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 Her2, Gender: F. Date of Service: A copy of this report will be faxed to: FINAL SURGICAL PATHOLOGY REPORT. Diagnosis: LEFT BREAST, MODIFIED RADICAL MASTECTOMY: - Two foci of invasive ductal carcinoma, Nottingham grade 2 (see comment). - Size: 2.3 cm and 0.7 cm. - Location: lower outer (4:00) and inner (7:00) quadrants, respectively. Associated ductal carcinoma in situ (DCIS), intermediate nuclear. grade, cribriform and micropapillary patterns with punctate necrosis. and without calcifications. - Size: DCIS spans a region measuring approximately 3.8 cm and. comprises 10% of tumor. - Margins of resection are widely free of invasive and in situ tumor (at least 1.2 cm. away). - Focus suspicious for lymphovascular invasion identified. Micrometastatic carcinoma (1.7 mm) identified in one of fourteen axillary. lymph nodes (1/14); no extranodal extension identified. - Prior biopsy site changes present. - Uninvolved breast parenchyma with fibrocystic changes and vascular. calcifications. - Benign skin and nipple. COMMENT: The two foci of invasive ductal carcinoma are similar histologically. Although there was little tubule formation identified on prior needle biopsy of the 7:00. lesion, tubule formation is more apparent on excision (>10%). Thus, the overall. histologic grade is Nottingham grade 2 for both lesions. PATHOLOGIC TUMOR STAGING SYNOPSIS: Type and grade (invasive): Invasive ductal carcinoma, Nottingham grade 2. Type and grade (in situ): DCIS, intermediate nuclear grade. Primary tumor: pT2(m). Regional lymph nodes: pN1(mi). Distant metastasis: N/A. Printed: This report continues. Pathology - Page 1/5. FINAL SURGICAL PATHOLOGY REPORT. Stage: IIB. Lymphovascular invasion: Not identified. Margin status: R0, negative. Invasive Breast Cancer Tumor Staging Information. AJCC Cancer Staging Handbook, 7th Ed., and CAP Protocol (revised. Previous pathology specimens. Printed: This report continues (FINAL). Pathology - Page 2/5. ) - Page 2 Doc# 1. SPECIMEN IDENTIFICATION. Procedure/specimen type: Modified radical mastectomy. Laterality: Left breast. Lymph node sampling: Axillary dissection. INVASIVE CARCINOMA TUMOR CHARACTERISTICS. Histologic type: Invasive ductal carcinoma. Tumor site: Lower outer (4:00) and inner (7:00) quadrants. Tumor size: 2.3 cm and 0.7 cm. Tumor focality: Multifocal (two foci). Histologic grade (Nottingham Score): 2 of 3 (Nottingham score 6 - -7 of 9). Tubule formation: 2 of 3. Nuclear pleomorphism: 2-3 of 3. Mitotic rate: 2 of 3. Lymphovascular invasion: Focus suspicious for lymphovascular invasion. identified. Macroscopic and microscopic extent of tumor: Benign skin and nipple. DUCTAL CARCINOMA IN SITU (DCIS): Associated DCIS, intermediate nuclear grade,. cribriform and micropapillary patterns,. comprising 10% of tumor and spanning about. 3.8 cm. MARGINS. Invasive carcinoma: Widely negative for tumor (at least 1.2 cm away). Ductal carcinoma in situ: Widely negative for tumor (at least 1.2 cm away). LYMPH NODES. Total lymph nodes examined. 14. Number of lymph nodes involved. 1 (micrometastasis). Size of largest metastatic deposit: 1.7 mm. Extranodal extension: Absent. PATHOLOGIC STAGING: Primary Tumor (pT): pT2(m). Regional lymph nodes (pN): pN1(mi). Distant metastasis (pM): N/A. AJCC Stage: IIB. ANCILLARY STUDIES: ProPath. Estrogen receptor: POSITIVE (80-85% positive cells,. moderate-strong intensity) (4:00). Progesterone receptor: Negative (0% positive cells) (4:00). HER2: Negative (score 0) (4:00). This report continues. (FINAL). Pathology - Page 3/5. ) - Page 3 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. Ki-67;. High (40% positive cells) (4:00). Estrogen receptor: POSITIVE (20% positive cells, moderate-strong. intensity) (7:00). Progesterone receptor: Negative (0% positive cells) (7:00). HER2: Negative (score 0) (7:00). Ki-67: High (65% positive cells) (7:00). Source of Specimen: Breast;let breast radical mastectomy. Clinical History/Operative Dx: Breast cancer. Gross Description: Single specimen designated left breast radical mastectomy. Initially received in a fresh state for. Oncogenotyping tissue harvest is a left modified radical mastectomy weighing 809 grams, and measuring. 20.8 x 17.3 x 5.8 cm (not including axillary extension). and the axillary wing extending 10.5 x 9,0 x 4.0. cm. The overlying ellipse of tan-brown skin is 22.8 x 11.3 cm, with a paracentral darken brown, wrinkled. areola, 3.2 cm in diameter and a flattened 1.1 cm nipple. A palpable mass is appreciated in the lower. outer quadrant. A suture marks the medial apex of the specimen. The surgical margins are now. differentially inked as follows: Superior-superficial is marked blue,. Inferior-superticial is marked orange,. Deep is marked black. The breast is serially sectioned perpendicularly through the medial-lateral long axis, to reveal a partially. circumscribed. dense pink-gray, tumor mass measuring upwards of 2.3 x 1.5 x 1.3 cm (slabs 4-6, from. lateral). This mass is placed in the lower outer quadrant, approximating the 4:00 position and grossly. approaching within 1.8 cm of the deep, 2.3 cm of the inferior superficial, 5.0 cm of the lateral extension of. breast (not including axillary) and greater than 12.0 cm from the most medial extension of breast. The. This report continues (FINAL). Acct No. Pathology - Page 4/5. Page 4 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. tumor includes an embedded hook-shaped metallic clip. Representative portion of the tumor,. peri-neoplastic, and normal breast parenchyma is submitted for Oncogenotyping studies. A second, discrete, poorly visualized glistening tan lesion, is within the lower inner quadrant,. approximating the 7:00 position, and measuring up to 0.7 x 0.5 x 0.5 cm and placed within 2.3 cm of the. inferior superficial, 2.4 cm of the deep. and greater than 5.0 cm from the most medial extension of breast,. A second biopsy site clip is not appreciated. The cut sections of the remainder of the breast demonstrate prominent ductal tracts in the subareolar. lesion, up to 0.5 cm in diameter, exuding yellow-gray cheesy material, and bluish purulent fluid. Several. blue dome cysts are up to 0.6 cm. Initial examination of the axillary extension of fat reveals fifteen lymph node candidates, ranging from 0.2. cm - 2.0 x 1.7 x 1.2 cm in greatest dimension. The lymph node tissue is represented for microscopic. evaluation. Cassette summary: A1) nipple, subareolar tissue, two pieces,. A2) medial and lateral extension of skin,. A3-A5) large tumor mass, lower outer quadrant, represented,. A6) deep margin adjacent to large tumor mass,. A7) inferior superficial margin adjacent to large tumor mass,. A8-A10) lateral extension of breast tissue, adjacent to large mass, slabs 3, 2, 1, respectively,. A11) breast tissue medial to large tumor, slab 7,. A12-A14) second nodular lesion and inferior superficial margin and deep margin (A14),. A15) central breast-subareolar,. A16) upper outer quadrant, slab 3,. A17) upper inner quadrant, second slab from medial,. A18) four small lymph node candidates,. A19) three lymph node candidates, most proximal to breast,. A20) four lymph node candidates,. A21) single lymph node candidate bisected,. A22) single lymph node candidate trisected,. A23) enlarged flattened lymph node bisected,. A24) largest lymph node candidate serially sectioned and submitted. Microscopic Description: Microscopic sections have been examined. The microscopic findings are reflected in the diagnosis. rendered. Intradepartmental consultation: has reviewed selected slides and concurs. FND OF REPORT. Acct No. -. Pathology - Page 5/5. Jol.

expanded version (tokens=2430) : 
 Histological Classification:
- Two foci of invasive ductal carcinoma
- Nottingham grade 2
- Associated ductal carcinoma in situ (DCIS), intermediate nuclear grade, cribriform and micropapillary patterns with punctate necrosis, and without calcifications.

Subtype: HER2

Description:
- The size of the first focus is 2.3 cm and the second focus is 0.7 cm.
- Location: lower outer (4:00) and inner (7:00) quadrants respectively
- The DCIS spans a region measuring approximately 3.8 cm and comprises 10% of the tumor
- A focus suspicious for lymphovascular invasion has been identified.
- Margins of resection are widely free of invasive and in situ tumor (at least 1.2 cm away)
- Micrometastatic carcinoma (1.7 mm) identified in one of fourteen axillary lymph nodes (1/14); no extranodal extension identified.

Tumor infiltrating lymphocytes: Not identified

Histological grade:
- Invasive ductal carcinoma, Nottingham grade 2
- DCIS, intermediate nuclear grade

Nuclear Grade: 2-3 of 3

Lymphovascular invasion: Focus suspicious

Calcification: No calcifications mentioned

Receptor status:

Estrogen receptor: Positive (80-85% positive cells, moderate-strong intensity) (4:00)
Progesterone receptor: Negative (0

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=2609) : 
 The patient, a woman, was diagnosed with HER2 subtype invasive ductal carcinoma, Nottingham grade 2, with associated DCIS. The tumor measuring 2.3 cm and 0.7 cm was located in the lower outer and inner quadrants respectively, without calcifications or tumor infiltrating lymphocytes. A focus suspicious for lymphovascular invasion and micrometastatic carcinoma were identified in a lymph node. Estrogen receptor-positive (80-85% positive cells) and progesterone receptor-negative were noted with high Ki-67 expression in the malignant cells. Margins of resection are widely free of invasive and in situ tumors.

