necrosis in the large tumor mass. Representative sections are sampled as labeled in. the following cassettes. C1. sliver of tumor which will be submitted following overnight tissue. processing for tissue markers. C2. nipple. C3. en face section of areola. C4. section of large tumor mass to deep margin. C5-C6. large tumor mass to superior/medial peripheral margins. RUN DATE. RUN TIME. Specimen Inquiry. RUN USER. SPEC # : GROSS DESCRIPTION (Continued). C7-C8. tumor to skin. C9. cross section of large tumor mass. C10. deep margin nearest smaller tumor mass. C11-C12. smaller tumor mass sampled. C13. upper/outer quadrant (quadrant most closely associated with smaller. tumor mass). C14. lower/outer quadrant sampled. C15. upper/inner quadrant sampled (quadrant most closely associated with. large tumor mass). C16. lower/inner quadrant. C17-C18. whole axillary lymph nodes. C19. one whole lymph node and one lymph node (positive). C20. largest lymph node sampled. KRM/mf. INTRAOPERATIVE CONSULTATION. A. FROZEN SECTION DIAGNOSIS LEFT BREAST: TAIL OF BREAST / AXILLARY LYMPH NODE POSITIVE FOR METASTATIC CARCINOMA. PRIMARY TUMOR JUDGED ADEQUATE FOR TISSUE BANKING WITH PORTION OF NEOPLASTIC. TISSUE PROVIDED TO TISSUE BANK COORDINATOR. RESULTS GIVEN TO. PHOTO DOCUMENITATION. Image. Image. Image. Image. N°.

expanded version (tokens=4103) : 
 Histological Classification:
- Left breast: Invasive Grade 3 Ductal Carcinoma with extensive tumor necrosis and associated high-grade Ductal Carcinoma In Situ (DCIS) with comedo necrosis.
- Right breast: Invasive Grade 3 Ductal Carcinoma with extensive tumor necrosis and associated high-grade DCIS with comedo necrosis.

Subtypes:
- Left breast: Basal subtype
- Right breast: Not specified

Necrosis:
- Left breast: Extensive tumor necrosis
- Right breast: Extensive tumor necrosis

Tumor Infiltrating Lymphocytes:
- Not mentioned in the report

Histological Grade:
- Left breast: Grade 3
- Right breast: Grade 3

Nuclear Grade:
- Left breast: Not mentioned in the report
- Right breast: Not mentioned in the report

Lymphovascular Invasion:
- Left breast: No definitive peritumoral angiolymphatic invasion identified
- Right breast: Focal area suspicious for perinodal venous invasion

Calcification:
- Left breast: Numerous amorphous chunk-like microcalcifications associated with the carcinoma
- Right breast: Not mentioned in the report

Receptor Status:
- Left breast: Weakly positive for estrogen receptor (ER)
- Right breast: Positive for ER

IHC and other ancillary testing results:
- Left breast: Discordant findings with regards to HER2/neu by

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=4299) : 
 Left breast: Basal subtype invasive Grade 3 Ductal Carcinoma with extensive necrosis, associated high-grade DCIS. Lymph nodes negative, except for one positive in tail of breast region. Tumor measures 1.8 cm (pT1c) with negative margins. Numerous microcalcifications present. Weakly positive for ER. HER2 status being further evaluated due to extensive necrosis.

Right breast: Invasive Grade 3 Ductal Carcinoma with extensive necrosis, associated high-grade DCIS. Two lymph nodes positive with capsular extension and suspicious venous invasion. Tumor measures 4 cm (pT2) with negative margins. Fibroadenoma present. Positive for ER, negative for

