breast-pathology-specialist - SKILL.md Agent Skill

name: breast-pathology-specialist description: Comprehensive breast cancer pathology workflow combining CAP/ICCR compliance validation, synoptic template generation, TNM staging (AJCC 8th edition), biomarker reporting (ER/PR/HER2/Ki-67) per ASCO/CAP guidelines, tumor board summaries, and SNOMED coding for invasive breast carcinoma. Use when the user uploads or pastes a breast pathology report (mastectomy, lumpectomy, wide local excision, sentinel/axillary lymph node biopsy) and asks to "check breast report", "validate breast pathology", "stage this breast cancer", "interpret ER/PR/HER2", "generate breast template", or any breast-cancer-specific pathology task. Supports .pdf, .docx, .txt input in English and Turkish. license: MIT metadata: version: 1.3.0 author: Serdar Balci

Breast Pathology Specialist

Complete breast cancer pathology workflow toolkit combining compliance checking, staging, biomarker reporting, and coding.

When to Use This Skill

Use this skill for:

Breast cancer pathology report validation
Invasive breast carcinoma specimens (mastectomy, lumpectomy, excision)
CAP/ICCR compliance checking with severity scoring
TNM staging calculation (AJCC 8th edition)
Biomarker interpretation (ER/PR/HER2/Ki-67)
Tumor board summary generation
SNOMED CT coding assistance

Supported Specimen Types

Total mastectomy
Partial mastectomy / Lumpectomy
Wide local excision
Re-excision specimens
Sentinel lymph node biopsy
Axillary lymph node dissection

Key Features

Compliance Checking: Validates against CAP Breast.Invasive and ICCR Invasive Carcinoma of the Breast protocols
TNM Staging: AJCC 8th edition breast cancer staging with pT/pN/M calculation
Biomarker Reporting: ER/PR/HER2/Ki-67 validation per ASCO/CAP guidelines
Template Generation: Pre-filled or blank synoptic templates
Tumor Board Summaries: Concise 3-5 line MDT presentation format
SNOMED Coding: Breast-specific code suggestions

Reference Files

When processing reports, reference these files on-demand (DO NOT load at startup):

Diagnosis guidelines: references/diagnosis/breast_invasive_carcinoma.md
Macroscopy guidelines: references/macroscopy/breast_macroscopy.md
TNM staging: ../../shared-references/staging/tnm_stage_calculator.md
Synoptic templates: ../../shared-references/templates/synoptic_templates.md
Biomarkers: ../../shared-references/biomarkers/BIOMARKERS_INDEX.md
SNOMED codes: ../../shared-references/coding/snomed_ct_codes.md

Usage Examples

# Validate report compliance
claude "Check this breast report using breast-pathology-specialist" < report.txt

# Generate staging
claude "What stage is pT2 N1a M0 for breast using breast-pathology-specialist"

# Create template
claude "Generate blank breast lumpectomy template using breast-pathology-specialist"

# Tumor board summary
claude "Create tumor board summary using breast-pathology-specialist" < report.txt

Processing Instructions

When analyzing breast pathology reports:

Identify request type (compliance check, staging, template, summary, coding)
Read relevant reference file on-demand based on request
Process the report using appropriate guidelines
Generate output in requested format
DO NOT load all reference files upfront

Compliance Scoring

Use severity-based weighting:

Critical elements (tumor size, grade, margins, nodes, ER/PR/HER2): -15 points each
Major elements (LVI, PNI, ductal carcinoma in situ): -5 points each
Minor elements (Ki-67, oncotype, tumor location): -2 points each

Scoring: 90-100 (Compliant) | 70-89 (Minor issues) | 50-69 (Major issues) | <50 (Critical)

Cross-Validation Checks

Always validate:

pT category vs tumor size consistency
pN category vs positive node count
Stage group vs pT/pN/M combination
Margin status vs R classification
ER/PR/HER2 vs molecular subtype

Language Support

Supports English and Turkish - detect from user prompt and use appropriate template file.

Note: This is a minimal skill definition. Large reference files are loaded on-demand only when processing requests, not at skill startup.