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, Date of Birth: Not for patient's chart. CLINICAL HISTORY. ORIGINAL TEXT: Cancer left breast. ORIGINAL VER ID. GROSS EXAMINATION. ORIGINAL TEXT: A. "Left breast", received fresh and placed in formalin. A 600 gram, 30.3. x. 9.9 x 5 cm specimen consisting of a 16.5 x 9.9 x 5 cm breast with a 11 x 7. x. 2.4 cm axilla, two at 24 x 8 cm ellipse of skin and 1.2 cm nipple with 4 cm. areola is received. The specimen is marked with blue ink and sectioned to. exhibit a 2.8 x 2.5 x 1.6 cm firm white mass towards the axilla. The tumor. comes to within 1.8 cm of the superior margin, 1.6 cm of the inferior margin,. 2 cm of the posterior margin and 3 cm from the skin. Areas of hemorrhage are. present around the site of the mass, consistent with the previous biopsy. A1- tumor closest to superior border. A2- tumor closest to inferior border. A3- tumor closest to posterior border. A4- tumor closest to anterior skin border. A5-6 upper outer quadrant. A7-8- lower outer quadrant. A9-10- upper inner quadrant. A11-12- lower inner quadrant. Al3- nipple. A14- nine proximal lymph node candidates. A15-16- nine mid lymph node candidates. A17- four distal lymph node candidates. A18- one distal lymph node candidate, bisected. ORIGINAL VER U. DIAGNOSTIC CPT CODES. ORIGINAL TEXT: Container A: ORIGINAL VER ID. DIAGNOSIS. ORIGINAL TEXT: A. "LEFT BREAST" (EXCISIONAL BIOPSY) : INVASIVE CARCINOMA OF THE BREAST. MULTIFOCAL INVASIVE CARCINOMA: PRESENT. - SIZE (UPPER-OUTER QUADRANT) : 2.8 x 2.5 x 1.6 CM. SIZE (LOWER-INNER QUADRANT) : 1 CM. - N.S.A.B.P. HISTOLOGIC GRADE: 3 OF 3. - N.S.A.B.P. NUCLEAR GRADE: 3 OF 3. - LYMPHATIC/VASCULAR INVASION: NOT IDENTIFIED. IN-SITU CARCINOMA: PRESENT. - TYPE OF IN-SITU CARCINOMA: DUCTAL, SOLID (MINIMAL CRIBRIFORM) . - N.S.A.B.P. NUCLEAR GRADE: 2 OF 3. NECROSIS: PRESENT. - LOCATION: IDENTIFIED IN RANDOM SECTIONS OF THE UPPER-OUTER. QUADRANT, UPPER-INNER QUADRANT, AND LOWER-INNE QUADRANT. - SIZE: UNABLE TO DETERMINE. SURGICAL MARGIN STATUS: FREE OF TUMOR. NIPPLE: FREE OF TUMOR. SKIN: FREE OF TUMOR. MUSCLE: NOT IDENTIFIED. LYMPH NODE STATUS: - NO EVIDENCE OF MALIGNANCY IS IDENTIFIED IN SEVENTEEN LYMPH NODES. (0/17). ESTROGEN/PROGESTERONE RECEPTOR, CELL CYCLE, AND HER2/NEU ANALYSIS: PENDING, THE RESULTS OF WHICH WILL BE REPORTED IN AN ADDENDUM. METHODOLOGY: IMMUNOHISTOCHEMISTRY, PARAFFIN BLOCK NUMBER A3. I certify that I personally conducted the diagnostic evaluation of the above. specimen(s) and have rendered the above diagnosis (es). ORIGINAL VER ID. CI ADDENDUM 1. ORIGINAL TEXT: NUCLEAR ESTROGEN AND PROGESTERONE RECEPTOR ANALYSIS. A tissue block was sent to the. for assay of. nuclear estrogen and progesterone receptors (block A3). The ESTROGEN RECEPTOR. activity is judged to be POSITIVE with an estimated fmol/mg cytosolic protein. value of 275. Approximately 95% of the infiltrating carcinoma cells exhibit. nuclear estrogen receptor expression. Benign ductal epithelium stains. positively and serves as the internal control. Results were obtained using. a. manual method with Signet antibodies and a. detection kit. The PROGESTERONE RECEPTOR activity is judged to be BORDERLINE with an. estimated fmol/mg cytosolic protein value of 6. Approximately 1% of the tumor. cells exhibit nuclear progesterone receptor expression. Benign ductal. epithelium stains positively and serves as the internal control. Results were. obtained using a manual method with Signet antibodies and a. detection. kit. Please refer to. for a complete report. HER2/neu IMMUNOHISTOCHEMICAL ANALYSIS. Immunostaining for HER2/neu (c-erbB-2) oncoprotein is performed on recut. sections of block A3. The tumor cells exhibit no staining of their cell. membrane (score - 0), indicating that they do not overexpress HER2/neu. oncoprotein. METHOD: The immunostaining is done using DAKO rabbit anti-human c-erbB-2. oncoprotein which is an affinity-isolated antibody (. The immunostaining is performed after antigen retrieval by heating the. unstained sections at 95 degrees centigrade for 20 minutes in 10 mM citrate. buffer, pH 6.0. The primary antibody is used at a dilution of 1:3000 (manual. staining) with an incubation for one hour at 37 degrees centigrade. The. Histostain Plus kit I. is used as the detection system. This test was developed and its performance characteristics determined by the. Immunopathology Laboratory. It has not been cleared or approved by the FDA. The FDA has determined that such clearance or approval is not necessary. This. test is used for clinical purposes. It should not be regarded as. investigational or for research only. This laboratory is certified under the. Clinical Laboratory Improvement Amendments of 1988 (CLIA) as qualified. to. perform high complexity clinical testing. PROLIFERATION INDEX IMAGE ANALYSIS. A tissue block was sent to the. for assay of. proliferation index (block A3). The PROLIFERATION INDEX is judged to be HIGH. with an estimated positive nuclear area percentage of 29%. Please refer to. for a complete report. I certify that I personally conducted the diagnostic evaluation of the above. specimen(s) and have rendered the above diagnosis (es). ORIGINAL VER ID.

expanded version (tokens=1837) : 
 The breast pathology report indicates that the patient has LumA subtype cancer in the left breast. The tumor is invasive and multifocal with a size of 2.8 x 2.5 x 1.6 cm in the upper-outer quadrant and 1 cm in the lower-inner quadrant. The histological grade is 3 of 3 and the nuclear grade is also 3 of 3. Lymphatic/vascular invasion is not identified. In-situ carcinoma of the ductal type is present and the nuclear grade is 2 of 3. Necrosis is present in random sections of the upper-outer, upper-inner, and lower-inner quadrants, but the size cannot be determined. The surgical margin, nipple, and skin are free of tumors. Muscle is not identified. Seventeen lymph nodes have been examined, and no evidence of malignancy has been found with a count of 0/17. 

Regarding the receptor status, estrogen receptor activity is estimated to be positive with an estimated fmol/mg cytosolic protein value of 275. About 95% of the infiltrating carcinoma cells express nuclear estrogen receptor and benign ductal epithelium is positively stained as the internal control. Progesterone receptor activity is borderline with an estimated fmol/mg cytosolic protein value of 6. Around 1% of the tumor cells exhibit nuclear progesterone receptor expression, and benign ductal epithelium is positively stained as an internal control

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=2016) : 
 The left breast tumor is multifocal and invasive with a size of 2.8 x 2.5 x 1.6 cm in the upper-outer quadrant and 1 cm in the lower-inner quadrant, classified as LumA subtype, histological/nuclear grade of 3/3, without lymphatic/vascular invasion. Ductal carcinoma in situ grade is 2/3; no muscle infiltration, necrosis size is unknown; free margins, nipple and skin; a total of 17 examined lymph nodes found to be malignant-free (0/17). Estrogen receptor activity is positive while progesterone receptor activity is borderline.

