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, Surgica Pathology Final Report. Temporary Copy. los. Diagnosis. A. LEFT BREAST AND AXILLARY LYMPH NODES, MASTECTOMY AND. LYMPHADENECTOMY: - INVASIVE DUCTAL CARCINOMA, GRADE 2, 9.0 CM IN GREATEST DIMENSION. - METASTATIC CARCINOMA ION TWO OF EIGHTEEN LYMPH NODES. - MARGINS OF RESECTION ARE NOT INVOLVED. - SEE SYNOPTIC REPORT AND NOTE. NOTE: biomarkers studies have been ordered and will be reported-in an addendum. B. SKIN OF LEFT BREAST, ADDITIONAL INFERIOR, EXCISION: - SEGMENT OF UNREMARKABLE SKIN. (Electronic signature). Verified: Synoptic Report. SPECIMEN: Total breast (including nipple and skin). PROCEDURE: Total mastectomy (including nipple and skin). LYMPH NODE SAMPLING: Axillary dissection (partial or complete dissection). SPECIMEN INTEGRITY: Single intact specimen (margins can be evaluated). SPECIMEN SIZE: Greatest dimension: 27 cm. Additional dimensions: 19 x 11 cm. SPECIMEN LATERALITY: Left. TUMOR SITE: INVASIVE CARCINOMA: Upper inner quadrant. Lower inner quadrant. Central. TUMOR SIZE: SIZE OF LARGEST INVASIVE CARCINOMA: Greatest dimension of largest focus of invasion over 0.1 cm: 9.0 cm. TUMOR FOCALITY: Single focus of invasive carcinoma. MACROSCOPIC AND MICROSCOPIC EXTENT OF TUMOR: Skin: Invasive carcinoma directly invades into the dermis or epidermis without skin ulceration. Nipple: DCIS does not involve the nipple epidermis. DUCTAL CARCINOMA IN SITU (DCIS): DCIS is present. Extensive intraductal component (EIC) negative (small foci, less than 5% of the entire tumor). ARCHITECTURAL PATTERNS: Cribriform. Temporary Copy. NUCLEAR GRADE: Grade II (intermediate). NECROSIS: Not identified. LOBULAR CARCINOMA IN SITU (LCIS): Not identified. HISTOLOGIC TYPE OF INVASIVE CARCINOMA: Invasive ductal carcinoma (no special type or not otherwise specified). GLANDULAR (ACINAR)/TUBULAR DIFFERENTLATION: Score 3: <10% of tumor area forming glandular/tubular structures. NUCLEAR PLEOMORPHISM: Score 2: Cells larger than normal with open vesicular nuclei, visible nucleoli, and moderate variability in. both size and shape. MITOTIC COUNT: Score 1. OVERALL GRADE: Grade 2: scores of 6 or 7. MARGINS: Margins uninvolved by invasive carcinoma. Distance from closest margin: 15 mm (deep fascial margin). Margins uninvolved by DCIS (if present). Distance from closest margin: 15 mm (deep fascial margin). LYMPH-VASCULARI INVASION: Present. DERMAL LYMPH-VASCULAR INVASION: Not identified. LYMPH NODES: Total number of lymph nodes examined (sentinel and nonsentinel): 16. Number of lymph nodes with macrometastases (>0.2 cm): 2. Size of largest metastatic deposit: 3.5 cm. EXTRANODAL EXTENSION: Not identified. PRIMARY TUMOR (INVASIVE CARCINOMA (pT): pT3: Tumor >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 (M): Not applicable. MICROCALCIFICATIONS: Present in non-neoplastic tissue. CLINICAL HISTORY: Palpable mass. Specimen Source. A. LT Breast and Axillary Nodes. B. Additional Inferior Skin. Clinical Information. Temporary Copy. Patient with large mass upper Central breast, core biopsy positive. PRE-OP DIAGNOSIS: Left breast cancer. POST-OP DIAGNOSIS: Same. TYPE OF PROCEDURE: Left mass and axillary node dissection. Gross Description. The specimen is labeled "LEFT BREAST AND AXILLARY NODES " and is received in formalin. It consist. of mastectomy specimen with lymph nodes weighing 1330 grams and measuring 27 x 19 x 11 cm with brown. skin ellipse measuring 24 x 13 cm, containing grossly unremarkable 1.8 cm in diameter nipple. The posterior. margin is composed of smooth fascia which is inked black. Superior non-deep margin is inked with red ink and. the inferior non-deep margin is inked with blue ink. The breast is slices in sagittal planes revealing a large well. defined pink-tan lobulated mass measuring 9 x 7 x 6 cm and is located central portion of the breast and. extending upper inner and lower inner quadrant. This mass is 1.5 cm away from the deep fascial margin of. resection, 1.5 cm from the superior non-deep fascial margin and 2 cm from the inferior non-deep fascia margin. of resection. The remaining portions reveal unremarkable yellow mammary fat with streaks of white-gray. mammary parenchyma. The axillary fat pad measuring 10 x 10 x 5 cm. On sectioning multiple lymph nodes are. identified. The largest lymph node is consists of a 2 matted lymph nodes measuring 4 x 3 x 3 cm and is pink tan. and firm in consistency for 3.5 cm. Representative sections are submitted as follows: Al = nipple. A2-A5 = mass. A 6 = mass closest deep fascial margin of resection. A7 = representative sections upper outer quadrant. A8 = representative sections lower outer quadrant. A 9 = mass with closest skin surface. A 10 = six lymph nodes. A 11 = bisection of a single lymph node. A 12 = bisection of a single lymph node. A 13 = bisection of a single lymph node. A 14 = bisection of a single lymph node. A 15 = bisection of a single lymph node. A 16 = bisection of a single lymph node. A 17 = bisection of a single lymph node. A 18 = bisection of a single lymph node. A 19-A 20 = representative sections of 2 matted lymph nodes. Specimen is in formalin more than 6 hours and less than 48 hours. Time specimen was removed from the patient: Time specimen was placed in formalin : Ischemic time: 45 minutes. Special Stains / Slides. 23 H&E. Temporary Copy. Tissue Code. Addendum Report. Temporary Copy. Addendum Report. IMMUNOHISTOCHEMICAL EVALUATION OF ESTROGEN RECEPTORS, PROGESTERONE. RECEPTORS, AND HER-2NEU IN INVASIVE MAMMARY CARCINOMA. ESTROGEN RECEPTORS: 99 %, positive, moderate staining intensity. PROGESTERONE RECEPTORS: <1 %, negative, moderate staining intensity. HER-2NEU: SCORE 1+, negative. Immunohistochemical studies were performed on formalin fixed paraffin embedded tissue (Block A4) using the. following monocional antibodies: Estrogen receptor (Clone SP1), Progesterone receptor (Clone 1E2) and. Her-2neu (. Clone 4B5); control sections for HER-2Neu are provided within a kit (score 0 MCF-7, score. 1+. T-47D, score 2+ MDA-MB-453, score 3+ BT-474). Detection system used: polymer. Primary antibodies,. reagents and control sections for HER-2neu are all provided by. All controls show appropriate reactivity. Reactivity of Estrogen and Progesterone receptors is determined based on the percentage of positively. stained nuclei of tumor cells. Reference values (CAP accreditation program checklist 2010 and guidelines on. webpage): Positive: nuclear staining in 1% or greater than 1% of invasive carcinoma cells. Negative : nuclear staining in less than 1% of invasive carcinoma cells. Staining intensity: is reported as weak, moderate or strong. HER-2neu reactivity is reported applying the CAP scoring guidelines (CAP accreditation program checklist. 2010 and guidelines on webpage): Score 0 = Negative: No immunoreactivity, or faint weak immunoreactivity in <10% of tumor cells but only a. portion of the membrane is positive.. Score 1 = Negative: Faint weak immunoreactivity in 10% or >10% of tumor cells but only a portion of the. membrane is positive. Score 2+ = Equivocal: Weak to moderate complete membrane immunoreactivity in > 10% of tumor cells or. circumferential intense membrane staining in <30% of cells. Score 3+ = Positive: More than 30% of the tumor cells must show circumferential intense and uniform. membrane staining. A homogeneous (chicken wire) pattern should be present. Equivocal results for HER-2neu (Score 2+) will be subsequently followed by a reflex dual-color ISH testing. The performance characteristics of these antibodies were determined by the. They have not been cleared or approved by the U.S. Food. and Drug Administration. The FDA has determined that such clearance or approval is not necessary. These tests are used for clinical. purposes. They should not be regarded as investigational or for research. This laboratory is certified under the Clinical Laboratory. Improvement Amendments of 1988 (CLIA-88) as qualified to perform high-complexity clinical laboratory testing. (Electronic signature). Verified:

expanded version (tokens=2578) : 
 The breast pathology report shows that the patient has Luminal A subtype of invasive ductal carcinoma. The tumor is grade 2 and measures 9.0 cm in greatest dimension. There are metastatic carcinomas in two out of eighteen lymph nodes. The resection margins are uninvolved, and biomarker studies have been ordered. 

The report also states that there is DCIS present, with no involvement of the nipple epidermis. The architectural pattern is cribriform, and the nuclear grade is intermediate. Necrosis is not identified, and lobular carcinoma in situ is not seen. 

Furthermore, the report confirms the presence of lymphovascular invasion but not dermal lymphovascular invasion. The overall histological grade is grade 2, and the mitotic count is score 1. The margins are uninvolved by invasive carcinoma, while the distance from the closest margin to the tumor is 15mm. The lymph nodes show macrometastases in two out of sixteen lymph nodes, with no extranodal extension. The tumor is invasive carcinoma measuring 9.0 cm and is present in the upper inner quadrant, lower inner quadrant, and central portion of the breast. 

The immunochemistry evaluation of estrogen receptors, progesterone receptors, and HER-2/neu shows that estrogen receptors are positive with moderate staining intensity, while progesterone receptors are negative with moderate staining intensity. HER-2/neu is negative but needs further testing for equivocal

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=2735) : 
 The patient has Luminal A subtype invasive ductal carcinoma (grade 2) with DCIS present. The tumor measures 9.0cm and shows lymphovascular invasion but no dermal lymphovascular invasion. Margins are uninvolved by invasive carcinoma, while there are macrometastases in two of sixteen nodes without extranodal extension. Estrogen receptors are positive, while progesterone receptors are negative, and HER-2/neu needs further testing for equivocal results. The patient requires further biomarker studies.

