Kugonana

Mastectomy ndi opaleshoni yochotsa minofu ya m'mawere. Ena khungu ndi nipple amathanso kuchotsedwa. Komabe, opaleshoni yomwe imalepheretsa mawere ndi khungu tsopano imatha kuchitika pafupipafupi. Kuchita opaleshoniyi kumachitika nthawi zambiri kuchiza khansa ya m'mawere.

Asanayambe opaleshoni, mudzapatsidwa mankhwala oletsa ululu. Izi zikutanthauza kuti mudzakhala mukugona komanso osamva ululu panthawi yopaleshoni.

Pali mitundu yosiyanasiyana ya ma mastectomies. Zomwe dokotala wanu amachita zimadalira mtundu wa vuto lomwe muli nalo. Nthawi zambiri, mastectomy amachitika kuti athetse khansa. Komabe, nthawi zina amachitidwa pofuna kupewa khansa (prophylactic mastectomy).

Dokotalayo adzadula pachifuwa panu ndikupanga imodzi mwamagwiridwe awa:

• Matenda osungunula mawere: Dotolo amachotsa bere lonse, koma amasiya nipple ndi areola (bwalo lachikuda mozungulira nipple) m'malo mwake. Ngati muli ndi khansa, dokotalayo amatha kupanga ma biopsy am'magawo am'munsi kuti awone ngati khansayo yafalikira.
• Matenda osungira khungu: Dokotala wochotsa amachotsa bere ndi nsonga yamabele ndi areola ndikuchotsa khungu pang'ono. Ngati muli ndi khansa, dokotalayo amatha kupanga ma biopsy am'magawo am'munsi kuti awone ngati khansayo yafalikira.
• Kuchuluka kwa mastectomy kwathunthu kapena kosavuta: Dokotalayo amachotsa bere lonse limodzi ndi nipple ndi areola. Ngati muli ndi khansa, dokotalayo amatha kupanga ma biopsy am'magawo am'munsi kuti awone ngati khansayo yafalikira.
• Kusintha kwakukulu kwa mastectomy: Dokotala wochotsa amachotsa bere lonse ndi mawere ndi malo am'madzi pamodzi ndi ma lymph node ena pansi pa mkono.
• Radical mastectomy: Dokotala wochotsa amachotsa khungu pamwamba pa bere, ma lymph node onse pansi pa mkono, ndi minofu ya pachifuwa. Kuchita opaleshoniyi kumachitika kawirikawiri.
• Khungu limatsekedwa ndi sutures (ulusi).

Tirigu kapena timachubu tating'ono tating'ono kapena pulasitiki nthawi zambiri zimasiyidwa mchifuwa mwanu kuti muchotse madzimadzi owonjezera kuchokera pomwe panali minofu ya m'mawere.

Dokotala wa pulasitiki amatha kuyamba kumanganso bere panthawi yomweyi. Muthanso kusankha kukonzanso mabere nthawi ina. Ngati mukumanganso, kusamba khungu kapena nipple kungakhale kosankha.

Mastectomy imatenga pafupifupi 2 mpaka 3 maola.

MKAZI WOPHUNZITSIDWA NDI KHANSA YA M'MAFU

Chifukwa chofala kwambiri cha mastectomy ndi khansa ya m'mawere.

Ngati mwapezeka kuti muli ndi khansa ya m'mawere, lankhulani ndi omwe amakuthandizani pa zaumoyo wanu pazomwe mungasankhe:

• Lumpectomy ndipamene khansa ya m'mawere ndi minofu yozungulira khansa imachotsedwa. Izi zimatchedwanso kuti kusamalira mawere kapena ma mastectomy pang'ono. Mabere anu ambiri amasiyidwa.
• Mastectomy ndipamene minofu yonse ya m'mawere imachotsedwa.

Inu ndi omwe mumapereka muyenera kulingalira:

• Kukula ndi malo a chotupa chanu
• Khungu limakhudzidwa ndi chotupacho
• Ndi zotupa zingati zomwe zili pachifuwa
• Kuchuluka kwa bere kumakhudzidwa
• Kukula kwa bere lanu
• Zaka zanu
• Mbiri yazachipatala yomwe imatha kukupatula pakusamala m'mawere (izi zitha kuphatikizira ma radiation am'mbere asanachitike komanso matenda ena)
• Mbiri ya banja
• Thanzi lanu lonse komanso ngati mwafika kumapeto

Kusankha zomwe zingakuthandizeni kungakhale kovuta. Inu ndi omwe akukupatsani chithandizo cha khansa ya m'mawere mudzasankha limodzi zomwe zili zabwino.

AMAYI AMAKHALA PANGOZI KWAMBIRI KWA KHANSA YA M'BELE

Azimayi omwe ali pachiwopsezo chachikulu chokhala ndi khansa ya m'mawere atha kusankha kukhala ndi njira yoteteza (kapena prophylactic) mastectomy yochepetsa khansa ya m'mawere.

Mutha kukhala ndi khansa ya m'mawere ngati m'modzi kapena abale apabanja apafupi adadwala, makamaka adakali aang'ono. Mayeso achibadwa (monga BRCA1 kapena BRCA2) atha kuthandiza kuwonetsa kuti muli pachiwopsezo chachikulu. Komabe, ngakhale mutakhala ndi mayeso abwinobwino, mutha kukhala pachiwopsezo chachikulu cha khansa ya m'mawere, kutengera zina. Kungakhale kothandiza kukumana ndi mlangizi wa majini kuti muwone momwe muliri pachiwopsezo.

Prophylactic mastectomy iyenera kuchitika pokhapokha mukaganiza mozama ndikukambirana ndi dokotala wanu, mlangizi wamtundu, banja lanu, ndi okondedwa anu.

Mastectomy imachepetsa kwambiri chiopsezo cha khansa ya m'mawere, koma siyimachotsa.

Kukhwima, kuphulika, kutsegula kwa mabala, seroma, kapena kutayika kwa khungu m'mphepete mwa kudula kapena mkati mwa zikopa za khungu kumatha kuchitika.

Zowopsa:

• Kumva kupweteka ndi kuuma. Muthanso kumva zikhomo ndi singano komwe bere linali komanso pansi pa mkono.
• Kutupa kwa mkono kapena bere (lotchedwa lymphedema) mbali yomweyo ngati bere lomwe lachotsedwa. Kutupa uku sikofala, koma kungakhale vuto lomwe likupitilira.
• Kuwonongeka kwa mitsempha yomwe imapita kumatumba a mkono, kumbuyo, ndi pachifuwa.

Mutha kukhala ndi mayeso amwazi ndi kujambula (monga CT scan, bone scans, ndi chifuwa x-ray) pambuyo poti wothandizira wanu wapeza khansa ya m'mawere. Izi zachitika kuti muwone ngati khansara yafalikira kunja kwa mawere ndi ma lymph node pansi pa mkono.

Nthawi zonse uzani omwe amakupatsani ngati:

• Mutha kukhala ndi pakati
• Mukumwa mankhwala aliwonse kapena zitsamba kapena zowonjezera zomwe mudagula popanda mankhwala
• Mumasuta

Sabata isanachitike opaleshoni:

• Masiku angapo musanachite opareshoni, mungafunsidwe kuti musiye kumwa aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamini E, clopidogrel (Plavix), warfarin (Coumadin), ndi mankhwala ena aliwonse omwe amachititsa kuti zikhale zovuta kuti magazi anu agwidwe.
• Funsani mankhwala omwe muyenera kumwa patsiku la opareshoni.

Patsiku la opaleshoniyi:

• Tsatirani malangizo ochokera kwa dokotala kapena namwino wokhudza kudya kapena kumwa musanachite opaleshoni.
• Tengani mankhwala omwe adauzidwa kuti mumwe pang'ono pokha madzi.

Mudzauzidwa nthawi yobwera kuchipatala. Onetsetsani kuti mwafika nthawi.

Amayi ambiri amakhala mchipatala kwa maola 24 mpaka 48 pambuyo pa mastectomy. Kutalika kwanu kumakhala kumadalira mtundu wa opareshoni yomwe mudali nayo. Amayi ambiri amapita kunyumba ali ndi machubu okhalabe pachifuwa pambuyo pa mastectomy. Dokotala adzawachotsa pambuyo pake akuchezera ofesi. Namwino akuphunzitsani momwe mungayang'anire ngalande, kapena mutha kuthandizidwa ndi namwino wosamalira kunyumba.

Mutha kukhala ndi zowawa mozungulira tsamba lomwe mudulidwa mukadzachitidwa opaleshoni. Kupweteka kumakhala kosavuta pambuyo pa tsiku loyamba kenako kumatha milungu ingapo. Mudzalandira mankhwala opweteka musanatuluke kuchipatala.

Madzi amatha kusonkhanitsa m'dera lanu la mastectomy pambuyo poti madzi onse achotsedwa. Izi zimatchedwa seroma. Nthawi zambiri zimangopita zokha, koma zimafunika kukhetsedwa pogwiritsa ntchito singano (aspiration).

Amayi ambiri amachira atachira.

Kuphatikiza pa opaleshoni, mungafunikire chithandizo china cha khansa ya m'mawere. Mankhwalawa atha kuphatikizira ma hormonal therapy, radiation radiation, ndi chemotherapy. Zonse zimakhala ndi zovuta, chifukwa chake muyenera kukambirana ndi omwe akukuthandizani pazomwe mungasankhe.

Kuchotsa mawere opaleshoni; Matenda amkati osakanikirana; Nipple yosungira mastectomy; Chiwerewere chonse; Khungu losunga mastectomy; Simple mastectomy; Kusintha kwakukulu kwa mastectomy; Khansa ya m'mawere - mastectomy

• Pambuyo chemotherapy - kumaliseche
• Chifuwa cha kunja kwa mawere - kutulutsa
• Chest radiation - kumaliseche
• Zodzikongoletsera mawere opaleshoni - kumaliseche
• Kumwa madzi mosamala mukamalandira khansa
• Pakamwa pouma mukamalandira khansa
• Kudya ma calories owonjezera mukamadwala - akuluakulu
• Lymphedema - kudzisamalira
• Mastectomy ndi kumanganso mawere - zomwe mungafunse dokotala wanu
• Mastectomy - kumaliseche
• Oral mucositis - kudzisamalira
• Kudya mosamala panthawi ya chithandizo cha khansa
• Chisamaliro cha bala la opaleshoni - chotseguka

• Chifuwa chachikazi
• Mastectomy - mndandanda
• Kumanganso mawere - mndandanda

Davidson NE. Khansa ya m'mawere ndi zovuta zamawere. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 188.

Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Khansa ya m'mawere. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 88.

Kutha KK, Mittendorf EA. Matenda a m'mawere. Mu: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 34.

Macmillan RD. Kugonana. Mu: Dixon JM, Barber MD, olemba., Eds. Opaleshoni Ya m'mawere: Wothandizana Naye Kuchita Opaleshoni. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2019: 122-133.

Tsamba la National Comprehensive Cancer Network. Malangizo azachipatala a NCCN mu oncology: 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.