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 Her2, F. Pathologic Interpretation: A. LEFT BREAST LUMPECTOMY: INVASIVE DUCTAL CARCINOMA, poorly differentiated, Nottingham grade 3 (3+3+3=9), 2.1 cm in greatest. dimension. Resection margins are free of tumor; closest is inferior, 0.1 cm. B. LEFT AXILLARY CONTENTS: METASTATIC DUCTAL CARCINOMA to two out of twenty-six lymph nodes (2/26) with extranodal. extension. C. ADDITIONAL LEFT AXILLARY CONTENTS LEVEL 2-3: No malignancy seen in five lymph nodes (0/5). Surgical Pathology Cancer Case Summary. Specimen: Partial breast. Procedure: Excision without wire-guided localization. Lymph Node Sampling: Axillary dissection (partial or complete dissection). Specimen Integrity: Single intact specimen (margins can be evaluated). Specimen Laterality: Left. Tumor Size: Size of Largest Invasive Carcinoma: Greatest dimension of largest focus of invasion over 0.1 cm: 2.1 cm. Additional dimensions: 1.7 x 1.7 cm. Tumor Focality: Single focus of invasive carcinoma. Macroscopic and Microscopic Extent of Tumor: Skin: Skin is not present. Skeletal Muscle: No skeletal muscle present. Ductal Carcinoma in Situ (DCIS): DCIS is present. Architectural Patterns: Solid. Nuclear Grade: Grade III (high). Histologic Type of Invasive Carcinoma: Invasive ductal carcinoma (no special type or not otherwise specified). Histologic Grade: Nottingham Histologic Score: Glandular (Acinar)/Tubular Differentiation. Score 3: < 10% of tumor area forming glandular/tubular structures. Nuclear Pleomorphism. Score 3: Vesicular nuclei, often with prominent nucleoli, exhibiting marked variation in size and. shape, occasionally with very large and bizarre forms. Mitotic Count. Score 3. Overall Grade. Grade 3. Margins: Margins uninvolved by invasive carcinoma. Distance from closest margin: 1 mm (inferior). Margins uninvolved by DCIS. Lymph Nodes: Number of sentinel lymph nodes examined: 0. Total number of lymph nodes examined (sentinel and nonsentinel): 31. Number of lymph nodes with macrometastases (> 0.2 cm): 2. Largest metastatic deposit: 3.0cm. Extranodal Extension: Present. Method of Evaluation of Sentinel Lymph Nodes: Hematoxylin and eosin (H&E), one level. Pathologic Staging (pTNM): Primary Tumor (pT): pT2: Tumor > 20 mm but 50 mm in greatest dimension. Regional Lymph Nodes (pN): pN1a: Metastases in 1 to 3 axillary lymph nodes, at least 1 metastasis greater than 2.0 mm. Distant Metastasis (pM): Not applicable. Ancillary Studies: Estrogen Receptor: Performed on another specimen: Results: Less than 1% immunoreactive cells present. Progesterone Receptor: Performed on another specimen: Results: Less than 1% immunoreactive cells present. HER2/neu Immunoperoxidase Studies: Performed on another specimen: Results: Positive (Score 3+). Clinical History: None Provided. Operation Performed. Left Breast Lumpectomy. Pre Operative Diagnosis: Breast Cancer. Specimen(s) Received/Processing Information: Fee. Codes: A: LEFT BREAST LUMPECTOMY H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E,. Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x. 1. B: LEFT AXILLARY CONTENTS H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E,. Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1, H&E, Initial x 1,. H&E, Initial x 1. C: ADDITIONAL LEFT AXILLARY CONTENTS LEVEL 2-3 H&E, Initial x 1, H&E, Initial x. Gross Description: A. Received in formalin is a yellow tan fibrotic adipose tissue fragment weighing 86 grams and measures 8.0 x. 7.0 x 4.0 cm. The specimen is oriented with a long stitch lateral, short superior and double stitch. Inked as. follows: Superior in Blue - deep black, anterior yellow, inferior green, lateral orange and medial red. Cross. sections of the specimen shows a firm pale tan well circumscribed mass measuring 2.1 x 1.7 x 1.7 cm. It is. within 1 mm from inferior resection margin, all additional margins are uninvolved by tumor. The mass shows. a metallic clip (previous biopsy site). No additional lesions are grossly present. Sections submitted as. follows: Cassette #1-4. Representative section of the mass with relations to the inferior margin (almost in toto). (Cassette #1) -largest dimension of the mass, (Cassette #4) previous biopsy site. Cassette# 5. Superior margin. Cassette# 6. Deep margin. Cassette# 7. Anterior margin. Cassette#8. Lateral margin. Cassette #9. Medial resection margin. B. Received in formalin are multiple yellow tan fibrotic adipose tissue fragments measuring 15.0 x 13.0 x 4.0. cm in aggregate. Twenty-six lymph nodes were grossly identified measuring up to 3.0 x 2.0 cm in greatest. dimension. The two largest lymph nodes show a metastatic tumor. Sections submitted as follows: Cassette #1. Representative section from one large lymph node. Cassette #2. Representative section from the second largest lymph node. Cassettes# 3&4. One lymph node in toto per cassette. Cassettes#5-10. Four lymph nodes in toto per cassette. C. Received in formalin is a yellow tan fibrotic adipose tissue fragment. It measures 10. 0 x 6.0 x 2.0 cm in. aggregate. The five lymph nodes are grossly identified measuring up to 0.4 x 0.3 cm in greatest dimension. Sections submitted as follows: Cassette #1. Two lymph nodes in toto. Cassette# 2. Three lymph nodes in toto.

expanded version (tokens=1878) : 
 Histological classification: Invasive ductal carcinoma (no special type or not otherwise specified) with poorly differentiated subtype, Nottingham grade 3 (3+3+3=9). Ductal carcinoma in situ (DCIS) is present, with solid architectural pattern and nuclear grade III (high).

Necrosis: None mentioned.

Tumor infiltrating lymphocytes: No mention of tumor infiltrating lymphocytes.

Histological grade: Nottingham Histologic Score of 9, indicating a high grade cancer.

Nuclear grade: Grade III, indicating vesicular nuclei that are often with prominent nucleoli and marked variation in size and shape, occasionally with very large and bizarre forms.

Lymphovascular invasion: Information not provided in the report.

Calcification: Information not provided in the report.

Receptor status: Estrogen and progesterone receptor testing was performed on another specimen. Results showed less than 1% immunoreactive cells present. HER2/neu immunoperoxidase studies were also performed on another specimen, with positive results (Score 3+).

Ancillary testing: No other ancillary testing results were mentioned in the report.

Overall, the report describes a left breast lumpectomy with invasive ductal carcinoma of the poorly differentiated subtype, with evidence of DCIS. The cancer has spread to two out of twenty-six axillary lymph nodes and has extranodal extension. The tumor is positive for HER2/neu and negative for estrogen and progesterone receptors. The

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=2000) : 
 Left breast lumpectomy reports invasive ductal carcinoma, poorly differentiated subtype of 2.1 cm in greatest dimension with distant metastasis to two lymph nodes and HER2 positive. Nottingham grade 3 (3+3+3=9) with DCIS present. Margins are uninvolved by invasive carcinoma. Estrogen and progesterone receptor are negative.

