Kumvetsetsa Gawo la Khansa ya m'mawere

Zamkati

• Kodi khansa ya m'mawere imayambitsidwa motani?
• Kodi magawo a khansa ya m'mawere ndi ati?
• Gawo 0
• Gawo 1
• Gawo 2
• Gawo 3
• Gawo 4
• Khansa ya m'mawere yabwereza
• Kodi gawo la khansa ya m'mawere limakhudza zizindikilo?
• Kutalika kwa moyo ndi gawo
• Njira zochizira pamagawo
• Gawo 0
• Gawo 1, 2, ndi 3
• Gawo 4
• Kukhululukidwa ndi chiopsezo chobwereza
• Kutenga

Khansa ya m'mawere ndi khansa yomwe imayamba m'magulu, timadontho, kapena minofu yolumikizana ya m'mawere.

Khansa ya m'mawere yakhala ikuyambika kuyambira 0 mpaka 4. sitejiyi imawonetsa kukula kwa chotupa, kutenga mbali ya lymph, komanso momwe khansa imafalikira. Zinthu zina, monga kuchuluka kwa ma hormone receptor ndi chotupa, zimathandizidwanso kuti zizikhala.

Izi ndizofunikira pakupanga zisankho zamankhwala ndikumvetsetsa malingaliro anu onse.

Pitirizani kuwerenga kuti mudziwe momwe khansa ya m'mawere idayambira, momwe zimakhudzira chithandizo, komanso zomwe mungayembekezere.

Kodi khansa ya m'mawere imayambitsidwa motani?

Dokotala amatha kukayikira khansa ya m'mawere atawunika thupi, mammogram, kapena mayeso ena azithunzi. Atha kulimbikitsanso za biopsy, ndiyo njira yokhayo yotsimikizira kuti ali ndi khansa ya m'mawere.

Dokotala adzagwiritsa ntchito zotsatira kuchokera ku biopsy yanu kuti akupatseni gawo "lachipatala".

Pambuyo pa opareshoni kuti muchotse chotupacho, dokotala wanu athe kukufotokozerani zambiri zamatenda a lymph node, komanso malipoti ena okhudzana ndi matenda.

Panthawiyo, dokotala wanu adzakupatsani gawo lolondola kwambiri la "pathologic" pogwiritsa ntchito sikelo ya TNM. Nayi kuwonongeka kwa zomwe T, N, ndi M zikutanthauza:

T imakhudzana ndi kukula kwa chotupa.

• NKHANI. Chotupa sichingayesedwe.
• T0. Palibe umboni wa chotupa choyambirira.
• Tis. Chotupa sichinakule kukhala minofu yabere yathanzi (in situ).
• T1, T2, T3, T4. Kuchuluka kwa chiwerengerocho, ndikukula kwa chotupacho kapena momwe chimalowerera minofu ya m'mawere.

N imakhudzana ndi kutenga nawo mbali kwa lymph node.

• NX. Ma lymph node omwe ali pafupi sangathe kuyesedwa.
• Ayi. Palibe chotengera chapafupi chomwe chimakhudzidwa.
• N1, N2, N3. Kuchuluka kwa chiwerengerocho, m'pamenenso kutenga ma lymph node.

M imakhudzana ndi metastasis kunja kwa bere.

• MX. Sangathe kuyesedwa.
• M0. Palibe umboni wa kutalika kwa metastasis.
• M1. Khansa yafalikira mbali yakutali ya thupi.

Maguluwa akuphatikizidwa kuti apange siteji, koma izi zingakhudzenso magawo:

• udindo wa receptor wa estrogen
• udindo wa progesterone receptor
• HER2 / neu udindo

Komanso, zotupa zimayikidwa pamlingo wa 1 mpaka 3 kutengera momwe maselo a khansa amawonekera. Kutalika kwa kalasi, kumakulirakulira ndikufalikira.

Kodi magawo a khansa ya m'mawere ndi ati?

Gawo 0

Khansa ya m'mawere yosavomerezeka imaphatikizapo ductal carcinoma in situ (DCIS). Maselo achilendo sanalowerere minofu yapafupi.

Gawo 1

Gawo 1 lagawidwa magawo 1A ndi 1B.

Pa siteji 1A khansa ya m'mawere, chotupacho chimafika mpaka 2 sentimita, koma palibe chotupa chilichonse chomwe chimakhudzidwa.

Ndili ndi khansa ya m'mawere ya 1B, chotupacho sichichepera masentimita awiri, koma pali masango ang'onoang'ono a khansa m'matumba oyandikira.

Gawo 1B khansa ya m'mawere imaperekedwanso ngati palibe chotupa, koma pali masango ang'onoang'ono a khansa m'matumba am'mimba.

Zindikirani: Ngati chotupacho ndi estrogen receptor- kapena progesterone receptor-positive, itha kuyikidwa ngati 1A.

Gawo 2

Gawo 2 lagawidwa magawo 2A ndi 2B.

Gawo 2A limaperekedwa pazinthu izi:

• alibe chotupa, koma ma lymph node amodzi kapena atatu pansi pa mkono kapena pafupi ndi chifuwa cha m'mawere amakhala ndi maselo a khansa
• chotupa mpaka masentimita awiri, kuphatikiza khansa m'mitsempha yam'mimba pansi pa mkono
• chotupa pakati pa 2 ndi 5 sentimita, koma palibe chotengera cha lymph chotengera

Zindikirani: Ngati chotupacho chili ndi HER2-positive komanso estrogen receptor- ndi progesterone receptor-positive, chitha kusankhidwa kukhala gawo 1A.

Gawo 2B limaperekedwa pazinthu izi:

• chotupa pakati pa 2 ndi 5 masentimita, kuphatikiza masango ang'onoang'ono a khansa m'modzi mwa ma lymph node apafupi
• chotupa chokulirapo kuposa masentimita 5, koma palibe kutengera kwa ma lymph node

Zindikirani: Ngati chotupacho chili ndi HER2-positive ndi estrogen receptor- ndi progesterone receptor-positive, chitha kusankhidwa kukhala gawo 1.

Gawo 3

Gawo 3 lagawidwa magawo 3A, 3B, ndi 3C.

Gawo 3A limaperekedwa pazinthu izi:

• khansa m'magawo anayi kapena asanu ndi anayi apafupi, okhala ndi chotupa kapena opanda
• chotupa chachikulu kuposa masentimita 5, kuphatikiza masango ang'onoang'ono a khansa m'matumba am'mimba

Zindikirani: Ngati chotupa chokulirapo kuposa masentimita 5 ndi giredi 2, estrogen receptor-, progesterone receptor-, ndi HER2-positive, kuphatikiza khansa imapezeka m'magawo anayi mpaka asanu ndi anayi am'mimba am'mimba, amatha kutchedwa 1B.

Pa gawo 3B, chotupa chafika pakhoma pachifuwa, kuphatikiza khansa ikhoza kukhala ndi:

• kufalikira kapena kuthyola khungu
• imafalikira mpaka ma lymph node pansi pa mkono kapena pafupi ndi chifuwa

Zindikirani: Ngati chotupacho chili ndi estrogen receptor-positive ndi progesterone receptor-positive, ndiye kuti chitha kutchedwa Gawo 1 kapena 2 kutengera chotupa. Khansa ya m'mawere yotupa nthawi zonse imakhala yocheperako 3B.

Pa gawo 3C, sipangakhale chotupa pachifuwa. Koma ngati alipo, mwina adafika pakhoma pachifuwa kapena pakhungu la m'mawere, kuphatikiza:

• Zilonda zam'mimba 10 kapena zingapo zam'mutu
• Ma lymph lymph pafupi ndi kolala
• Zilonda zam'mimba pansi pa mkono komanso pafupi ndi chifuwa

Gawo 4

Gawo 4 limawerengedwa kuti ndi khansa ya m'mawere, kapena khansa ya m'mawere. Izi zikutanthauza kuti yafalikira kumadera akutali a thupi.Khansa ikhoza kupezeka m'mapapu, ubongo, chiwindi, kapena mafupa.

Khansa ya m'mawere yabwereza

Khansa yomwe imabweranso pambuyo pochiritsidwa bwino ndi khansa ya m'mawere yabwereza.

Kodi gawo la khansa ya m'mawere limakhudza zizindikilo?

Simungakhale ndi zizindikilo mpaka chotupa chikakwanira kuti mumve. Zizindikiro zina zoyambirira zimaphatikizaponso kusintha kukula kapena mawonekedwe a bere kapena nsonga yamabele, kutulutsa kuchokera kunsonga, kapena chotupa pansi pa mkono.

Zizindikiro zamtsogolo zimadalira pomwe khansara yafalikira ndipo imaphatikizaponso:

• kusowa chilakolako
• kuonda
• kupuma movutikira
• chifuwa
• mutu
• masomphenya awiri
• kupweteka kwa mafupa
• kufooka kwa minofu
• jaundice

Kutalika kwa moyo ndi gawo

Ngakhale atagawidwa ndi siteji, zimakhala zovuta kudziwa kutalika kwa moyo kwa munthu amene ali ndi khansa ya m'mawere chifukwa cha izi:

• Pali mitundu yambiri ya khansa ya m'mawere, ndipo imasiyanasiyana pamlingo wawo wankhanza. Ena alondolera chithandizo, pomwe ena satero.
• Chithandizo chabwino chimadalira zaka, mavuto ena azaumoyo, ndi chithandizo chomwe mungasankhe.
• Ziwerengero za opulumuka ndizoyesa kutengera anthu omwe adapezeka zaka zapitazo. Chithandizo chikuyenda mwachangu, chifukwa chake mutha kukhala ndi chiyembekezo chokhala ndi moyo kuposa omwe anapezeka ngakhale zaka zisanu zapitazo.

Ichi ndichifukwa chake simuyenera kutenga kuwerengera konse pamtima. Dokotala wanu akhoza kukupatsani malingaliro abwinowo pazomwe mungayembekezere kutengera mawonekedwe anu azaumoyo.

Surveillance, Epidemiology, and End Results Program (SEER) sichitsata kuchuluka kwa khansa ya m'mawere ndi mtundu kapena magawo 0 mpaka 4. Kuchuluka kwa kupulumuka kumafanizira anthu omwe ali ndi khansa ya m'mawere ndi anthu wamba.

Otsatirawa ndi SEER azaka zisanu omwe apulumuka poyerekeza ndi amayi omwe amapezeka pakati pa 2009 ndi 2015:

Njira zochizira pamagawo

Gawo ndilofunikira pakuzindikira chithandizo, koma pali zina, monga:

• mtundu wa khansa ya m'mawere
• chotupa
• estrogen receptor ndi progesterone receptor udindo
• HER2 udindo
• msinkhu komanso ngati mwafika kumapeto
• thanzi lathunthu

Dokotala wanu azilingalira zonsezi mukamapereka chithandizo. Anthu ambiri amafunikira mankhwala osiyanasiyana.

Gawo 0

• Opaleshoni yosunga bere (lumpectomy). Dokotala wanu amachotsa minofu yachilendo kuphatikiza pang'ono pathupi lathanzi.
• Kugonana. Dokotala wanu amachotsa bere lonse ndipo, nthawi zina, yang'anani ma lymph node pafupi ndi khansa.
• Thandizo la radiation. Mankhwalawa atha kulimbikitsidwa ngati mutakhala ndi lumpectomy.
• Opaleshoni yomanganso mawere. Mutha kukonza njirayi mwachangu kapena mtsogolo.
• Thandizo la mahomoni (tamoxifen kapena aromatase inhibitor). Dokotala wanu angakulimbikitseni chithandizochi pamene DCIS ili ndi estrogen receptor- kapena progesterone receptor-positive.

Gawo 1, 2, ndi 3

• lumpectomy kapena mastectomy ndikuchotsa ma lymph node kuti ayang'anire khansa
• kumanganso mawere nthawi yomweyo kapena mtsogolo
• chithandizo cha radiation, makamaka ngati mwasankha lumpectomy kuposa mastectomy
• chemotherapy
• mankhwala a mahomoni amtundu wa khansa ya estrogen yolandila komanso progesterone receptor-positive
• mankhwala osokoneza bongo monga trastuzumab (Herceptin) kapena pertuzumab (Perjeta) ya khansa ya HER2

Gawo 4

• chemotherapy yochepetsera zotupa kapena kukula pang'ono kwa chotupa
• opaleshoni kuti achotse zotupa kapena azizindikiro
• chithandizo cha radiation kuti muchepetse zizindikiro
• mankhwala osokoneza bongo a estrogen receptor-, progesterone receptor-, kapena khansa ya m'mawere ya HER2
• mankhwala ochepetsa ululu

Nthawi iliyonse, mutha kutenga nawo mbali pazoyeserera zamankhwala. Kafukufukuyu atha kukupatsirani mwayi wazithandizo zomwe zikukula. Funsani dokotala wanu za mayesero azachipatala omwe angakhale abwino kwa inu.

Kukhululukidwa ndi chiopsezo chobwereza

Kukhululukidwa kwathunthu kumatanthauza kuti zizindikilo zonse za khansa zatha.

Nthawi zina, maselo a khansa omwe amatsalira pambuyo pa chithandizo amatha kupanga zotupa zatsopano. Khansa imatha kubwereranso kwanuko, mdera lanu, kapena malo akutali. Ngakhale izi zitha kuchitika nthawi iliyonse, zili mkati mwa zaka zisanu zoyambirira.

Mukamaliza kulandira chithandizo, kuwunika pafupipafupi kuyenera kuphatikizapo kupita kuchipatala, kuyesa kuyerekezera, komanso kuyesa magazi kuti muwone ngati muli ndi khansa.

Kutenga

Khansa ya m'mawere yakhazikitsidwa kuyambira 0 mpaka 4. Mukadziwa mtundu ndi gawo, gulu lanu lazachipatala lithandizana nanu kusankha njira yabwino kwambiri.