Khansa ya m'mawere

Khansa ya m'mawere ndi khansa yomwe imayamba m'matumba a m'mawere. Pali mitundu iwiri ikuluikulu ya khansa ya m'mawere:

• Ductal carcinoma imayamba m'machubu (timadontho) timene timanyamula mkaka kuchokera pachifuwa kupita kunsonga. Khansa zambiri za m'mawere zimakhala zamtunduwu.
• Lobular carcinoma imayamba m'malo am'mabere, omwe amatchedwa lobules, omwe amatulutsa mkaka.

Nthawi zambiri, mitundu ina ya khansa ya m'mawere imatha kuyamba m'malo ena a bere.

Zomwe zimayambitsa khansa ya m'mawere ndi zinthu zomwe zimawonjezera mwayi wokhala ndi khansa ya m'mawere:

• Zina mwaziwopsezo zomwe mutha kuwongolera, monga kumwa mowa. Zina, monga mbiri ya banja, simungathe kuwongolera.
• Zomwe mumakhala pachiwopsezo chachikulu, chiwopsezo chanu chimakulirakulira. Koma, sizitanthauza kuti mudzakhala ndi khansa. Amayi ambiri omwe amakhala ndi khansa ya m'mawere alibe zoopsa zilizonse kapena mbiri yakubanja.
• Kumvetsetsa zoopsa zanu kungakuthandizeni kuchitapo kanthu kuti muchepetse chiopsezo chanu.

Amayi ena ali pachiwopsezo chachikulu cha khansa ya m'mawere chifukwa cha zina mwazomwe zimayikidwa kuchokera kwa makolo awo.

• Chibadwa chotchedwa BRCA1 kapena BRCA2 chimayambitsa matenda ambiri a khansa ya m'mawere.
• Chida chowunikira chokhala ndi mafunso okhudza mbiri ya banja lanu komanso yanu chitha kuthandiza othandizira anu azaumoyo ngati muli pachiwopsezo chonyamula majini awa.
• Ngati muli pachiwopsezo chachikulu, kukayezetsa magazi kuti muwone ngati muli ndi majini.
• Mitundu ina yamtundu wina imatha kubweretsa chiopsezo chowonjezeka cha khansa ya m'mawere.

Zodzala m'mawere, kugwiritsa ntchito antiperspirants, ndi kuvala ma bras a underwire sikuwonjezera chiopsezo cha khansa ya m'mawere. Palibenso umboni woti pali mgwirizano pakati pa khansa ya m'mawere ndi mankhwala ophera tizilombo.

Khansa ya m'mawere yoyambirira nthawi zambiri siyimayambitsa zizindikiro. Ichi ndichifukwa chake kuyezetsa mawere ndi mammograms nthawi zonse ndikofunikira, chifukwa chake khansa yomwe ilibe zizindikilo imatha kupezeka koyambirira.

Khansara ikukula, zizindikilo zimatha kuphatikiza:

• Mkota wamawere kapena chotupa m'khwapa chomwe ndi cholimba, chimakhala ndi m'mbali zosagwirizana, ndipo nthawi zambiri sichipweteka.
• Sinthani kukula, mawonekedwe, kapena kumva kwa bere kapena nsonga yamabele. Mwachitsanzo, mutha kukhala ndi redness, dimpling, kapena puckering yomwe imawoneka ngati khungu la lalanje.
• Zamadzimadzi kuchokera pachifuwa. Madzi amatha kukhala amwazi, owoneka achikaso, obiriwira, kapena owoneka ngati mafinya.

Amuna, zizindikiro za khansa ya m'mawere zimaphatikizapo chotupa cha m'mawere ndi kupweteka m'mawere ndi kukoma mtima.

Zizindikiro za khansa ya m'mawere ingaphatikizepo:

• Kupweteka kwa mafupa
• Kupweteka m'mimba kapena kusapeza bwino
• Zilonda pakhungu
• Kutupa kwamatenda am'mimba (pafupi ndi bere ndi khansa)
• Kuchepetsa thupi

Wopereka chithandizo chamankhwala amafunsa za zizindikilo zanu komanso zomwe zimayambitsa chiopsezo. Kenako wothandizirayo ayesa mayeso. Kuyesaku kumaphatikizapo mawere, khwapa, khosi ndi chifuwa.

Amayi amalimbikitsidwa kuti azidziyesa m'mabere mwezi uliwonse. Komabe, kufunikira kodziyesa nokha kuti mupeze khansa ya m'mawere sikungatheke.

Mayeso omwe amagwiritsidwa ntchito pofufuza ndikuwunika anthu omwe ali ndi khansa ya m'mawere atha kukhala:

• Zojambulajambula kuti ziwonetse khansa ya m'mawere kapena zithandizire kuzindikira chotupa cha m'mawere
• Mawere ultrasound kuti awonetse ngati chotupacho ndi cholimba kapena chodzaza madzi
• Chifuwa cha m'mawere, pogwiritsa ntchito njira monga aspiration aspiration, malangizo a ultrasound, stereotactic, kapena open
• Chifuwa cha MRI chothandizira kuzindikira bwino chotupa cha m'mawere kapena kuwunika kusintha kosasintha pa mammogram
• Sentinel lymph node biopsy kuti awone ngati khansara yafalikira ku ma lymph node
• Kuyeza kwa CT kuti muwone ngati khansara yafalikira kunja kwa bere
• PET scan kuti muwone ngati khansara yafalikira

Ngati dokotala atamva kuti muli ndi khansa ya m'mawere, mayeso ena adzachitika. Izi zimatchedwa staging, zomwe zimawunika ngati khansara yafalikira. Kuyika masitepe kumathandizira kuwongolera chithandizo ndikutsata. Ikukupatsaninso lingaliro la zomwe muyenera kuyembekezera mtsogolo.

Magawo a khansa ya m'mawere amachokera pa 0 mpaka IV. Kutalika kwa siteji, khansa imakulirakulira.

Chithandizo chimadalira pazinthu zambiri, kuphatikizapo:

• Mtundu wa khansa ya m'mawere
• Gawo la khansa (kusanja ndi chida chomwe operekera anu amagwiritsa ntchito kuti adziwe momwe khansara yayendera)
• Kaya khansara imakhudzidwa ndi mahomoni ena
• Kaya khansa ipitilira (overexpresses) puloteni ya HER2 / neu

Mankhwala a khansa angaphatikizepo:

• Thandizo la mahomoni.
• Chemotherapy, yomwe imagwiritsa ntchito mankhwala kupha ma cell a khansa.
• Thandizo la radiation, lomwe limagwiritsidwa ntchito kuwononga minofu ya khansa.
• Opaleshoni yochotsa minofu ya khansa: Chotupa chimachotsa chotupa cha m'mawere. Mastectomy amachotsa onse kapena gawo la bere komanso nyumba zapafupi. Ma lymph node apafupi amathanso kuchotsedwa pakuchita opaleshoni.
• Chithandizo chomwe akuyembekeza chimagwiritsa ntchito mankhwala pothana ndi kusintha kwa majini m'maselo a khansa. Thandizo la mahomoni ndi chitsanzo cha mankhwala omwe akuwatsata. Imaletsa mahomoni ena omwe amalimbikitsa kukula kwa khansa.

Kuchiza khansa kumatha kukhala kwanuko kapena kwadongosolo:

• Mankhwala am'deralo amangokhudza matenda okhaokha. Poizoniyu ndi opaleshoni ndi njira zochiritsira zakomweko. Zimathandiza kwambiri ngati khansara siinafalikire kunja kwa bere.
• Mankhwala amachitidwe amakhudza thupi lonse. Chemotherapy ndi mankhwala a mahomoni ndi mitundu yamankhwala ochiritsira.

Amayi ambiri amalandira mankhwala osiyanasiyana. Kwa amayi omwe ali ndi khansa ya m'mawere ya siteji I, II, kapena III, cholinga chawo chachikulu ndikuchiza khansa ndikuitchinjiriza kuti isabwerere (mobwerezabwereza). Kwa amayi omwe ali ndi khansa yapa IV, cholinga ndikukulitsa zizindikilo ndikuwathandiza kukhala ndi moyo wautali. Nthaŵi zambiri, khansa ya m'mawere ya IV ya m'mawere sichitha.

• Gawo 0 ndi ductal carcinoma: Lumpectomy kuphatikiza radiation kapena mastectomy ndiye mankhwala wamba.
• Gawo I ndi II: Lumpectomy kuphatikiza radiation kapena mastectomy yokhala ndi lymph node kuchotsa ndiye mankhwala wamba. Chemotherapy, mankhwala a mahomoni, ndi mankhwala ena omwe angagwiritsidwe ntchito atha kugwiritsidwanso ntchito atachitidwa opaleshoni.
• Gawo lachitatu: Chithandizo chimaphatikizapo kuchitidwa opareshoni, mwina yotsatiridwa ndi chemotherapy, mankhwala a mahomoni, ndi chithandizo china chofunikira.
• Gawo lachinayi: Chithandizo chitha kuphatikizira kuchitidwa ma radiation, radiation, chemotherapy, mankhwala a mahomoni, njira zina zothandizira, kapena kuphatikiza kwa mankhwalawa.

Akalandira chithandizo, amayi ena amapitiliza kumwa mankhwala kwakanthawi. Amayi onse amapitiliza kuyezetsa magazi, mammograms, ndi mayeso ena atalandira chithandizo kuti awunikire kubwerera kwa khansa kapena khansa ina ya m'mawere.

Azimayi omwe adachitapo kachilomboka amatha kuchitidwa opaleshoni ya m'mawere. Izi zidzachitika mwina nthawi ya mastectomy kapena mtsogolo.

Mutha kuchepetsa nkhawa zamankhwala ndikulowa nawo gulu lothandizira khansa. Kugawana ndi ena omwe akumana ndi mavuto omwe akukumana nawo kungakuthandizeni kuti musamve nokha.

Mankhwala atsopano, othandiza amathandiza anthu omwe ali ndi khansa ya m'mawere kuti azikhala motalikirapo. Ngakhale atalandira chithandizo, khansa ya m'mawere imafalikira mbali zina za thupi. Nthawi zina, khansa imabweranso, ngakhale chotupa chonsecho chitachotsedwa ndipo ma lymph node apafupi amapezeka kuti alibe khansa.

Amayi ena omwe adakhala ndi khansa ya m'mawere amakhala ndi khansa yatsopano ya m'mawere yosagwirizana ndi chotupa choyambirira.

Momwe mumachitira mutalandira chithandizo cha khansa ya m'mawere zimadalira zinthu zambiri. Khansa yanu ikakulirakulira, zotsatira zake zimakhala zosauka. Zina mwazomwe zimatsimikizira kuopsa kobwerezabwereza komanso mwayi wothandizidwa bwino ndi izi:

• Kumene kuli chotupacho komanso momwe chafalikira
• Kaya chotupacho ndi cholandilira kapena sichabwino
• Zolemba zotupa
• Gene kufotokoza
• Kukula kwa chotupa ndi mawonekedwe
• Kuchuluka kwa magawano am'maselo kapena kukula kwa chotupacho

Pambuyo pokambirana zonsezi, omwe akukuthandizani akhoza kukambirana za chiopsezo chanu chobwereza khansa ya m'mawere.

Mutha kukhala ndi zovuta kapena zovuta zamankhwala a khansa. Izi zitha kuphatikizira kupweteka kwakanthawi kapena kutupa kwa bere ndi malo oyandikana nawo. Funsani omwe akukuthandizani pazovuta zomwe zingachitike chifukwa chothandizidwa.

Lumikizanani ndi omwe amakupatsani ngati:

• Muli ndi chotupa cha m'mawere kapena chapakhosi
• Mumatuluka mawere

Mukalandira chithandizo cha khansa ya m'mawere, itanani omwe akukuthandizani ngati mukukula ndi matenda monga:

• Kutulutsa kwamabele
• Ziphuphu pa bere
• Ziphuphu zatsopano m'mawere
• Kutupa m'deralo
• Ululu, makamaka kupweteka pachifuwa, kupweteka m'mimba, kapena kupweteka kwa mafupa

Lankhulani ndi omwe akukuthandizani za kangati momwe mungakhalire ndi mammogram kapena mayeso ena kuti muwonetse khansa ya m'mawere. Khansa yoyambirira ya m'mawere yomwe imapezeka ndi mammogram imakhala ndi mwayi wochiritsidwa.

Tamoxifen imavomerezedwa kupewa khansa ya m'mawere azimayi azaka 35 kapena kupitilira apo omwe ali pachiwopsezo chachikulu. Kambiranani izi ndi omwe akukuthandizani.

Azimayi omwe ali pachiwopsezo chachikulu cha khansa ya m'mawere amatha kuganiza zodzitetezera (prophylactic) mastectomy. Uku ndi opaleshoni yochotsa mabere khansa ya m'mawere isanapezeke. Okhala nawo ndi awa:

• Amayi omwe adachotsedwa kale bere limodzi chifukwa cha khansa
• Amayi omwe ali ndi mbiri yolimba ya khansa ya m'mawere
• Amayi omwe ali ndi majini kapena kusintha kwa majini komwe kumawonjezera chiopsezo cha khansa ya m'mawere (monga BRCA1 kapena BRCA2)

Zinthu zambiri zoopsa, monga chibadwa chanu komanso mbiri ya banja, sizingayang'aniridwe.Koma kusintha moyo wathanzi kumachepetsa mwayi wanu wonse wokhala ndi khansa. Izi zikuphatikiza:

• Kudya zakudya zabwino
• Kukhala wathanzi labwino
• Kuchepetsa kumwa mowa kamodzi pa tsiku

Khansa - bere; Carcinoma - ductal; Carcinoma - lobular; DCIS; LCIS; Khansa ya m'mawere ya HER2; Khansa ya m'mawere ya ER; Ductal carcinoma mu situ; Lobular carcinoma mu situ

• Chifuwa cha kunja kwa mawere - kutulutsa
• Chemotherapy - zomwe mungafunse dokotala wanu
• Lymphedema - kudzisamalira
• Mastectomy ndi kumanganso mawere - zomwe mungafunse dokotala wanu
• Mastectomy - kumaliseche
• Thandizo la radiation - mafunso omwe mungafunse dokotala wanu

• Chifuwa chachikazi
• Singano biopsy ya m'mawere
• Tsegulani zolemba za m'mawere
• Kudziyesa mabere
• Kudziyesa mabere
• Kudziyesa mabere
• Lumpectomy
• Kuchotsa chotupa cha m'mawere - mndandanda
• Mastectomy - mndandanda
• Chidziwitso cha Sentinel

Makhoul I. Njira zothandizira khansa ya m'mawere. Mu: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, olemba. Chifuwa: Kusamalira kwathunthu kwa matenda a Benign ndi Malignant. 5th ed. Philadelphia, PA: Elsevier; 2018: chap 24.

Tsamba la National Cancer Institute. Chithandizo cha khansa ya m'mawere (wamkulu) (PDQ) - mtundu wa akatswiri azaumoyo. www.cancer.gov/types/breast/hp/chithandizo-chifupa-pdq. Idasinthidwa pa February 12, 2020. Idapezeka pa February 25, 2020.

Tsamba la National Comprehensive Cancer Network. Malangizo azachipatala a NCCN mu oncology (malangizo a NCCN): Khansa ya m'mawere. Mtundu wa 2.2020. www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Idasinthidwa pa February 5, 2020. Idapezeka pa February 25, 2020.

Siu AL; Gulu Lankhondo Loteteza ku US. Kuunikira khansa ya m'mawere: Ndemanga ya US Preventive Services Task Force. Ann Intern Med. 2016; 164 (4): 279-296. [Adasankhidwa] PMID: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.

Gulu Lankhondo Laku US Lodzitchinjiriza, Owens DK, Davidson KW, et al. Kuwunika zowopsa, upangiri wa majini, komanso kuyesa kwa majini a khansa yokhudzana ndi BRCA: US Preventive Services Task Force Recommendation Statement [kukonza kofalitsa kumapezeka ku JAMA. 2019; 322 (18): 1830]. JAMA. 2019; 322 (7): 652-665. PMID: 31429903 pubed.ncbi.nlm.nih.gov/31429903/.