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 - FINAL SURGICAL PATHOLOGY REPORT. Source of Specimen: A. Breast;left complete mastectomy. B. Breast;right modified radical mastectomy. Clinical History/Operative Dx: None provided. Gross Description: A. The specimen is labeled left breast complete mastectomy and is received in formalin. It consists of a. mastectomy specimen which weighs 227 grams. A black suture with a metallic clip marks the "tail of the. breast". With this orientation the specimen measures 18,5 cm from medial to lateral, 11.8 cm from. superior to inferior, and 2.5 cm superficial to deep. There is an overlying broad ellipse of dark brown skin. which measures 17 x 6.5 cm. Centrally and slightly superiorly within the skin is a 2,3 cm areola and a. protuberant 0.7 cm nipple. The anterior-superior margin is inked blue, the anterior-interior margin is inked. green, and the posterior margin, which consists of smooth fascial tissue, is inked black. The specimen is serially sectioned at close intervals to reveal lobulated fatty tissue and centrally located. tan-white fibrous parenchyma. There are no areas which have a stellate or retracted appearance. suggestive of neoplasm. In the lateral portion of the specimen, 2 cm from the lateral edge, there is a. circumscribed 0.7 cm pale red lymph node. Representative sections are submitted. Section summary: A1) nipple and tissue just deep to nipple,. A2) representative upper inner quadrant,. A3) representative lower inner quadrant,. A4) representative upper outer quadrant,. A5) representative lower outer quadrant. A6) representative central breast and representative central deep margin,. A7) lateral lymph node. Printed: This report continues. (FINAL). Acct No -. Pathology - Page 4/6. Job. Page 4 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. B. The specimen is labeled right breast modified radical mastectomy and is received without fixative. It. consists of a mastectomy specimen together with axillary tissue weighing 292 grams. The breast measures. 16 cm from medial to lateral, 9 cm from superior to inferior and up to 4 cm from superticial to deep. There. is an overlying etlipse of dark brown skin which measures 15.5 X 7.6 cm. Slightly medially located within. the skin is a circumscribed 2.5 cm areola and a protuberant 0.6 cm nipple. The skin is unremarkable,. Axillary tissue is present and measures 15 x 6.5 x 1.8 cm. The anterior-superior margin is inked blue, the. anterior-inferior margin is inked green, and the posterior margin, which consists of smooth facial tissue, is. inked black. In the central lateral portion of the deep margin, there is a 3 X 0.5 cm band of skeletal muscle. which is indicated by the surgeon as pectoralis major behind the tumor. The specimen is serially sectioned at close intervals to reveal a relatively well-circumscribed, firm,. tan-white tumor mass beginning directly underneath the nipple and extending laterally within the breast,. This tumor mass measures 4.7 cm from medial to lateral, 4.5 cm from superior to inferior, and 3.5 cm from. superficial to deep. This neoplasm is 3.5 cm from the closest medial margin, 5 cm from the axillary tail,. 2.5 cm from the closest superior margin, and 2.2 cm from the closest interior margin. Centrally, it is grossly. 0,2 cm from the closest deep margin and does not appear to extend into the small strip of pectoralis. muscle. The remainder of the breast is composed of soft fatty tissue without other palpable masses. Representative tumor and adjacent breast parenchyma are obtained for research purposes. In the medial. portion of the axillary tail, there is a prominent firm 1.5 cm lymph node suspicious for metastatic. involvement Representative tissue from this lymph node is obtained for research purposes also. The. axillary tissue is dissected for nodes. Representaitve sections are submitted. Section summary: B1) nipple and tissue just deep to nipple,. B2) representative lateral skin overlying tumor,. B3) medial edge of tumor,. B4-B11) sections of tumor progressing from medial to lateral,. B12) section of tumor and closest approach to deep margin,. B13) deep margin with pectoralis muscle,. B14) representative upper inner quadrant. B15) representative lower inner quadrant,. B16) representative upper outer quadrant,. B17) representative lower outer quadrant,. 818) medial axillary node (some submitted for research),. B19) single node, multiply sectioned,. B20) single node, multiply sectioned,. B21) one larger node, serially sectioned, two smaller nodes inked and bivalved,. B22) two nodes, serially sectioned (one inked). B23-B24) smaller possible nodes, intact. Microscopic Description: A. Microscopic sections have been examined. The microscopic findings are retlected in the diagnosis. rendered. B. Microscopic sections have been examined. The microscopic findings are reflected in the diagnosis. Printed: This report continues. (FINAL). Acct No. Patholegy a Page 5/6. age 5 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. rendered. Printed: END O REPORT (FINAL). Acct No. -. Pathology - Page 6/6. Page 6 Ooc# 1. Gender: M. Rel#: Provider Group. Date of Service: Date Received: ADDENDUM SURGICAL PATHOLOGY REPORT. Addendum Information: This addendum report is issued to the provide results of breast carcinoma biomarker. studies, performed on the previous ultrasound-guided core needle biopsy of the primary. breast carcinoma (. biomarker results-. Estrogen receptor: 100% positive cells, strong intensity. Progesterone receptor: Less than 1% positive cells. HER2: IHC score O. Ki-67 proliferative index: 35% positive cells. The above results are similar to the those obtained on the metastatic carcinoma in the left. iliac bone. Diagnosis: A. LEFT BREAST, PROPHYLACTIC MASTECTOMY: - Gynecomastia. - Unremarkable skin and nipple. - Negative for malignancy. B. RIGHT BREAST, MODIFIED RADICAL MASTECTOMY: - Invasive ductal carcinoma, Nottingham grade 3. - Tumor size: 4.7 cm in diameter. - Focal features of invasive micropapillary carcinoma. Ductal carcinoma in situ (DCIS), high nuclear grade. - Cribriform and papillary architecture. - Comedo necrosis and calcifications present. DCIS present adjacent to invasive carcinoma, in lactiferous ducts,. and focally in upper inner quadrant. - Mastectomy margins are free of tumor. - Carcinoma is 0.2 cm from the deep margin, and is at least. 2 cm from all other margins. - Metastatic carcinoma in 3 of 17 axillary lymph nodes. Printed: This report continues. MR No, a. Acct No. Pathology - Page 1/6. 1. Page 1 Doc# 1. ADDENDUM SURGICAL PATHOLOGY REPORT. - No extranodal extension is identified. - Largest metastatic focus measures 1.3 cm in diameter. - Gynecomastia. PATHOLOGIC TUMOR STAGING SYNOPSIS: Type and grade (invasive): Invasive ductal carcinoma, Nottingham grade 3. Primary tumor: pT2. Regional lymph nodes: pN1a. Distant metastasis: pM1 (metastasis to iliac bone). Lymphovascular invasion: Present. Pathologic stage: IV. Margin status: Negative. Invasive Breast Cancer Tumor Staging Information. AJCC Cancer Staging Handbook, 7th Ed., and CAP Protocol (revised June 2012). Previous pathology specimens: (breast biopsy),. left iliac bone biopsy). Printed. This report continues. Acct No. atient Name -. Pathology - Page 2/6. Page 2 Dec# 1. SPECIMEN IDENTIFICATION. Procedure/specimentype: Modified radical mastectomy. Laterality: Right. Lymph node sampling: Lymph node dissection. INVASIVE CARCINOMA TUMOR CHARACTERISTICS. Histologic type: Invasive ductal carcinoma. Tumor site: Upper outer quadrant. Tumor size: 4.7 cm. Tumor focality: Single focus of invasive carcinoma. Histologic grade (Nottingham Score): 3 of 3. Tubule formation: 3 of 3. Nuclear pleomorphism: 3 of 3. Mitotic rate: 3 of 3. Lymphovascular invasion: Present,. Macroscopic and microscopic extent of tumor: No skin or chest wall invasion identified,. DUCTAL CARCINOMA IN SITU (DCIS): high nuclear grade. MARGINS. Invasive carcinoma: 0.2 cm from deep margin, at least 2 cm from all. other margins. Ductal carcinoma in situ: at least 1 cm from all margins. LYMPH NODES. Total lymph nodes examined. 17. Number of lymph nodes involved. 3. Size of largest metastatic deposit: 1.3 cm. Extranodal extension: Not identified. PATHOLOGIC STAGING: Primary Tumor (pT): pT2. Regional lymph nodes (pN): pN1a. Distant metastasis (pM): pM1. AJCC Stage: IV,. ANCILLARY STUDIES: ProPath,. performed on bone biopsy. Estrogen receptor: 100% positive cells, strong intensity. Progesterone receptor: 0% positive cells. HER2: IHC score 1+. Ki-67;. 15% positive cells. Page, 3. Printed: ,. This report continues. MR No. -. Acct No, -. Pathology - Page 3/6. Page 3 Doc# 1. ADDENDUM SURGICAL PATHOLOGY REPORT. Source of Specimen: A. Breast:left complete mastectomy. B. Breast;right modified radical mastectomy. Clinical History/Operative Dx: None provided. Gross Description: A. The specimen is labeled left breast complete mastectomy and is received in formalin. It consists of a. mastectomy specimen which weighs 227 grams. A black suture with a metallic clip marks the "tail of the. breast". With this orientation the specimen measures 18.5 cm from medial to lateral, 11.8 cm from. superior to inferior, and 2.5 cm superficial to deep. There is an overlying broad ellipse of dark brown skin. which measures 17 x 6.5 cm. Centrally and slightly superiorly within the skin is a 2.3 cm areola and a. protuberant 0.7 cm nipple. The anterior-superior margin is inked blue, the anterior-inferior margin is inked. green, and the posterior margin, which consists of smooth fascial tissue, is inked black. The specimen is serially sectioned at close intervals to reveal lobulated fatty tissue and centrally located. tan-white fibrous parenchyma. There are no areas which have a stellate or retracted appearance. suggestive of neoplasm. In the lateral portion of the specimen, 2 cm from the lateral edge, there is a. circumscribed 0,7 cm pale red lymph node. Representative sections are submitted, Section summary: A1) nipple and tissue just deep to nipple,. A2) representative upper inner quadrant,. A3) representative lower inner quadrant,. A4) representative upper outer quadrant. A5) representative lower outer quadrant,. A6) representative central breast and representative central deep margin,. A7) lateral lymph node. Printed: This report continues. Acct No. -. Pathology - Page 4/6. - Page 4 Doc# 1. ADDENDUM SURGICAL PATHOLOGY REPORT. B. The specimen is labeled right breast modified radical mastectomy and is received without fixative. It. consists of a mastectomy specimen together with axillary ussue weighing 292 grams. The breast measures. 16 cm from medial to lateral, 9 cm from superior to inferior and up to 4 cm from superficial to deep. There. is an overlying ellipse of dark brown skin which measures 15.5 x 7.6 cm. Slightly medially located within. the skin is a circumscribed 2,5 cm areola and a protuberant 0,6 cm nipple, The skin is unremarkable. Axillary tissue is present and measures 15 x 6.5 X 1.8 cm. The anterior-superior margin is inked blue, the. auterior-inferior margin is inked green, and the posterior margin, which consists of smooth facial tissue, is. inked black. in the central lateral portion of the deep margin, there is a 3 x 0,5 cm band of skeletal muscle. which is indicated by the surgeon as pectoralis major behind the tumor. The specimen is serially sectioned at close intervals to reveal a relatively well-circumscribed. firm,. tan-white tumor mass beginning directly underneath the nipple and extending laterally within the breast. This tumor mass measures 4,7 cm from medial to lateral, 4.5 em from superior to inferior, and 3.5 cm from. superticial to deep. This neoplasm is 3.5 cm from the closest medial margin, 5 cm from the axillary tail,. 2.5 cm from the closest superior margin, and 2.2 cm from the closest inferior margin. Centrally, it is grossly. 0.2 cm from the closest deep margin and does not appear to extend into the small strip of pectoralis. muscle. The remainder of the breast is composed of soft fatty tissue without other palpable masses. Representative tumor and adjacent breast parenchyma are obtained for research purposes. In the medial. portion of the axillary tail, there is a prominent firm 1.5 cm lymph node suspicious for metastatic. involvement. Representative tissue from this lymph node is obtained for research purposes also. The. axillary tissue is dissected for nodes. Representaitve sections are submitted. Section summary: B1) nipple and tissue just deep to nipple,. B2) representative lateral skin overlying tumor,. B3) medial edge of tumor,. B4-B11) sections of tumor progressing from medial to lateral,. B12) section of tumor and closest approach to deep margin,. B13) deep margin with pectoralis muscle,. B14) representative upper inner quadrant,. B15) representative lower inner quadrant,. B16) representative upper outer quadrant,. B17) representative lower outer quadrant,. B18) medial axillary node (some submitted for research),. B19) single node, multiply sectioned,. B20) single node, multiply sectioned,. 821) one larger node, serially sectioned, two smaller nodes inked and bivalved,. 822) two nodes, serially sectioned (one inked),. B23-B24) smaller possible nodes, intact. Microscopic Description: A. Microscopic sections have been examined. The microscopic findings are reflected in the diagnosis. rendered. B. Microscopic sections have been examined. The microscopic findings are retlected in the diagnosis. Case i. Printed: : his report ontinues. MR No. -. Acct No. Pathology - Page 5/6. Job. Page 5 Doc# 1. ADDENDUM SURGICAL PATHOLOGY REPORT. rendered. Final report originally signed by. Printed. END OF REPORT (ADDENCUM). MR No. -. Acct No. Pathology - Page 6/6. Page h Doc# 1. Gender: M. Provider Group : Date of Service: Date Received: FINAL SURGICAL PATHOLOGY REPORT. Diagnosis: A. LEFT BREAST, PROPHYLACTIC MASTECTOMY: - Gynecomastia. - Unremarkable skin and nipple. - Negative for malignancy. B. RIGHT BREAST, MODIFIED RADICAL MASTECTOMY: - Invasive ductal carcinoma, Nottingham grade 3. - Tumor size: 4.7 cm in diameter. - Focal features of invasive micropapillary carcinoma. - Ductal carcinoma in situ (DCIS), high nuclear grade. - Cribriform and papillary architecture. - Comedo necrosis and calcifications present. DCIS present adjacent to invasive carcinoma, in lactiferous ducts,. and focally in upper inner quadrant. - Mastectomy margins are free of tumor. Carcinoma is 0.2 cm from the deep margin, and is at least. 2 cm from all other margins. - Metastatic carcinoma in 3 of 17 axillary lymph nodes. - No extranodal extension is identified. Largest metastatic focus measures 1.3 cm in diameter. - Gynecomastia. PATHOLOGIC TUMOR STAGING SYNOPSIS: Type and grade (invasive): Invasive ductal carcinoma, Nottingham grade 3. Primary tumor: pT2. Regional lymph nodes: pN1a. Distant metastasis: pM1 (metastasis to iliac bone). Lymphovascular invasion: Present. Pathologic stage: IV. Margin status: Negative. Printed: Tnis report continues. (I INAL). MR No. -. Acct No -. Pathology - Page 1/6. 1 Doc# 1. FINAL SURGICAL PATHOLOGY REPORT. Invasive Breast Cancer Tumor Staging Information. AJCC Cancer Staging Handbook, 7th Ed., and CAP Protocol (revised June 2012). Previous pathology specimens: 1 (breast biopsy). (left iliac bone biopsy). Case 4. Printed: This report continues - (FINAL). Acct No. Patient Name - T. Pathology - Page 2/6. Job. Page 2 Doc# 1. SPECIMEN IDENTIFICATION. Procedure/specimen type: Modified radical mastectomy. Laterality: Right. Lymph node sampling: Lymph node dissection. INVASIVE CARCINOMA TUMOR CHARACTERISTICS. Histologic type: Invasive ductal carcinoma. Tumor site: Upper outer quadrant. Tumor size: 4.7 cm. Tumor focalify: Single focus of invasive carcinoma. Histologic grade (Nottingham Score): 3 of 3. Tubule formation: 3 of 3. Nuclear pleomorphism: 3 of 3. Mitotic rate: 3 of 3. Lymphovascular invasion: Present. Macroscopic and microscopic extent of tumor: No skin or chest wall invasion identified. DUCTAL CARCINOMA IN SITU (DCIS): high nuclear grade. MARGINS. Invasive carcinoma: 0.2 cm from deep margin, at least 2 cm from all. other margins. Ductal carcinoma in situ: at least 1 cm from all margins. LYMPH NODES. Total lymph nodes examined. 17. Number of lymph nodes involved. 3. Size of largest metastatic deposit. 1.3 cm. Extranodal extension: Not identified. PATHOLOGIC STAGING: Primary Tumor (pT): pT2. Regional lymph nodes (pN): pN1a. Distant metastasis (pM): pM1. AJCC Stage: IV. ANCILLARY STUDIES: ProPath,. (performed on bone. biopsy). Estrogen receptor: 100% positive cells, strong intensity. Progesterone receptor. 0% positive cells. HER2: IHC score 1+. Kj-67: 15% positive cells. Printed: This report continues (FINAL). Acct No. Pathology - Page 3/6. Jo. Page 3 Doc# 1.

expanded version (tokens=4667) : 
 Histological classification: 
A. Left breast, prophylactic mastectomy: Gynecomastia, negative for malignancy.
B. Right breast, modified radical mastectomy: Invasive ductal carcinoma, Nottingham grade 3. Focal features of invasive micropapillary carcinoma. Ductal carcinoma in situ (DCIS), high nuclear grade. Cribriform and papillary architecture. Comedo necrosis and calcifications present. DCIS present adjacent to invasive carcinoma, in lactiferous ducts, and focally in upper inner quadrant.

Description of necrosis: Comedo necrosis present in DCIS.

Tumor infiltrating lymphocytes: No mention in the report.

Histological grade: Invasive ductal carcinoma, Nottingham grade 3.

Nuclear grade: High nuclear grade in DCIS.

Lymphovascular invasion: Present.

Calcification: Calcifications present in DCIS.

Receptor status: 
- Estrogen receptor: 100% positive cells, strong intensity.
- Progesterone receptor: Less than 1% positive cells.
- HER2: IHC score 1+.
- Ki-67 proliferative index: 35% positive cells.

Other ancillary testing results: No additional ancillary testing results mentioned in the report.

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=4828) : 
 Right breast: Invasive ductal carcinoma, Nottingham grade 3 with focal features of micropapillary carcinoma. High nuclear grade DCIS present adjacent to the invasive carcinoma. Comedo necrosis and calcifications seen in DCIS. Estrogen receptor positive (100%), progesterone receptor negative (<1%), HER2 IHC score 1+. Lymphovascular invasion present. Tumor size 4.7cm, at least 2cm from all margins. Metastatic carcinoma in 3 of 17 axillary lymph nodes without extranodal extension.

