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 Basal, SPECIMEN(S): A. RIGHT BREAST PARTIAL MASTECTOMY. B. SLN #1 RIGHT AXILLA. C. ADDITIONAL AXILLARY TISSUE RIGHT AXILLA. CLINICAL HISTORY: This is a. year old female with a 1.4 cm tumor in the right breast, IDC at 11:00. S/P. benign MRI biopsy inferior and lateral to this index lesion, not clipped. Here for N/L. lumpectomy with SLN biopsy. INTRAOPERATIVE CONSULTATION DIAGNOSIS: A. Right breast, partial mastectomy: Tumor is 0.3 cm from anterior margin. TPB1-TPB4: SLN#1, right axilla, excision: Four lymph nodes, negative for carcinoma. Diagnosis called to Dr. at by Dr. PRE-OPERATIVE DIAGNOSIS: Right breast cancer. GROSS DESCRIPTION: A. RIGHT BREAST PARTIAL MASTECTOMY. Received fresh in a container labeled with the patients name and "right breast partial. mastectomy" is an oriented (straight: superior= 1 clip, long: lateral = 2 clips, double: deep, air knot in axillary tail), previously inked, 130g, 11 x 9 x 3.5 cm partial mastectomy. with accompanying radiograph. Ink code: anterior-yellow, posterior-black, medial-green,. lateral-red, superior-blue, inferior-orange. The specimen is serially sectioned from. superior to inferior into 8 slices revealing a 1.6 x 1.4 x 0.8 cm firm, circumscribed, tan. mass that is closest to the anterior margin at 0.3 cm. Tissue is procured. Representatively. submitted: A1: slice 1, superior margin. A2-A3: slice 4, mass with skin and anterior margin, bisected. A4-A5: slice 4, posterior margin underlying mass, bisected. A6-A7: slice 4, anterior and posterior margins, bisected. A8-A9: slice 4, lateral and posterior margins, bisected. A10-A11: slice 4, anterior and medial margins, bisected. A12-A13: slice 4, medial and posterior margins, bisected. A14: slice 5, mass with skin and anterior margin. A15-A16: slice 8, inferior margin. B. SLN #1 RIGHT AXILLA. Received fresh labeled with the patients name and "SLN #1 right axilla" is a 5 x 2 x 0.7. cm aggregate of fatty tissue within which four lymph nodes, 2 X 0.6 x 0.6 cm, 2 X 1 x 0.6. cm, 2 x 1.1 x 0.4 cm, 1.2 x 1 x 0.6 cm are identified. Touch preps are performed. Lymph. nodes are entirely submitted: B1-B2; one lymph node. B3: one lymph node. B4: one lymph node. B5: one lymph node. C. ADDITIONAL AXILLARY TISSUE RIGHT AXILLA. Received in formalin in a container labeled with the patients name and designated. "additional axillary tissue" is a 1.7 x 1 x 0.2 cm fragment of soft fatty tissue. The. specimen is bisected and entirely submitted. DIAGNOSIS: A. BREAST, RIGHT, PARTIAL MASTECTOMY: - INVASIVE DUCTAL CARCINOMA WITH LYMPHOPLASMACYTIC. INFILTRATE AND GEOGRAPHIC NECROSIS, SBR GRADE 3,. MEASURING 1.1-CM. - SURGICAL RESECTION MARGINS NEGATIVE FOR TUMOR. - BIOPSY SITE CHANGES WITH FIBROSIS AND FAT NECROSIS. - SEE SYNOPTIC REPORT. B. LYMPH NODE, SENTINEL #1, RIGHT AXILLA, EXCISION: - FOUR LYMPH NODES, NEGATIVE FOR METASTASES (0/4). C. ADDITIONAL AXILLARY TISSUE, RIGHT, AXILLARY DISSECTION: - FIBROADIPOSE TISSUE, NO TUMOR OR LYMPHOID TISSUE. IDENTIFIED. SYNOPTIC REPORT - BREAST. Specimen Type: Partial mastectomy. Needle Localization: Laterality: Right. Invasive Tumor: Present. Multifocality: WHO CLASSIFICATION. Invasive ductal carcinoma, NOS 8500/3. Tumor size: 1.1cm. Tumor Site: Upper outer quadrant. Margins: Negative. Distance from closest margin: 0.3cm. anterior. Tubular Score: 3. Nuclear Grade: 3. Mitotic Score: 2. Modified Scarff Bloom Richardson Grade: 3. Necrosis: Present. Vascular/Lymphatic Invasion: None identified. Lobular neoplasia: None. Lymph nodes: Sentinel lymph node. Lymph node status: Negative 0/4. DCIS not present. ER/PR/HER2 Results. ER: Pending. PR: Pending. HER2: Pending. Pathological staging (pTN): pT 1c N 0. Pathological staging is based on the AJCC Cancer Staging Manual, 7th Edition. ADDENDUM: SYNOPTIC REPORT - BREAST, ER/PR RESULTS. Specimen: Surgical Excision. Block Number: A2. ER: Negative. Allred Score: 0 = Proportion Score 0 + Intensity Score 0. PR: Negative. Allred Score: 0 = Proportion Score 0 + Intensity Score 0. 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: A2. Interpretation: EQUIVOCAL. Intensity: 2+. % Tumor Staining: 10%. Fish Ordered: 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. ising 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. 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. ADDENDUM: FISH/ISH ANALYSIS REPORT 3. Specimens Involved. Specimens: A: RIGHT BREAST PARTIAL MASTECTOMY. HER2/NEU RESULTS. ANALYTICAL INTERPRETATION OF RESULTS. HER-2 NOT AMPLIFIED. Clinical interpretation of the results. A majority of tumors cells displayed 2 chromosome 17 centimeter signals and 2 HER2. signals, with a HER2/CEP 17 Ratio 1.3, consistent with no amplification of the HER2/neu. gene. Probes identification. LSI Her-2/neu 17q11.2-12, spectrumorange. CEP 17, 17 p11.1-q11.1 alpha satellite DNA, spectrumgreen. Image analysis method - Manual. Results interpreted. ISCN. nuc ish: (CEP17,HER2)x2[200]. Number of invasive tumor cells counted. 200. Number of observers. 1. Number of Her2 signals/nucleus. 2.3. Number of CEP 17 signals/nucleus. 1.8. Her2/CEP 17 ratio. 1.3. TEST CHARACTERISTICS: 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 Pathology Core Facility, Department of Pathology,. under the direction of Dr.. The results of these studies should always be. interpreted in the context of the clinical, morphological, and immunophenotypic diagnosis. The. 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. Specimen information. RPCI surgical pathology/cytology case number. Source of case. RPCI. Block number used A2. Specimen site. Breast. Female breast right. Specimen type. Complete excision (less total mastectomy). Specimen fixative type. Formalin. Duration of fixation (hrs). 6 48 hrs. Comment: Controls: The FISH study was performed with appropriately stained positive and negative. controls.

expanded version (tokens=2738) : 
 Histological Classification: The breast pathology report shows that the patient has invasive ductal carcinoma (IDC) with lymphoplasmacytic infiltrate and geographic necrosis. It is described as a subtype basal.

Nuclear and Histological Grade: The report shows that the histological and nuclear grade of the cancer is Grade 3, which denotes an aggressive cancer type.

Presence of Necrosis: The report mentions the presence of geographic necrosis.

Tumor Infiltrating Lymphocytes: The pathology report states the presence of lymphoplasmacytic infiltrate surrounding the cancerous tissue.

Lymphovascular Invasion: The report shows no evidence of vascular/lymphatic invasion.

Calcification: No mention of calcifications was noted in the pathology report.

Receptor Status: The initial report shows that the patient's ER/PR/HER2 results were pending. However, the addendum report shows that the ER and PR receptors were negative with an Allred score of 0. The HER2/neu was equivocal, with an intensity of 2+ and a HER2/CEP17 ratio of 1.3. The PathVysion HER-2 DNA Probe Kit was used for this test.

Ancillary Testing Results: The pathology report mentions no other ancillary testing results other than the receptor status and HER2/NEU results.

In summary, the patient has invasive ductal carcinoma (IDC) with lymphoplasmacytic infiltrate and geographic necrosis

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=2901) : 
 A 1.1cm subtype basal invasive ductal carcinoma was found in the right breast of a patient. Necrosis was present, but there was no evidence of lymphovascular invasion or calcification. The nuclear and histological grade of the cancer is Grade 3, which denotes an aggressive cancer type. The receptor status revealed that ER/PR were negative with an Allred score of 0 while HER2/neu was equivocal with HER2/CEP17 ratio of 1.3, determined by PathVysion HER-2 DNA Probe Kit.

