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, SPECIMENS: A. SENTINEL LYMPH NODE RIGHT AXILLA #1. B. SLN RIGHT AXILLA #2. C. SLN RIGHT AXILLA #3. D. EXC. RIGHT BREAST CA. SPECIMEN(S): A. SENTINEL LYMPH NODE RIGHT AXILLA #1. B. SLN RIGHT AXILLA #2. C. SLN RIGHT AXILLA #3. D. EXC. RIGHT BREAST CA. GROSS DESCRIPTION: A. SENTINEL LYMPH NODE RIGHT AXILLA #1. Received fresh is a tan pink lymph node 0.5 x 0.5 x 0.3cm. The specimen is bisected and 2 touch preps. are taken. Toto A1. B. SLN RIGHT AXILLA #2. Received fresh is a tan pink lymph node 1.5 x 0.5 x 0.5cm. The specimen is bisected and 2 touch preps. are taken. Toto B1. C. SLN RIGHT AXILLA. Received fresh is are 3 tan pink lymph nodes ranging from 0.5cm to 1.2cm in greatest dimensions. Each specimen is bisected and touch preps are taken. Toto C1. D. EXCISION RIGHT BREAST: Single Stitch-Anterior/Double Stitch-Lateral/Triple Stitch-Superior. Received fresh is a 59g oriented tan pink WLE breast specimen, 7.0cm from superior to inferior, 6.0cm. from anterior to posterior and 5.5cm from medial to lateral. The specimen is inked as follows: Red-. Superior, Orange-inferior, Blue-Anterior, Black-Posterior, Green-Medial, Yellow-Lateral. The specimen. is serially sectioned from lateral to medial into 7 slices; slice 1 being most lateral, slice 7 being most. medial. The cut surface reveal a gray white firm well circumscribed mass 2.1 x 1.7 x 1.5cm, 0.6cm from. the closest superior margin, located in slices 3, 4 and 5. A surgical clip is identified in slice 3. The. mass is 0.9cm from the deep margin and greater than 10cm from the remaining margins. The. remaining cut surfaces reveal yellow lobulated adipose tissue interspersed with gray white fibrous. tissue. A portion of the specimen is submitted for tissue procurement. Representative sections are. submitted as follows: D1: lateral margin, perpendicular sections taken from superior to inferior, slice 1. D2: area adjacent to mass with deep margin, slice 2. D3: mass with anterior/superior margin, slice 3. D4: mass with superior/deep margin, clip identified, slice 3. D5: anterior/inferior margin, slice 3. D6: inferior/deep margin, slice 3. D7: mass with superior and anterior margin, slice 4. D8: anterior/inferior, slice 4. D9: mass with superior and deep margin, slice 4. D10: inferior/deep margin, slice 4. D11: superior/deep margin, slice 5. D12: anterior/superior margin, slice 5. D13: anterior margin, slice 5. D14: area next to mass with anterior and deep margin, slice 6. D15: anterior margin, slice 6. D16: deep margin, slice 6. D17: medial margin, perpendicular sections submitted from superior to inferior, slice 7. As per attached diagram. DIAGNOSIS: A. SENTINEL LYMPH NODE #1, RIGHT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR CARCINOMA (0/1). B. SENTINEL LYMPH NODE #2, RIGHT AXILLA, BIOPSY: - MICROMETASTATIC CARCINOMA (1.5 MM) IN ONE LYMPH NODE (1/1). (SEE NOTE). NOTE: The metastasis is subcapsular. No extranodal extension is seen; however, there is cautery. artifact at one edge of the metastasis limiting evaluation. The touch prep slides were reviewed and. show no evidence of metastasis. Dr. has reviewed specimen B. C. SENTINEL LYMPH NODE #3, RIGHT AXILLA, BIOPSY: - ONE LYMPH NODE, NEGATIVE FOR CARCINOMA (0/1). D. BREAST, RIGHT, WIDE LOCAL EXCISION: INVASIVE DUCTAL CARCINOMA, MODERATELY DIFFERENTIATED. (SBR GRADE 2) WITH FOCAL NECROSIS (SEE NOTE). - TUMOR MEASURES 2.1 X 1.7 X 1.5 CM. INVASIVE CARCINOMA IS 0.3 CM FROM POSTERIOR MARGIN. - LYMPHVASCULAR INVASION IS IDENTIFIED. DUCTAL CARCINOMA IN SITU (DCIS), SOLID AND CRIBRIFORM TYPES,. NUCLEAR GRADE 2-3, WITH FOCAL NECROSIS. - ATYPICAL DUCTAL HYPERPLASIA. NOTE: Microcalcifications are seen in vessels and non-neoplastic breast tissue. SYNOPTIC REPORT - BREAST. Specimen Type: Excision. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 2.1cm. Additional dimensions: 1.7cm x 1.5cm. Tumor Site: 9:00. Margins: Negative. Distance from closest margin: 0.3cm. deep. Tubular Score: 3. Nuclear Grade: 2. Mitotic Score: 2. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Present. Vascular/Lymphatic Invasion: Present. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node only. Lymph node status: Positive 1 / 3. Micrometastases: Non-neoplastic areas: columnar cell change. DCIS present. Margins uninvolved by DCIS :0.5 cm from the superior margin. DCIS Quantity: Estimate 20%. DCIS Type: Solid. Cribriform. DCIS Location: Both associated and separate from invasive tumor mass. Nuclear grade: Intermediate. Necrosis: Present. Location of CA++: Benign epithelium. ER/PR/HER2 Results. ER: Positive. PR: Positive. HER2: Pending by FISH. Pathological staging (pTN): pT 2N1. SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Surgical Excision. Block Number: 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: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Immunohistochemistry was performed using the mouse anti-human ER (ER 1D5, 1:100) and PR (PGR. 136, 1:100) provided by. following the manufacturer S instructions. This. assay was not modified. interpretation of the ER/PR immunohistochemical stain is guided by published. results in the medical literature, information provided by the reagent manufacturer and by internal. review of staining performance. SYNOPTIC REPORT - BREAST HER-2 RESULTS. Specimen: Surgical Excision. Block Number: Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 20%. Fish Ordered: Yes, on Date. METHODOLOGY: Tissue was fixed in 10% neutral buffered formalin for no less than 8 and no longer than 24 hours. Her2 analysis was performed using the FDA approved Dako HercepTes (TM) test kit. using rabbit anti-human HER2. This assay was not modified. External kit-slides. provided by the 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. Adequate, well. preserved, clear-cut invasive carcinoma was identified for HER2 evaluation. Interpretation of the HER2. immunohistochemical stain is guided by published results in the medical literature, information provided. by the reagent manufacturer and by internal review of staining performance. This assay has been validated according to the 2007 joint recommendations and guidelines from. ASCO and CAP and from the NCCN HER2 testing in Breast Cancer Task Force. The L. takes full responsibility for this test's performance. PRE-OPERATIVE DIAGNOSIS: Right breast cancer. PRE-OPERTATIVE CONSULTATION: TPA/TPB/TPC: Negative for carcinoma. Diagnosis called to Dr. at. Dr. D. Gross Inspection Diagnosis: 2.1 cm tumor at 0.6cm from closest superior margin. Diagnosis called to. Dr. at. by Dr. ADDENDUM: 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. 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 D9. Source of case: RPCI. Tissue fixation. formalin-fixed tissue. Outside Case No: NA. Tissue source. breast Results interpreted: HER2/CEP17 ratio: 1.05. 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. 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. Institute under the direction. of. The results of these studies should always be interpreted in the context of the. clinical, morphological, and immunophenotypic diagnosis. Microscopic/Diagnostic Dictation:., Pathologist, l. Final Review:. Pathologist,. Final Review:. Pathologist. Microscopic/Diagnostic Dictation:., Pathologist,. Final Review:, Pathologist. Final:., Pathologist,. Addendum: Pathologist,. Addendum Final:. Pathologist,.

expanded version (tokens=3122) : 
 This breast pathology report includes information about the luminal A subtype tumor found in the patient's right breast. Here are the main points from the report:

- Histological classification: Invasive ductal carcinoma, NOS (not otherwise specified) 8500/3, with tubular score 3 and nuclear grade 2
- Subtype: Luminal A
- Description of any necrosis: Focal necrosis was found in the invasive ductal carcinoma and in the ductal carcinoma in situ (DCIS)
- Tumor infiltrating lymphocytes: No information provided
- Histological grade: SBR grade 2
- Nuclear grade: 2
- Lymphovascular invasion: Present
- Calcification: Microcalcifications were seen in vessels and non-neoplastic breast tissue
- Receptor status: ER positive, PR positive
- IHC and ancillary testing results: HER2 equivocal by IHC, pending by FISH. PathVysion HER-2 DNA Probe Kit showed HER-2 not amplified. The Allred score for estrogen and progesterone receptors was 8 and 6, respectively.

In addition, sentinel lymph node biopsies were taken from the patient's right axilla, with one node negative for carcinoma, one node with micrometastatic carcinoma (subcapsular with no extranodal extension seen), and one node negative for carcinoma. The report also includes details about the gross description of the excised

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=3286) : 
 Report: LumA subtype invasive ductal carcinoma found in the right breast with tubular score 3, nuclear grade 2, and SBR grade 2. Focal necrosis present in invasive carcinoma and DCIS. Lymphovascular invasion present, but calcification showed microcalcifications in non-neoplastic breast tissue and vessels. ER and PR positive. HER2 status is equivocal by IHC but not amplified by PathVysion HER-2 DNA Probe Kit. One sentinel lymph node positive for micrometastatic carcinoma while others negative for carcinoma.

