[Sonoelastography usage among German DEGUM-certified breast ultrasound specialists]. / Einsatz der Sonoelastografie in der Mammadiagnostik: Analyse unter DEGUM-zertifizierten Untersuchern.

PURPOSE: Sonoelastography of the breast is an emerging technology with evident data in the literature suggesting diagnostic advantages. Our study investigates the current usage of sonoelastography among German DEGUM-certified breast ultrasound specialists. MATERIALS AND METHODS: We used a standardized questionnaire with 18 items. In 2012, the survey was sent to all members of the breast ultrasound section of the DEGUM (n = 654). RESULTS: The group of survey participants (n = 208) performs 193 025 breast ultrasound examinations and examines 20 110 breast cancers per year. 21.2 % of the participants in the survey use sonoelastography, mainly for diagnostic purposes in BI-RADS®-US 3 and 4 lesions, less often for other categories or under study conditions. The most commonly applied criteria for the evaluation of the elastogram are the Tsukuba Elasticity Score (43.2 %), the fat-lesion ratio (29.5 %) and the determination of tissue stiffness with shear wave elastography expressed in kilopascal (25.0 %). The majority of non-users of elastography (58.6 %) would like to have the option of using sonoelastography in the future. CONCLUSION: Sonoelastography is a feasible and helpful method in the evaluation of breast lesions. A significant number of German ultrasound specialists already apply this technology today. We expect a growing number of sonographers to perform sonoelastography in the near future, provided that they have the necessary ultrasound system and that they are trained in the method. Evidence from the literature and the recommendations of the medical societies support this development.

Aurora-B protein expression is linked to initial response to taxane-based first-line chemotherapy in stage III ovarian carcinoma.

AIMS: Aurora kinases are central to cell proliferation and considered to be prognostic/predictive markers and therapeutic targets for epithelial cancers. Here, the prognostic/predictive value of Aurora-B protein expression was evaluated in patients with serous, FIGO stage III ovarian carcinomas treated with taxane- or platinum-based first-line chemotherapy (1st-CTx). METHODS: Immunohistochemistry was performed on tissue microarrays, including 80 ovarian carcinomas and 18 non-neoplastic ovaries, previously characterised for Aurora-A protein expression. None or marginal (score 0+1), moderate (score 2) and strong (score 3) Aurora-B protein expression was correlated with clinico-pathological parameters as well as recurrence-free survival (RFS) and overall survival (OS). RESULTS: While non-neoplastic ovaries were negative for Aurora-B, almost all (79/80; 99%) ovarian carcinomas exhibited Aurora-B positive tumour cells, with score 1 in 41/80 (51%), score 2 in 23/80 (29%) and score 3 in 15/80 (19%) cases. Aurora-B and Aurora-A protein expression correlated significantly (p=0.002). In optimal debulked patients, Aurora-B protein expression was associated with RFS (p=0.011, n=53) and marginally with OS (p=0.460; n=53). Moreover, Aurora-B protein expression was predictive for RFS of optimal debulked patients with taxane-based (p=0.006; n=32), but not with platinum-based (p=0.720; n=20) 1st-CTx. Aurora-B protein expression was not linked to OS in optimal debulked patients with either of the two 1st-CTx. CONCLUSIONS: Aurora-B protein expression frequently occurs in serous, FIGO stage III ovarian carcinomas, making it a 'drugable' molecular target in the majority of ovarian carcinoma patients. Moreover, Aurora-B protein expression is predictive for initial response to taxane-based 1st-CTx in optimal debulked, late stage ovarian carcinoma patients.