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. SLN#1 LEFT AXILLA. B. LEFT BREAST AND AXILLARY CONTENTS. C. SENTINEL LYMPH NODE BX. RIGHT AXILLA. D. SENTINEL LYMPH NODE #2 RIGHT AXILLA. E. RIGHT BREAST & AXILLARY CONTENTS. F. ADDITIONAL AXILLARY TISSUE. SPECIMEN(S): A. SLN#1 LEFT AXILLA. B. LEFT BREAST AND AXILLARY CONTENTS. C. SENTINEL LYMPH NODE BX. RIGHT AXILLA. D. SENTINEL LYMPH NODE #2 RIGHT AXILLA. E. RIGHT BREAST & AXILLARY CONTENTS. F. ADDITIONAL AXILLARY TISSUE. GROSS DESCRIPTION: A. SLN#1 LEFT AXILLA. Received fresh is a tan white firm lymph node 2.6 x 2.1 x 1.4cm. The lymph node is serially sectioned. and a portion of the specimen is submitted in FSA. A portion of the specimen is submitted for tissue. procurement. The remainder of the specimen is submitted in A2-A3. B. LEFT BREAST AND AXILLARY CONTENTS. STITCH IN AXILLA. Received fresh is a 1651g oriented total mastectomy specimen 29.5 x 27.0 x 4.0cm. The specimen is. partially surfaced with a tan brown ellipse of skin 26.5 x 11cm. The centrally located partially raised. nipple is 0.9cm and the areolar rim is 1.2cm. The skin surface is remarkable for a well healed scar. 1.5cm, 2.0cm from the nipple in the Upper Outer Quadrant. The specimen is inked as follows: Anterior/Superior-Blue, Anterior/Inferior-Orange, Posterior-Black. The specimen is serially sectioned. from medial to lateral in to 13 slices; slice 1 being most medial, slice 13 being most lateral. The nipple is. located in slice 10. The cut surfaces reveal a gray white stellate mass 2.3 x 2.0 x 2.0cm in the UOQ and. UCQ of slice 9, 10 and 11. The mass is greater than 2.0cm from the deep margin. The remaining breast. parenchyma is grossly unremarkable. The axillary tail is 6.0 x 4.0 x 2.0cm. Dissection reveals 15. possible lymph nodes ranging from 0.3 x 0.2 x 0.2cm to 2.0 x 1.5 x 1.5cm. A portion of the specimen is. submitted for tissue procurement. Representative sections are submitted as follows: B1: nipple slice 10. B2: base of nipple slice 10. B3: skin with possible scar slice 8. B4: UIQ slice 7. B5: LIQ slice 7. B6: area adjacent to mass UIQ slice 8. B7-B8: mass UIQ slice 9. B9: deep margin slice 9. B10: superior/anterior margin slice 9. B11: inferior/anterior margin slice 9. B12-B14: mass slice 10. B15: deep margin slice 10. B16: mass UOQ slice 11. B17: deep margin slice 11. B18: LOQ with deep margin slice 11. B19: LOQ with inferior margin slice 12. B20: 5 lymph nodes. B21: 5 lymph nodes. B22: 3 lymph nodes. B23: 1 lymph node serially sectioned. B24: 1 lymph node serially sectioned. C. SLN# 2 RIGHT AXILLA. Received fresh is a tan white firm lymph node 1.5 x 1.0 x 0.6cm. The lymph node is serially sectioned. and a portion of the specimen is submitted in FSC. The remainder of the specimen is submitted in C2. D. SLN # 3 RIGHT AXILLA. Received fresh is a tan white firm lymph node 0.9 x 0.6 x 0.4cm. The lymph node is serially sectioned. and a portion of the specimen is submitted in FSD. The remainder of the specimen is submitted in D2. E. RIGHT BREAST AND AXILLARY CONTENTS. Received in formalin is an oriented simple mastectomy specimen weighing 1892 g and measuring 38.5. x 33 x 4.2 cm. There is a stitch designating the axillary tail. On the surface is an ellipse of brown-tan. skin measuring 26.5 cm in length and 10.3 cm in width. The skin surface is unremarkable. The areola. is 3.8 cm in diameter with an everted nipple measuring 1.4 cm. The anterior surface of the specimen is. inked blue and the posterior/deep margin is inked black. The specimen is serially sectioned from. medial to lateral. Within the upper inner quadrant and 8 cm from the deep margin is a firm tan stellate. lesion {#1} measuring 3.3 X 2.5 x 1.3 cm which extends into an hour-glass configuration. Approximately. 2.3 cm lateral and inferior to this lesion is a firm tan stellate lesion {#2} measuring 1.3 x 1 x 0.8 cm. It is. 3.8 cm from the anterior/skin. The remainder of the parenchyma is unremarkable. The axillary tail was. serially sectioned and fixed in O-Fix. Two hemorrhagic lymph nodes are identified measuring 1.8 and. 2.3 cm. Representative sections are submitted as follows: E1: Margin deep to lesion. E2-E6: Lesion #1 submitted from medial to lateral. E7-E8: Lesion #1and adjacent deep tissue. E9: Tissue inferior to lesion #1 from blocks 7 and 8. E10: Left lateral portion of lesion #1. E11: Tissue inferior to block 10. E12-E15: Tissue adjoining lesion #1 and lesion #2. E16-E17: Lesion #2. E18-E19: Fibrous tissue from upper outer quadrant. E20-E21: Fibrous tissue from lower outer quadrant. E22-E23: Fibrous tissue from lower inner quadrant. E24: Skin. E25-E26: Nipple. E27-E28: 1 lymph node each. E29-E30: presumptive lymph nodes from the axillary region. F. ADDITIONAL LEFT AXILLARY TISSUE. Received in formalin is a piece of yellow-tan adipose tissue measuring 8.5 x 3.5 x 0.6 cm. Two lymph. nodes are identified measuring 0.8 and 1.4 cm. Specimen is submitted entirely as follows: F1-F2: one lymph node each. F3-F6: remainder of soft tissue. DIAGNOSIS: A. LYMPH NODE, SENTINEL #1, LEFT AXILLA, BIOPSY: - METASTATIC CARCINOMA TO ONE OF ONE LYMPH NODE (1/1),. MEASURING 2-CM WITH EXTRANODAL EXTENSION. B. BREAST, LEFT, MASTECTOMY AND AXILLARY LYMPH NODE DISSECTION: - INVASIVE, LOBULAR CARCINOMA, SBR GRADE 2, MEASURING 2.2-CM. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. - METASTATIC CARCINOMA TO ONE OF 12 LYMPH NODES (1/12). - SEE SYNOPTIC REPORT. C. LYMPH NODE, SENTINEL #2, RIGHT AXILLA, BIOPSY: - METASTATIC CARCINOMA TO ONE OF ONE LYMPH NODE (1/1),. MEASURING 0.6-CM, WITH NO EXTRANODAL EXTENSION. D. LYMPH NODE, SENTINEL #3, RIGHT AXILLA, BIOPSY: - METASTATIC CARCINOMA TO ONE OF ONE LYMPH NODE (1/1). E. BREAST, RIGHT, MASTECTOMY AND AXILLARY LYMPH NODE DISSECTION: - INVASIVE, DUCTAL CARCINOMA, SBR GRADE 2, MEASURING 3.3-CM,. PRESENT IN A BACKGROUND OF EXTENSIVE DUCTAL CARCINOMA IN. SITU. - INTERMEDIATE NUCLEAR GRADE, DUCTAL CARCINOMA IN SITU,. CRIBRIFORM AND SOLID TYPES WITH CENTRAL NECROSIS, INVOLVING. THE CENTRAL PORTION OF THE BREAST WITH EXTENSION TO MAJOR. DUCTS OF NIPPLE, UPPER INNER AND LOWER INNER QUADRANTS. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. - THREE LYMPH NODES, NEGATIVE FOR METASTASES (0/3). - SEE SYNOPTIC REPORT AND SEE NOTE. F. LYMPH NODES, ADDITIONAL AXILLARY, DISSECTION: - ONE LYMPH NODE, NEGATIVE FOR METASTASES (0/1). NOTE: The right breast is involved by extensive DCIS. There are two grossly identified tumor masses,. microscopically show invasive ductal carcinoma. The submitted tissue between these two masses. shows microscopic foci of invasive tumor as well as DCIS. The largest confluent invasive tumor. measures 3.3-cm. Breast biomarkers were ordered on the right breast tumor and addendum report to follow. These. markers were reported on the needle biopsy of the left breast . SYNOPTIC REPORT - BREAST. Specimens Involved. Specimens: A: SLN#1 LEFT AXILLA. B: LEFT BREAST AND AXILLARY CONTENTS. Specimen Type: Mastectomy. Needle Localization: Laterality: Left. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive lobular carcinoma 8520/3. Tumor size: 2.2cm. Tumor Site: Upper outer quadrant. Upper inner quadrant. Margins: Negative. Tubular Score: 3. Nuclear Grade: 3. Mitotic Score: 1. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Absent. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node and axillary dissection. Lymph node status: Positive 2 / 13 Extranodal extension. DCIS not present. ER/PR/HER2 Results. ER: Positive. PR: Positive. HER2: Negative by FISH. Performed on Case: Pathological staging (pTN): pT 2 N 1a. SYNOPTIC REPORT - BREAST. Specimens Involved. Specimens: C: SENTINEL LYMPH NODE BX. RIGHT AXILLA. D: SENTINEL LYMPH NODE #2 RIGHT AXILLA. E: RIGHT BREAST & AXILLARY CONTENTS. F: ADDITIONAL AXILLARY TISSUE. Specimen Type: Mastectomy. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: No. WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 3.3cm. Tumor Site: Upper inner quadrant. Lower inner quadrant. Central. Margins: Negative. Tubular Score: 3. Nuclear Grade: 2. Mitotic Score: 2. Modified Scarff Bloom Richardson Grade: 2. Necrosis: Absent. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node and axillary dissection. Lymph node status: Positive 2/6 Extranodal extension. DCIS present. Margins uninvolved by DCIS. DCIS Quantity: Estimate 75%. DCIS Type: Solid. Cribriform. DCIS Location: Both associated and separate from invasive tumor mass. Nuclear grade: Intermediate. Necrosis: Present. ER/PR/HER2 Results. ER: Pending. PR: Pending. HER2: Pending. Pathological staging (pTN): pT2N1a. CLINICAL HISTORY: year old post menopausal AA woman with abnormal screening mammogram and bilateral breast. neoplasia. Left breast 2.5 x 1.5cm mass at 12:00 is invasive lobular Ca. Right breast with 2, 1cm foci of. DCIS at 3 o'clock medial and subareolar position. No prior chemo. PRE-OPERATIVE DIAGNOSIS: R and L breast Ca. INTRAOPERATIVE CONSULTATION. FSA: Metastatic carcinoma extensively involving one lymph node. Diagnosis called to Dr. at. Dr. FSC/FSD: Metastatic carcinoma extensively involving one lymph node. Diagnosis called to Dr at. by Dr. ADDENDUM: SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimens Involved. Specimens: E: RIGHT BREAST & AXILLARY CONTENTS. Specimen: Surgical Excision. Block Number: E6. ER: Positive. Allred Score: 8 = Proportion Score 5 + Intensity Score 3. PR: Positive Allred Score: 6 = Proportion Score 4 + Intensity Score 2. 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. Specimens Involved. Specimens: E: RIGHT BREAST & AXILLARY CONTENTS. Specimen: Surgical Excision. Block Number: E6. 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. 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 Pathology. Department takes full responsibility for this test's performance. Additional presumptive lymph nodes from part E (right mastectomy) were submitted in 15 blocks, from. E31 to E45. Three additional lymph nodes are identified, negative for metastasis (0/3). 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. majority of tumors cells displayed extensive polysomy 17. with 4 to 8 chromosome 17 signals and 4 to 8 HER-2 signals, with a HER-2/CEP 17 Ratio </=2.0,. consistent with no amplification of the HER2/neu gene. Block used E6. Source of case: Tissue fixation. formalin-fixed tissue. Outside Case No: NA. Tissue source. breast Results interpreted: HER2/CEP17 ratio: 0.95. 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® therapv is being considered. These tests were performed in the. under the direction. of Dr.. The results of these studies should always be interpreted in the context of the. clinical, morphological, and immunophenotypic diagnosis. Microscopic/Diagnostic Dictation: Pathologist, (. Final Review: Pathologis. Final Review: Pathologis: Final: Pathologist, C. Addendum: Pathologist,. Addendum Final: Pathologist, L. Addendum: Pathologist, 0. Addendum Final: Pathologis. Addendum: Pathologist. Addendum Final: Pathologist,.

expanded version (tokens=4545) : 
 Histological Classification: 

- Left Axillary Lymph Node (SLN#1): Metastatic Carcinoma (1/1 lymph node), measuring 2 cm with extranodal extension.
- Left Breast: Invasive Lobular Carcinoma, SBR Grade 2, measuring 2.2 cm. Surgical resection margins negative for tumor. Metastatic carcinoma in 1/12 lymph nodes.
- Right Axillary Lymph Node (Sentinel #2): Metastatic Carcinoma (1/1 lymph node), measuring 0.6 cm, without extranodal extension.
- Right Axillary Lymph Node (Sentinel #3): Metastatic Carcinoma (1/1 lymph node).
- Right Breast: Invasive Ductal Carcinoma, SBR Grade 2, measuring 3.3 cm, with extensive Ductal Carcinoma In Situ (DCIS) involving the central portion of the breast and major ducts of the nipple, upper inner, and lower inner quadrants. Surgical resection margins negative for tumor. No metastases in 3 lymph nodes.

Histological Subtypes and Features:
- Left Breast: Invasive lobular carcinoma and invasive ductal carcinoma.
- Right Breast: Invasive ductal carcinoma with extensive DCIS (solid and cribriform types) and central necrosis.

Lymphovascular invasion: None identified.

Calcification: Not mentioned in the report.

T

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=4723) : 
 Left Axillary Lymph Node: Metastatic Carcinoma (2 cm, extranodal extension). Left Breast: Invasive Lobular Carcinoma (2.2 cm), negative margins, metastasis in 1/12 lymph nodes. Right Axillary Lymph Node: Metastatic Carcinoma (0.6 cm). Right Breast: Invasive Ductal Carcinoma (3.3 cm), extensive DCIS, negative margins, no metastases in 3 lymph nodes. ER/PR: Positive. HER2: Equivocal (20% tumor staining). Pathological staging: pT2N1a.

