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 LumB, SPECIMENS: A. SENTINEL LYMPH NODE #1. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. SENTINEL LYMPH NODE #3 LEFT AXILLA. D. SENTINEL LYMPH NODE #4 LEFT AXILLA. E. SENTINEL LYMPH NODE #5 LEFT AXILLA. F. WLE LEFT BREAST. G. AXILLARY CONTENTS. SPECIMEN(S): A. SENTINEL LYMPH NODE #1. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. C. SENTINEL LYMPH NODE #3 LEFT AXILLA. D. SENTINEL LYMPH NODE #4 LEFT AXILLA. E. SENTINEL LYMPH NODE #5 LEFT AXILLA. F. WLE LEFT BREAST. G. AXILLARY CONTENTS. INTRAOPERATIVE CONSULTATION DIAGNOSIS: TPA (microscopic): Lymph node, sentinel #1, biopsy: Negative for carcinoma. By called to Dr. at. TPB/C (microscopic): Lymph nodes, sentinels #2-3, biopsy: Negative for carcinoma. By Dr., called to. Dr. at. (B) and. C). TPD (microscopic): Lymph node, sentinel #4, biopsy: Positive for carcinoma. By Dr., called to Dr. at. (D). Gross Exam F Breast, left, wide local excision: Tumor mass is 0.6 cm from the anterior/inferior. margins. By Dr, called to Dr. GROSS DESCRIPTION: A. SENTINEL LYMPH NODE #1. Received fresh is a tan-pink fragment of fibrofatty tissue 3.5 x 2.4 x 0.8 cm. Dissection reveals. one. presumptive lymph node 1.0 x 0.7 x 0.4 cm. The specimen is serially sectioned and touch preps are. taken. The specimen is submitted entirely in cassette A1. B. SENTINEL LYMPH NODE #2 LEFT AXILLA. Received fresh is a tan-pink lymph node 1.0 x 1.0 x 0.7 cm. The specimen is serially sectioned. Touch. preps are taken and the specimen is submitted entirely in cassette B1,. C. SENTINEL LYMPH NODE #3 LEFT AXILLA. Received fresh is a tan-pink lymph node 1.0 x 1.0 X 0.7 cm. The specimen is serially sectioned. Touch. preps are taken and the specimen is submitted entirely in cassette C1. D. SENTINEL LYMPH NODE #4 LEFT AXILLA. Received fresh is a tan-pink lymph node 1.5 X 1.0 x 0.7 cm. The specimen is serially sectioned and. touch preps are taken. The specimen is submitted in toto in D1. E. SENTINEL LYMPH NODE #5 LEFT AXILLA. Received in formalin is a tan-pink lymph node 2.0 x 1.0 x 1.0 cm. The specimen is serially sectioned. and submitted in toto in cassette E1. F. WIDE LOCAL EXCISION LEFT, BREAST. Received fresh is an oriented 57 gram wide local excision breast specimen measuring 8 x 6 X 4 cm. The specimen is inked as follows: anterior-blue, posterior-black, superior-red, inferior-orange, medial-. green, lateral-yellow. The specimen is serially sectioned from lateral to medial into six slices, slice 1. being most lateral and slice 6 being most medial, to reveal a gray-white, firm stellate mass measuring. 2.2 X 2 X 2 cm located 0.6 cm from the closest anterior/inferior margin in slice 3, 4, 5 and 6. The. remainder of the cut surfaces reveal predominantly yellow lobulated adipose tissue interdispersed with. gray-white fibrous tissue. A portion of the specimen is submitted for tissue procurement. Representative sections are submitted as follows: A1: perpendicular sections of the lateral margin from superior to inferior, slice. 1. A2: anterior margins and area immediately adjacent to mass, slice 2. A3: anterior margin, slice 3. A4: inferior margin, slice 3. A5: deep margin, slice 3. A6: superior margin, slice 3. A7: mass with anterior and superior margins, slice 4. A8: mass with anterior and inferior margins, slice 4. A9-A10: mass with superior and deep margins bisected. A11: mass with inferior and deep margins. A12: mass with anterior margin, slice 5. A13: mass with inferior margin, slice 5. A14-A15: perpendicular sections of the mass with the medial margin from superior. to inferior, slice 6 as per attached diagram. G. LEFT AXILLARY CONTENTS. Received in formalin are multiple tan-pink fragments of fibrofatty tissue aggregating to 9 X 6 x 3 cm. Dissection reveals nine possible lymph nodes ranging from 0.1 x 0.1 x 0.1 cm to 1.1 x 1.0 X 0.9 cm. Section code: G1: three possible lymph nodes. G2: three possible lymph nodes. G3: two possible lymph nodes. G4: one lymph node trisected. G5: one lymph node trisected. DIAGNOSIS: A. LYMPH NODE, SENTINEL #1, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). B. LYMPH NODE, SENTINEL #2, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). C. LYMPH NODE, SENTINEL #3, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). D. LYMPH NODE, SENTINEL #4, LEFT AXILLA, BIOPSY: METASTATIC CARCINOMA TO ONE OF ONE LYMPH NODE (1/1),. MEASURING 0.6-CM WITH EXTERANODAL EXTENSION. E. LYMPH NODE, SENTINEL #5, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). F. BREAST, LEFT,WIDE LOCAL EXCISION: - INVASIVE, DUCTAL CARCINOMA, SBR GRADE-3, MEASURING 2.2-CM. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. INTERMEDIATE NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU WITH. CENTRAL NECROSIS, CRIBRIFORM AND SOLID TYPES. - SEE SYNOPTIC REPORT. G. LYMPH NODES, LEFT AXILLARY CONTENTS, RESECTION: - EIGHT LYMPH NODES, NEGATIVE FOR METASTASES (0/8). SYNOPTIC REPORT - BREAST. Specimen Type: Excision. Needle Localization: No. Laterality: Left. Invasive tumor. Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 2.2cm. Tumor site: Not specified. Margins: Negative. Distance from closest margin: 0.5cm. anterior/medial. Tubular score: 2. Nuclear grade: 3. Mitotic score:3. Modified Scarff Bloom Richardson Grade: 3. Necrosis: Absent. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node and axillary dissection. Lymph node status: Positive 1/13 Extranodal extension. DCIS present. Margins uninvolved by DCIS: DCIS Quantity: Estimate 5%. DCIS type: Solid. Cribriform. DCIS location: Associated with invasive tumor. Nuclear grade: Intermediate. Necrosis: Absent. ER/PR/HER2 Results. ER: Positive. PR: Positive. HER2: Negative by IHC. Pathological staging (pTN): pT 2 N 1a. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Surgical Excision. Block Number: F12. ER: Positive. Allred Score: 8 = Proportion score: 5 + Intensity Score 3. PR: Positive Allred Score: 6 = Proportion Score 3 + Intensity Score 3. COMMENT: The Allred score for estrogen and progesterone receptors is calculated by adding the sum of the. proportion score (0 = no staining, 1 = <1% of cells staining, 2 = 1 - 10% of cells staining, 3 = 11-30% of. cells staining, 4 = 31-60% of cells staining, 5 = >60% of cells staining) to the intensity score (1 = weak. intensity of staining, 2 = intermediate intensity of staining, 3 = strong intensity of staining), with a scoring. range from 0 to 8. ER/PR positive is defined as an Allred score of >2 and ER/PR negative is defined as an Allred score of. less than or equal to 2. Methodology: Fixation Type and Length: Tissue was fixed in 10% neutral buffered formalin (. ) for no less than 8 and no longer than 24 hours. Antibody and Assay Methodology: Mouse anti-human ER and PR,. Comment: This assay can be used to select invasive breast cancer patients for hormone therapy (1). ER and PR analysis was performed on this case by immunohistochemistry utilizing the ER (ER 1D5,. 1:100) and PR (PGR 136, 1:100) antibody provided by. following the manufacturer's instructions. listed in the package insert. This assay was not modified, and adherence to all instruction and. guidelines were strictly followed. Interpretation of the ER/PR immunohistochemical staining. characteristics is guided by published results in the medical literature (1), information provided bv the. reagent manufacturer and by internal review of staining performance within the F. 1. Harvey JM, et al. Estrogen receptor status by immunohistochemistry is superior to the ligand-binding. assay for predicting response to adjuvant endocrine therapy in breast cancer. J Clin Oncol. 17:1474-. 1481, 1999. SYNOPTIC REPORT - BREAST HER-2 RESULTS. HER2 Status Results, Immunohistochemistry Evaluation. Specimen: Surgical Excision. Block Number: F12. Interpretation: NEGATIVE. Intensity: 1+. % Tumor Staining: 5%. Fish Ordered: METHODOLOGY. Methodology: Fixation Type and Length: Tissue was fixed in 10% neutral buffered formalin. Inc. ) for no less than 8 and no longer than 24 hours. Antibody and Assay Methodology: Rabbit anti-human HER2, HerceptestTM (FDA-approved test kit),. Control. Slides Examined: External kit-slides provided by 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. These control slides run along side of this patient's sample showed appropriate. staining. Adequacy of Specimen: Adequate, well preserved, clear-cut invasive carcinoma identified for. HER2 evaluation. Scoring Criterion and Scoring System: IHC Level of Expression(Score /Tumor Cell Membrane Staining Pattern. Negative (0)/Absence of Staining. Negative (1+)/Faint Incomplete membrane Staining, >10% of Cells. Equivocal (2+)/Weak complete membrane Staining, >10% of Cells. Positive (3+)/Strong complete membrane Staining, >10% of Cells. Equivocal Category for HER2 IHC results: A HER2, 2+ staining result that is interpreted as equivocal. may not indicate gene amplification. A FISH test for HER2 gene amplification will be ordered for all. HER2 IHC 2+ results. COMMENT. This assay can be used to select invasive breast cancer patients for Trastuzumab (Hereptin) therapy. (1,2). Clinical Trials have shown that Trastuzumab substantially increases the likelihood for an objective. response and overall survival for patients with metastatic HER2-positive breast cancer, regardless of. whether HER2 tumor status was determined as IHC 3+ or FISH positive. Trastuzumab added to. adjuvant chemotherapy substantially increase disease-free survival and decreases the risk of disease. recurrence by about 50% for patients with early-stage HER2 protein over-expressed or gene amplified. invasive breast cancer (3). HER2 analysis was performed on this case by immunohistochemistry utilizing the FDA approved. HercepTest (TM) test kit following the manufacturer's instructions listed in the package insert. This. assay was not modified, and adherence to all instruction and guidelines were strictly followed. Interpretation of the HER2 immunohistochemical staining characteristics is guided by published results. in the medical literature (4), information provided by the reagent manufacturer and by internal review of. staining performance within the Pathology Department. HER2 TEST VALIDATION. This HER2 immunohistochemical assay has been validated according to the recently revised. recommendations and guidelines from the NCCN HER2 testing in Breast Cancer Task Force, and the. jointly issued recommendations and guidelines from ASCO and the CAP (5). 80 randomly selected. breast cancer samples were tested for HER2 by IHC as outline above and interpreted as, negative. (score 0/1+) equivocal (score 2+) and positive (score 3+) without knowledge of the previous reported. results. These cases were also blindly read using two different FISH assay as amplified or non-amplified and. the HER2/CEP17 ratios were recorded. After analyzing these results, there was 100% concordance. between the IHC and FISH results for cases that were interpreted as either positive or negative by IHC. 9 of the 80 cases were interpreted as equivocal by IHC and of these 3/9 (33%) were non-amplified by. FISH and 6/9 (66%) were found to be amplified. The Pathology Department Immunohistochemistry laboratory takes full responsibility for this tests. performance and has programs in place to regularly monitor the proficiency and the interpretation of. HER2 assays. The laboratory also participates in external quality assurance HER2 programs including. the CAP proficiency testing program. REFERENCE. 1. Carlson RW, Anderson BO, Burstein HJ, et al., NCCN breast cancer clinical practice guidelines in. oncology. J Natl Compr Canc Netw. 2005;3:238-289. 2. Carlson RW, Brown E, Burstein HJ, et al., NCCN Task Force Report: adjuvant therapy for breast. cancer. J Natl Compr Canc Netw. 2006;4:S1-S26. 3. Romond EH, Perez EA, Bryant J, et al. Trastuzumab plus adjuvant chemotherapy for operable. HER2-positive breast cancer. N Eng J Med 2005;353(16):1673-84. 4. Leong ASY, Formby M, Haffajee Z, et al. Refinement of immunohistologic parameters for Her2/neu. scoring validation by FISH and CISH. Appl Immunohistochem Mol Morphol. 2006;14:384-389. 5. Wolff AC, Hammond EH, Schwartz JN, et al., American Society of Clinical Oncology/College of. American Pathologists Guideline Recommendations for Human Epidermal Growth Factor Recepto 2. Testing in Breast Cancer. Arch of Path and Lab Med 2007; 131:18-43. CLINICAL HISTORY: None provided. PRE-OPERATIVE DIAGNOSIS: Left breast cancer. Microscopic/Diagnostic Dictation: Pathologist,. Microscopic/Diagnostic Dictation: Pathologist,. Microscopic/Diagnostic Dictation:., Pathologist. Final Review:., Pathologist. Final: Pathologist.

expanded version (tokens=3955) : 
 Histological Classification: Luminal B subtype breast cancer.
Subtype: Invasive Ductal Carcinoma (IDC) with intermediate nuclear grade, associated with ductal carcinoma in situ (DCIS) with central necrosis, cribriform and solid types.
Description of Necrosis: Central necrosis present in DCIS component.
Tumor Infiltrating Lymphocytes: Not mentioned.
Histological Grade: SBR Grade 3 (Scarff-Bloom-Richardson Grade 3).
Nuclear Grade: Intermediate.
Lymphovascular Invasion: None identified.
Calcification: Not mentioned.
Receptor Status: 
- Estrogen Receptor (ER): Positive.
- Progesterone Receptor (PR): Positive.
- HER2: Negative by IHC.
Ancillary Testing Results: 
- Sentinel Lymph Node #1: Negative for metastases (0/1).
- Sentinel Lymph Node #2: Negative for metastases (0/1).
- Sentinel Lymph Node #3: Negative for metastases (0/1).
- Sentinel Lymph Node #4: Metastatic carcinoma to one lymph node (1/1), measuring 0.6 cm with extranodal extension.
- Sentinel Lymph Node #5: Negative for metastases (0/1).
- Axillary Contents: Eight lymph nodes, negative for metastases (0/8).

Summary:
1. Luminal B subtype breast cancer.
2. Invasive D

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=4110) : 
 Left breast Luminal B subtype invasive ductal carcinoma (IDC) with intermediate nuclear grade and associated ductal carcinoma in situ (DCIS) showing central necrosis, cribriform and solid types. SBR grade 3 with negative lymphovascular invasion. ER and PR positive. HER2 negative by IHC. Sentinel lymph nodes 1, 2, and 5 negative for metastases, while sentinel lymph node 4 showed metastatic carcinoma with extranodal extension. Eight axillary lymph nodes all negative for metastases.

