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 - SPECIMENS: A. WLE LEFT BREAST NEEDLE LOCALIZATION. B. SENTINEL NODE #1 LEFT AXILLA. C. SENTINEL NODE #2 LEFT AXILLA. D. ADDITIONAL SUPERIOR MARGIN. SPECIMEN(S): A. WLE LEFT BREAST NEEDLE LOCALIZATION. B. SENTINEL NODE #1 LEFT AXILLA. C. SENTINEL NODE #2 LEFT AXILLA. D. ADDITIONAL SUPERIOR MARGIN. GROSS DESCRIPTION: A. WLE LEFT BREAST NEEDLE LOCALIZATION. Single stitch: Anterior. Double stitch: Lateral. Triple stitch: Superior. Received fresh is a 42g oriented WLE breast specimen 7.0cm from medial to lateral, 6.5cm from superior to inferior. and 4.0cm from anterior to posterior, with needle localization wire and attached radiograph. The specimen is inked. as follows: Superior-Red, Inferior-Orange, Anterior-Blue, Posterior-Black, Medial-Green, Lateral-Yellow. The. specimen is serially sectioned from lateral to medial in to 6 slices: slice 1 being most lateral, slice 6 being most. medial to reveal a gray white firm well circumscribed mass 1.8 x 1.2 x 1.2cm, 0. 1cm from the closest superior. margin, 0.6cm from the deep margin and 0.7cm from the anterior margin in slices 3 and 4. The remaining cut. surfaces reveal grossly unremarkable breast parenchyma. A portion of the specimen is submitted for tissue. procurement. Representative sections are submitted as follows: A1: lateral margin slice 1. A2: superior/anterior/deep margin next to mass slice 2. A3: mass with superior margin slice 3. A4: deep margin slice 3. A5: anterior margin slice 3. A6: inferior margin slice 3. A7: mass with superior/anterior margin slice 4. A8: mass with superior/deep margin slice 4. A9: anterior/inferior margin slice 4. A10: deep/inferior margin slice 4. A11: superior margin next to mass slice 5. A12: medial margin perpendicular sections slice 6. As per attached diagram. B. SLN #1 LEFT AXILLA. Received fresh is a tan pink lymph node 1.7 x 1.0 x 0.6cm. The specimen is serially sectioned and a touch prep is. taken. Toto B1-B2. C. SLN #2 LEFT AXILLA. Received fresh is a tan pink lymph node 1.5 x 1.0 x 0.5cm. The specimen is serially sectioned and a touch prep is. taken. Toto C1-C2. D. ADDITIONAL SUPERIOR MARGIN: Stitch at final margin. Received fresh is a 12g oriented fragment of fibrofatty tissue 5.5 x 3.5 x 2.0cm. The new true margin is inked Blue. and the specimen is serially sectioned to reveal grossly unremarkable breast parenchyma. DIAGNOSIS: A. BREAST, LEFT, WIDE LOCAL EXCISION: - INVASIVE, DUCTAL CARCINOMA, SBR GRADE 2, MEASURING 1.5-CM WITH. SATELLITE TUMOR MEASURING 0.2-CM. - INTERMEDIATE NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU, SOLID. AND CRIBRIFORM TYPES WITH CENTRAL NECROSIS. - INVASIVE TUMOR PRESENT WITHIN 1-MM FROM THE INFERIOR SURGICAL. RESECTION MARGIN. DCIS PRESENT 2-MM FROM THE DEEP SURGICAL RESECTION MARGIN. - SEE SYNOPTIC REPORT AND SEE NOTE. B. LYMPH NODE, SENTINEL #1, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). C. LYMPH NODE, SENTINEL #2, LEFT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). D. BREAST, ADDITIONAL SUPERIOR MARGIN, EXCISION: - MICROSCOPIC FOCUS OF USUAL DUCTAL HYPERPLASIA, NO IN SITU. OR INVASIVE CARCINOMA SEEN. NOTE: A 0.2-cm satellite invasive tumor is identified inferior to the main mass. While this focus is present within 1. mm from the inferior surgical resection margin, DCIS is present 2 mm from the posterior (deep) surgical resection. margin. SYNOPTIC REPORT - BREAST. Specimen Type: Excision. Needle Localization: Yes For mass. Laterality: Left. Invasive Tumor: Present. Multifocality: Yes. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 1.5cm. Tumor Site: lateral. Margins: Negative. Distance from closest margin: Less than 0.1cm. inferior. Tubular Score: 3. Nuclear Grade: 2. Mitotic Score: 1. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Absent. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Negative 0/2. DCIS present. Margins uninvolved by DCIS 0.2 cm from posterior margin. DCIS Quantity: Estimate 10%. DCIS Type: Solid. Cribriform. DCIS Location:Associated with invasive tumor. Nuclear grade: Intermediate. Necrosis: Present. ER/PR/HER2 Results. ER: Pending. PR: Pending. HER2: Pending by FISH. Pathological staging (pTN): pT 1c NO. CLINICAL HISTORY: year old with density in Left Lateral Breast noted on recent mammo. Core bx: Infiltrating Ductal Ca SBR Grade 2. ER/PR +, Her2 Equivocal. PRE-OPERATIVE DIAGNOSIS: None provided. INTRAOPERATIVE CONSULTATION: A. GROSS INSPECTION: 1. 8cm mass 0. 1cm from the closest Superior margin, 0.6cm from Deep margin and 0.7cm. from Anterior margin. Diagnosis called to Dr. at. by Dr. TPB/TPC: Negative for tumor. Diagnosis called to Dr. at. (B) and. (C) by Dr. ADDENDUM: SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Surgical Excision. Block Number: A8. ER: Positive Allred Score: 8 = Proportion Score 5. Intensity Score 3. PR: Positive Allred Score: 7 = Proportion Score 4 + 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: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Immunohistochemistrv was performed using the mouse anti-human ER (ER 1D5, 1:100) and PR (PGR 136, 1:100). provided by Dako. following the manufacturer S instructions. This assay was not modified. Interpretation of the ER/PR immunoristochemical stain is guided by published results in the medical literature,. information provided by the reagent manufacturer and by internal review of staining performance. PathVysion HER-2 DNA Probe Kit. Analytical Interpretation of Results: HER-2 NOT AMPLIFIED. Clinical Interpretation of results. Amplification of the HER-2 gene was evaluated with interphase fluorescence in-situ. hybridization (FISH) on formalin-fixed paraffin embedded tissue sections using a chromosome. 17 centromeric probe and a HER-2 probe that spans the entire HER-2 gene in the. I. by Dr. A majority of tumors cells displayed 2 chromosome 17. signals and 2 HER-2 signals, with a HER-2/CEP 17 Ratio </=2.0, consistent with no. amplification of the HER2/neu gene. Block used. A8. Source of case: Tissue fixation formalin-fixed tissue Outside Case No: NA. Tissue source breast Results interpreted: yes. HER2/CEP17 ratio: 1.04. This ratio is derived by dividing the total number of LSI HER-2/neu signals by the total number of. CEP17 signals in at least 20 interphase nuclei with nonoverlapping nuclei in the neoplastic. mammary epithelial cells. Cells with no signals or with signals of only one color are disregarded. Method of ratio enumeration: manual count. Limitations. The Vysis PathVysion Kit is not intended for use to screen for or diagnose breast cancer. It is. intended to be used as an adjunct to other prognostic factors currently used to predict disease-free. and overall survival in stage II, node-positive breast cancer patients. In making decisions regarding. adjuvant CAF treatment, all other available clinical information should also be taken into. consideration, such as tumor size, number of involved lymph nodes, and steroid receptor status. No. treatment decision for stage II, node-positive breast cancer patients should be based on HER-2/neu. gene amplification status alone. Overview of this test. FDA APPROVED REAGENT. PathVysion HER-2 DNA Probe Kit is FDA approved for selection of. patients for whom Herceptin therapy is being considered. These tests were performed in the. 1. under the direction. of Dr. The results of these studies should always be interpreted in the context of the. clinical, morphological, and immunophenotypic diagnosis. ONCOTYPE DX BREAST CANCER ASSAY. RESULTS: Recurrence Score: 23. CLINICAL EXPERIENCE: Patients with a recurrence score of: 23 in the clinical validation study had an average. rate of Distant Recurrence at 10 years of 15%. ER Score: 11 Positive. PR Score: 7.6 Positive. Her2 Score: 9.1 Negative. Interpretation: ER Negative < 6.5 Positive >= 6.5. PR Negative < 5.5 Positive >= 5.5. Her2 Negative <10.7 Positive >=11.5. Equivocal = 10.7 - 11.4. See separate. report for further information. Microscopic/Diagnostic Dictation: Pathologist. t. Final Review: Pathologist,. Final: Pathologist, I. Addendum: Pathologist,. Addendum Final: Pathologist,. Addendum: Pathologist,. Addendum Final: Pathologist. Addendum: Pathologist,. Addendum Final: Pathologist, -.

expanded version (tokens=2927) : 
 The breast pathology report indicates the following information:

1. Histological classification: The left breast wide local excision specimen shows invasive ductal carcinoma with a satellite tumor measuring 0.2 cm, intermediate nuclear grade, and SBR grade 2. Additionally, there is the presence of ductal carcinoma in situ of solid and cribriform types with central necrosis.

2. Subtype: The report identifies invasive ductal carcinoma with multifocality as the subtype.

3. Necrosis: Central necrosis is present in ductal carcinoma in situ.

4. Tumor infiltrating lymphocytes: No mention of tumor infiltrating lymphocytes is present in the report.

5. Histological grade: SBR grade 2 with intermediate nuclear grade.

6. Nuclear grade: Intermediate nuclear grade.

7. Lymphovascular invasion: None identified.

8. Calcification: No mention of calcification is present in the report.

9. Receptor status: ER and PR status are pending. Her2 is negative by FISH. The OncoType DX test results show an ER score of 11 (positive) and a PR score of 7.6 (positive).

10. IHC: ER and PR were positive by immunohistochemistry (Allred score: 8 and 7, respectively).

11. Ancillary testing: The report mentions a touch prep for all sentinel lymph nodes, which were negative for metastases. Additionally, a fragment of fibrofatty tissue from

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=3069) : 
 Left breast wide local excision reveals multifocal invasive ductal carcinoma, intermediate nuclear and SBR grade 2. Additionally, the specimen indicates ductal carcinoma in situ of the solid and cribriform types with central necrosis. ER and PR status pending but negative HER2 by FISH. Sentinel lymph nodes negative for metastasis on touch prep. Oncotype DX test results show an ER score of 11 and a PR score of 7.6 (positive).

