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, AGE/SX: ROOM. REG DR: BED: DIS: TLOC: COLL. TIME IN FORMALIN: 4:16. hrs. CLINICAL INFORMATION: Pre-Op Diagnosis: Right breast CA. Remarks: Specimen (s) : A. Right breast tissue stitch axillary tail. B. Right axillary node x2. C. #1 sentinel node right breast. D. IS level 3 node stitch marks highest level node. E. Axillary contents. MICROSCOPI DIAGNOSIS. A. RIGHT BREAST, TOTAL MASTECTOMY: INVASIVE LOBULAR CARCINOMA. INVASIVE CARCINOMA MEASURES AT LEAST 4.5 CM IN GREATEST DIMENSION (pT2). NOTTINGHAM COMBINED HISTOLOGIC GRADE 2 OF 3. TUBULE FORMATION SCORE 3 OF 3. NUCLEAR PLEOMORPHISM SCORE 2 OF 3. MITOTIC COUNT SCORE 1 OF 3. SURGICAL MARGINS OF RESECTION FREE OF INVASIVE LOBULAR CARCINOMA. FOCI OF LOBULAR CARCINOMA IN SITU. FOCI OF DUCT CARCINOMA IN SITU. INTERMEDIATE NUCLEAR GRADE, NOT EXTENSIVE. SEE COMMENT FOR SURGICAL PATHOLOGY CANCER CASE SUMMARY CHECKLIST. B. RIGHT AXILLARY LYMPH NODES X2, EXCISION: METASTATIC BREAST CARCINOMA IN TWO OF TWO LYMPH NODES. C. SENTINEL LYMPH NODE #1, EXCISION: NEGATIVE. NO EVIDENCE OF METASTATIC CARCINOMA IN THIS SPECIMEN. D. LEVEL 3 AXILLARY LYMPH NODES, REGIONAL RESECTION. NEGATIVE. NO EVIDENCE OF METASTATIC CARCINOMA IN SIX HIGHEST LEVEL 3 LYMPH NODES. E. RIGHT AXILLARY LYMPH NODES, REGIONAL RESECTION: METASTATIC BREAST CARCINOMA IN ONE OF 14 AXILLARY LYMPH NODES. COMMENT(S). SURGICAL PATHOLOGY CANCER CASE SUMMARY CHECKLIST - CAP APPROVED. Procedure: Total mastectomy. RUN DATE. RUN TIME. RUN USER: SPEC #: COMMENT (S). Lymph Node Sampling : Sentinel lymph node(s). axillary dissection. Specimen Laterality: Right. Histologic Type of Invasive Carcinoma : Invasive lobular carcinoma. Tumor Size: Greatest dimension of largest focus of invasion : 45. mm. Histologic Grade (Nottingham) : Glandular/Tubular Differentiation: Score 3. Nuclear Pleomorphism: Score 2. Mitotic Rate: Scors 1. Overall Grade Grade 2. Ductal Carcinoma In Situ: DCIS is present; negative for extensive intraductal. component (EIC). Architectural Patterns: Cribriform, solid. Nuclear Grade Grade II. Necrosis: Present, focal. Lobular Carcinoma In Situ: Present. Invasive Carcinoma: Margins uninvolved by invasive. Margins: carcinoma. Distance from closest margin : 1 0mm. DCIS: Margins uninvolved by DCIS. Distance from closest margin > 10 mm. Lymph Nodes: Number of sentinel lymph nodes examined: 1. Total number of lymph nodes examined (sentinel and. nonsentinel) : 23. Number of lymph nodes with macrometastases (>2 mm) : 3. Number of lymph nodes with micrometastases (>0.2 mm. to 2 mm and/or 200 cells) : 0. Number of lymph nodes with isolated tumor cells. (50.2 mm and <200 cells) : 0. Number of lymph nodes without tumor cells. identified 20. Extranodal Extension : Not identified. Method of Evaluation : Hematolxylin and eosin, level 1. Lymph-Vascular Invasion. Not identified. Dermal Lymph-Vascular Invasion. Not identified. Pathologic Staging: Primary Tumor: pT2. Regional Lymph Nodes: pN1a. Distant Metastasis: Not applicable. Ancillary Studies: ER: Positive (92% of tumor cells with nuclear. positivity); strong. PR: Negative. HER2: Positive (score 3+). In Situ Hybridization for HER2 Not amplified. RUN DATE : RUN TIME: Specimen Inquiry. RUN USER: SPEC #: GROSS DESCRIPTION: The specimen is submitted in five containers. A. The first specimen submitted in the fresh state is labeled "right breast tissue" The. specimen is the right breast, total mastectomy specimen Suture marks the axillary tail of. the breast. There is an ellipse of white skin containing the nipple. This measures 9 x 4.5. cm The breast itself measures 23 x 22.5 x 6.5 cm. There is a firm mass palpable beneath. the surface at approximately the 11 o'clock position The overlying superficial margin. adjacent to the skin is marked with black ink and the deep margin beneath this is marked. with blue ink. On cut section the mass measures approximately 4.5 x 3 x 3 cm. The edges. are quite difficult to discern and are more easily palpated than visualized In the center. of the specimen there is a small focus of hemorrhage consistent with previous biopsy. À. portion of this mass is set aside for tissue banking per protocol. The mass extends to. within approximately 1 cm of the overlying superficial margin at approximately 11 O'clock. at its closest point. It is located well above the deep margin which is approximately 7 cm. beneath the mass. Cut sections through the remainder of the breast tissue reveals some. rubbery white parenchymal breast tissue and abundant yellow fat. There. are. other. nodules or mass is identified. Sections are submitted as follows: A1. nipple. A2-5 -. mass in breast. A6. mass in breast with adjacent tissue. A7-9 -. non-neoplastic appearing breast tissue. B. The. second specimen is received in the fresh state in the operating room and represents. two axillary lymph nodes, one measuring 2 x 1.5 x 1 cm and the other measuring 1 x 0.7 x. 0.7. cm. The cut sections are hard. A section of each is examined by frozen section. These are submitted in block B1, frozen section control. Additional section of each is. submitted in block B2. C. The. third specimen initially in the fresh state is labeled "sentinel node #1" and is a. piece of yellow fat measuring 2.5 x 2 x 1 cm with a 1 cm round moderately firm lymph node. which is bisected and submitted in toto in block C1. D. The fourth specimen is labeled "level 3 axillary nodes" The specimen is a piece of. yellow fatty tissue measuring 9 x 3 x 1.! cm with a suture marking the highest level 3. lymph node. There are five additional small lymph nodes. The highest node is submitted in. block D1 and the other five lymph nodes are submitted in block D2. E. The fifth container is labeled "right axillary contents" The specimen is yellow fatty. tissue measuring 10 x 9 x 2.5 cm. Within the fatty tissue are several nodules consistent. with. lymph nodes. The largest of these measures 2 cm in diameter and on cut section is. partially replaced by very hard white tissue. A section of each node is. submitted. in. blocks E1 through E4. MICROSCOPIC DESCRIPTION. The slides are examined and evaluated. RUN DATE. RUN TIME. Specimen Inquiry. RUN USER. SPEC #: INTRAOPERATIVE CONSULTATION. OPERATING ROOM CONSULTATIONS : À. Portions of the breast mass are processed for tumor tissue banking per protocol. B. FROZEN SECTION DIAGNOSIS OF RIGHT AXILLARY LYMPH NODES X2: METASTATIC CARCINOMA IN TWO LYMPH NODES. PHOTO DOCUMENTATION. Image. Image. Image. Image. Image. Image. (signature on file).

expanded version (tokens=2181) : 
 The pathology report describes a luminal A subtype breast cancer in a total mastectomy specimen. The invasive carcinoma is identified as invasive lobular carcinoma measuring at least 4.5 cm in size, with an intermediate histologic grade (Nottingham combined histologic grade 2 of 3) and a tubule formation score of 3 of 3, nuclear pleomorphism score of 2 of 3, and mitotic count score of 1 of 3. Foci of lobular carcinoma in situ and duct carcinoma in situ are also found. Necrosis is present focally and there is no evidence of lymphovascular invasion. Lymph nodes in the right axilla are positive for metastatic breast carcinoma in two of two lymph nodes, one of 14 axillary lymph nodes, and none of the sentinel node #1. The receptor status for estrogen is positive in 92% of tumor cells, with strong nuclear positivity and a negative progesterone receptor status. HER2 is positive with a score of 3+, however the in situ hybridization for HER2 was not amplified. Intraoperatively, portions of the breast mass were preserved for tissue banking per protocol, and frozen section of the right axillary lymph nodes showed metastatic carcinoma. 

In summary: 

- Histological classification: Invasive lobular carcinoma with foci of lobular carcinoma in situ, duct carcinoma in situ
- Subtype: Luminal A
- Necrosis: Present focally


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=2330) : 
 Invasive lobular breast carcinoma (Luminal A subtype) at least 4.5 cm in size found on a total mastectomy specimen with foci of lobular and duct carcinoma in situ. Metastatic spread to two lymph nodes out of two, and one out of 14 axillary lymph nodes is also detected. Estrogen receptor-positive, progesterone receptor-negative, HER2 positive with a score of 3+. Necrosis present focally, no lymphovascular invasion seen.

