Khansa Nditha Kulimbana Nayo. Kutaya Chifuwa Changa Sindingathe

Zamkati

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• Fiona MacNeill ndi wamkulu zaka zingapo kuposa ine, wazaka za m'ma 50.
• Chithandizo cha khansa ya m'mawere chikukula kwambiri.
• Koma kuseketsa zomwe zikuchitika kwa amayi pambuyo pa mastectomy ndizovuta.
• Sabata yatha kuchotsedwa kwa mastectomy, ndidabwereranso kuchipatala kukachotsa lumpectomy.

Taxi idafika mbandakucha koma imatha kubwera ngakhale koyambirira; Ndikanakhala nditagona usiku wonse. Ndinkachita mantha ndi tsiku lomwe likubwera komanso tanthauzo lake kwa moyo wanga wonse.

Kuchipatala ndidasintha chovala chapamwamba kwambiri chomwe chimanditenthetsa nthawi yayitali ndikakhala kuti ndakomoka, ndipo dotolo wanga adabwera kudzandipimitsa chisanachitike. Sanali mpaka pakhomo, pafupi kutuluka m'chipindacho, pomwe mantha anga pamapeto pake adapeza mawu. “Chonde,” ndinatero. "Ndikufuna thandizo lanu. Mungandiuzenso nthawi ina: ndichifukwa chiyani ndikufunika kuchita izi? ”

Anabwereranso kwa ine, ndipo ndinamuwona pankhope pake kuti akudziwa kale zomwe mkati mwanga ndimamva. Opaleshoni iyi sichinachitike. Tiyenera kupeza njira ina.

Khansa ya m'mawere inali itakuta moyo wanga masabata angapo m'mbuyomu, pomwe ndidazindikira kaching'onoting'ono pafupi ndi bumbu langa lamanzere. GP idaganiza kuti sichinali kanthu - koma bwanji ndikuika pachiwopsezo, adafunsa mokondwera, ndikudina kiyibodi yake kuti atumize kutumizako.

Ku chipatala patatha masiku khumi, nkhaniyi idawonekeranso kukhala yopatsa chiyembekezo: mammogram inali yomveka, mlangiziyo adaganiza kuti ndi chotupa. Patatha masiku asanu, kubwerera ku chipatala, kusaka kwa mlangizi kunapezeka kuti kulakwitsa. Biopsy idawulula kuti ndinali ndi kalasi yachiwiri ya invasive carcinoma.

Ndinadabwa, koma osakhumudwa. Mlangizi uja adanditsimikizira kuti ndiyenera kukhala woyenera kuchita zomwe adatcha kuti opaleshoni yosamalira bere, kuchotsa zokhazokha zomwe zimakhudzidwa (izi zimadziwika kuti lumpectomy). Uwo ungadzakhale kulosera kwina kolakwika, ngakhale ndili wokondwa ndi chiyembekezo choyambirira chomwe chidandipatsa. Khansa, ndimaganiza, nditha kuthana nayo. Kutaya bere langa sindinathe.

Kuwombera kosintha kwamasewera kudabwera sabata yotsatira. Chotupa changa chinali chovuta kuchipeza chifukwa chinali m'makanda a bere, mosiyana ndi ma ducts (pomwe pafupifupi 80% ya khansa ya m'mawere imayamba). Khansara yam'mimba nthawi zambiri imanyenga mammography, koma imakonda kuwonekera pakuwunika kwa MRI. Ndipo zotsatira zakuwunika kwanga kwa MRI zidandipweteka.

Chotupa cholumikizidwa pachifuwa changa chinali chachikulu kwambiri kuposa momwe ultrasound imanenera, mpaka 10 cm kutalika (10 cm! Sindinamvepo za aliyense yemwe ali ndi chotupa chachikulu chotere). Dokotala yemwe adaulula nkhaniyi sanayang'ane nkhope yanga; maso ake adalumikizidwa pakompyuta yake, zida zake motsutsana ndi kutengeka kwanga. Tinali otalikirana mainchesi koma tikadakhala m'mapulaneti osiyanasiyana. M'mene amayamba kuwombera mawu ngati "implant", "dorsi flap" ndi "nipple reconstruction" kwa ine, ndinali ndisanayambe kufalitsa nkhani yoti, kwa moyo wanga wonse, ndikadakhala ndi bere limodzi.

Dokotala uyu amawoneka wokonda kwambiri masiku olankhula za opaleshoni kuposa kundithandiza kuzindikira za maelstrom. Chinthu chimodzi chomwe ndidazindikira ndikuti ndiyenera kuchoka kwa iye. Tsiku lotsatira mnzake adanditumizira mndandanda wa alangizi ena, koma ndiyambira pati? Ndiyeno ndinazindikira kuti dzina limodzi lokha pandandanda linali la mkazi. Ndinaganiza zoyesa kupeza nthawi yoti ndikamuwonane.

Fiona MacNeill ndi wamkulu zaka zingapo kuposa ine, wazaka za m'ma 50.

Sindikukumbukira chilichonse chokhudza kucheza kwathu koyamba, patangopita masiku ochepa nditawerenga dzina lake. Ndinali onse panyanja, ndikuyenda mozungulira. Koma mu mphepo yamphamvu ya 10 yomwe moyo wanga udakhala modzidzimutsa, MacNeill ndidakhala koyamba kuwona malo owuma kwa masiku angapo. Ndinadziwa kuti ndi munthu amene ndimamukhulupirira. Ndinamva kukhala wosangalala kwambiri m'manja mwake kotero kuti ndinali nditayamba kufafaniza kuopsa kotayika bere langa.

Zomwe sindimadziwa ndiye kuti ndikumverera kotani komwe azimayi amakhala nako pamawere awo. Pamapeto pake pali omwe ali ndi njira yowanyamulira, yomwe imawona kuti mabere awo sali ofunika kwenikweni kuti adziwike. Pomwe pali azimayi onga ine, omwe mabere amawoneka ofunikira ngati mtima kapena mapapo.

Zomwe ndapezanso ndikuti nthawi zambiri pamakhala kuvomereza pang'ono kapena ayi. Amayi ambiri omwe ali ndi opaleshoni yosintha moyo wa khansa ya m'mawere alibe mwayi wokaonana ndi katswiri wamaganizidwe asanafike.

Ndikadapatsidwa mwayiwu, zikadakhala zowonekeratu m'mphindi khumi zoyambirira momwe ndinaliri wosasangalala, mkati mwanga, poganiza zotaya bere langa. Ndipo ngakhale akatswiri a khansa ya m'mawere akudziwa kuti thandizo lamaganizidwe lingakhale mwayi waukulu kwa azimayi ambiri, kuchuluka kwa omwe amapezeka kumapangitsa kukhala kosathandiza.

M'zipatala zambiri za NHS, zithandizo zama psychology zothandizira khansa ya m'mawere ndizochepa. A Mark Sibbering, ochita opaleshoni ya m'mawere ku Royal Derby Hospital komanso omwe amalowa m'malo mwa MacNeill kukhala Purezidenti wa Association of Breast Surgery, akuti ambiri amagwiritsidwa ntchito m'magulu awiri: odwala omwe akuganiza zochitidwa opaleshoni yochepetsera chiopsezo chifukwa amakhala ndi kusintha kwa majini komwe kumawapangitsa khansa ya m'mawere, ndi omwe ali ndi khansa pachifuwa chimodzi omwe akuganizira za matumbo a omwe sanakhudzidwe.

Chimodzi mwazifukwa zomwe ndidadzimvera chisoni chifukwa chotaya bere langa chinali chifukwa MacNeill adapeza njira yabwinoko kuposa njira yomwe dotolo wina woperekayo anali kupereka: kumangidwanso kwa DIEP. Wotchedwa pambuyo pamitsempha yamagazi m'mimba, njirayi imagwiritsa ntchito khungu ndi mafuta kuchokera pamenepo kumanganso bere. Linalonjeza chinthu chotsatira kwambiri kusunga bere langa, ndipo ndinali ndi chidaliro chachikulu kwa dokotala wa opaleshoni wapulasitiki yemwe ati adzamangidwenso monga momwe ndinachitira ku MacNeill, yemwe amati achite mastectomy.

Koma ndine mtolankhani, ndipo pano luso langa lofufuzira landilepheretsa. Zomwe ndimayenera kufunsa zinali izi: kodi pali njira zina m'malo mwa mastectomy?

Ndinali kukumana ndi maopareshoni akulu, opareshoni ya maola 10 mpaka 12. Zikanandisiya ndi bere latsopano lomwe sindimatha kulimva ndi zipsera zoopsa pachifuwa panga ndi pamimba panga, ndipo sindingathenso kukhala ndi nipple yakumanzere (ngakhale kumangidwanso kwa mawere kuli kotheka kwa anthu ena). Koma nditavala zovala zanga, mosakayikira ndimayang'ana modabwitsa, ndimatumba otupa ndi mimba yocheperako.

Ndimakhala ndi chiyembekezo. Koma pomwe ndimawoneka kwa omwe anali pafupi nane kuti ndikusunthira molimba mtima kukonza, chikumbumtima changa chinali kubwerera kutali. Inde ndimadziwa kuti opaleshoniyi ichotsa khansa, koma zomwe sindinathe kuziyerekeza ndi momwe ndimamvera za thupi langa latsopano.

Nthawi zonse ndimakonda mabere anga, ndipo ndi ofunikira kuti ndidziwe. Ndi gawo lofunikira pakugonana kwanga, ndipo ndimayamwitsa aliyense wa ana anga anayi kwa zaka zitatu. Mantha anga akulu anali akuti ndikachepetsedwa ndi minyewa, kuti sindidzamvanso bwino, kapena kudzidalira kapena kukhala womasuka ndi ine ndekha.

Ndinakana malingaliro awa malinga momwe ndingathere, koma m'mawa wa opareshoni kunalibe pobisalira. Sindikudziwa zomwe ndimayembekezera pomwe pamapeto pake ndidatulutsa mantha anga. Ndikulingalira ndimaganiza kuti MacNeill abwerera m'chipindacho, nakhala pansi pakama ndikundilankhula. Mwinanso ndimangofunika kugwirana ndi dzanja ndikulimbikitsidwa kuti zonse zikhala bwino pamapeto pake.

Koma MacNeill sanandipatseko zokambirana. Komanso sanayese kundiuza kuti ndimachita zabwino. Zomwe ananena ndi izi: "Muyenera kukhala ndi chiberekero ngati mukutsimikiza kuti ndichinthu choyenera. "Ngati simukutsimikiza, sitiyenera kuchita opaleshoniyi - chifukwa idzasintha moyo, ndipo ngati simunakonzekere kusintha kumeneku mwina kukhudza tsogolo lanu."

Zinatenga ola limodzi kapena apo tisanapange chisankho chotsimikiza. Mwamuna wanga amafunikira kukhulupirira kuti inali njira yoyenera, ndipo ndimafunikira kuyankhula ndi MacNeill pazomwe angachite m'malo mochotsa khansa (kwenikweni, amayesa lumpectomy; sakanakhoza kulonjeza kuti adzatha kuti andichotse ndikundisiya ndili ndi bere labwino, koma amachita zonse zomwe angathe). Koma kuyambira pomwe adayankha momwe amachitira, ndidadziwa kuti mastectomy sangachitike, ndikuti inali yankho lolakwika kwa ine.

Zomwe zidawonekera kwa tonsefe ndikuti thanzi langa lamaganizidwe lidali pachiwopsezo. Zachidziwikire ndimafuna kuti khansara ipite, koma nthawi yomweyo ndimafuna kuti ndikhale wopanda nkhawa.

Kwa zaka zitatu ndi theka kuyambira tsiku lomwelo ndili mchipatala, ndasungidwanso nthawi zambiri ndi MacNeill.

Chimodzi mwazomwe ndaphunzira kuchokera kwa iye ndikuti amayi ambiri molakwika amakhulupirira kuti mastectomy ndiyo njira yokhayo kapena yotetezeka yothanirana ndi khansa yawo.

Anandiuza kuti azimayi ambiri omwe amatenga chotupa cha m'mawere - kapena khansa ya m'mawere yomwe imayambiranso monga ductal carcinoma mu situ (DCIS) - khulupirirani kuti kupereka limodzi kapena mabere awo onse kudzawapatsa zomwe akufuna: mwayi wokhala ndi moyo wopanda tsogolo la khansa.

Umenewo udawoneka ngati uthenga womwe anthu adatenga kuchokera ku chisankho chodziwika bwino cha Angelina Jolie mu 2013 chokhala ndi mastectomy awiri. Koma sikunali kuchiza khansa yeniyeni; chinali chodzitchinjiriza kwathunthu, chosankhidwa atazindikira kuti anali ndi mtundu wowopsa wa jini la BRCA. Izi, komabe, zinali zosangalatsa kwa ambiri.

Zowona za mastectomy ndizovuta, koma azimayi ambiri amachitidwa kamodzi kapena kawiri osadukiza. Chifukwa chiyani? Chifukwa chinthu choyamba chomwe chimakuchitikirani mukauzidwa kuti muli ndi khansa ya m'mawere ndikuti mumachita mantha kwambiri. Chimene mumawopa kwambiri ndichachidziwikire: kuti mufa. Ndipo mukudziwa kuti mutha kupitiriza kukhala opanda bere lanu, ndiye mukuganiza ngati kuwachotsa ndichinsinsi chokhala ndi moyo, ndinu okonzeka kutsanzikana nawo.

M'malo mwake, ngati mwakhala ndi khansa pachifuwa chimodzi, chiwopsezo chotenga m'mawere anu ena chimakhala chocheperako poyerekeza ndi khansa yoyambirira yomwe ingabwerere mbali ina ya thupi lanu.

Mlandu wa mastectomy mwina ungakhale wokopa kwambiri mukauzidwa kuti mutha kumangidwanso komwe kungafanane ndi chinthu chenicheni, mwina ndikumangapo mimba. Koma pano pali vuto: pomwe ambiri mwa iwo omwe amapanga chisankhochi amakhulupirira kuti akuchita zotetezeka komanso zotetezeka kuti adziteteze ku imfa ndi matenda amtsogolo, chowonadi sichimveka bwino.

"Azimayi ambiri amafunsira kuti azichita masewera olimbitsa thupi kawiri chifukwa amaganiza kuti zitanthauza kuti sangathenso khansa ya m'mawere, kapena sadzafa nayo," akutero MacNeill. “Ndipo madokotala ena ochita opaleshoni amangofikira zolemba zawo. Koma zomwe ayenera kuchita ndikufunsa: chifukwa chiyani mukufuna kuchita masewera olimbitsa thupi? Mukuyembekeza kukwaniritsa chiyani? ”

Ndipo panthawiyi, akuti, azimayi nthawi zambiri amati, "Chifukwa sindikufunanso kuti ndiwatenge," kapena "Sindikufuna kufa nawo," kapena "Sindikufunanso kulandira chemotherapy." "Kenako mutha kukambirana," akutero MacNeill, "chifukwa palibe zokhumba izi zomwe zingakwaniritsidwe mwa kuchita masewera olimbitsa thupi."

Madokotala ochita opaleshoni ndi anthu okha. Afuna kuyang'ana kwambiri pazabwino, atero a MacNeill. Chowonadi chosamvetsetseka kwambiri cha mastectomy, akuti, ndi ichi: kusankha ngati wodwala ayenera kapena alibe sayenera kukhala ndi vuto lomwe limayambitsidwa ndi khansa. "Ndi lingaliro lamaluso, osati chisankho cha khansa.

“Zitha kuti khansara ndi yayikulu kwambiri kwakuti simungathe kuichotsa ndikusiya mawere aliwonse; kapena mwina bere ndi laling'ono kwambiri, ndipo kuchotsa chotupacho kungatanthauze kuchotsa ambiri [mabere]. Zonsezi ndizokhudza kuchuluka kwa khansa poyerekeza ndi kuchuluka kwa bere. "

A Mark Sibbering akuvomereza. Zokambirana zomwe dokotala wochita mawere amafunika kukhala ndi mayi yemwe wapezeka kuti ali ndi khansa, akuti, ndizovuta kwambiri kulingalira.

"Azimayi omwe amapezeka kuti ali ndi khansa ya m'mawere amabwera ndi magawo osiyanasiyana a chidziwitso cha khansa ya m'mawere, komanso malingaliro amomwe angagwiritsire ntchito chithandizo chamankhwala," akutero. Nthawi zambiri umayenera kuweruza zomwe zakambidwazo molingana. ”

Mwachitsanzo, akuti, mayi yemwe ali ndi khansa ya m'mawere yomwe angomupeza kumene atha kufunsa kuti awonongeke. Koma ngati ali ndi khansa ya m'mawere yowopsa, yomwe ingawopsyeze moyo wake, chithandizo chake chimayenera kukhala choyambirira. Kuchotsa bere lina sikungasinthe zotsatira za chithandizochi koma, a Sibbering akuti, "achulukitsa zovuta zamankhwala ndikuwonjezera mwayi wazovuta zomwe zingachedwetse chithandizo chofunikira monga chemotherapy".

Pokhapokha ngati wodwala akudziwa kale kuti ali pachiwopsezo chambiri cha khansa yachiwiri ya m'mawere chifukwa wanyamula kusintha kwa BRCA, Sibbering akuti amanyansidwa kuti achite maopareshoni apadziko lonse lapansi. Cholinga chake ndikuti azimayi omwe angopezedwa kumene kuti apange zisankho mozindikira, osaganizira zakufunika kuthamangira kuchitidwa opaleshoni.

Ndikuganiza kuti ndidafika pafupi momwe zingathere kuti ndikwaniritse chisankho chomwe ndikukhulupirira ndikadadandaula nacho. Ndipo ndikuganiza kuti pali azimayi kunja uko omwe akanatha kupanga chisankho china ngati akanadziwa zonse zomwe akudziwa tsopano.

Ndikufufuza nkhaniyi, ndidafunsa gulu lina lanthabwala za khansa za omwe adapulumuka khansa omwe amawapereka ngati olankhulira atolankhani kuti akambirane milandu yawo. Othandizirawo adandiuza kuti alibe kafukufuku wamilandu wa anthu omwe samadzidalira chifukwa cha zisankho zomwe adachita. "Kafukufuku wamtunduwu amavomereza kuti akhale olankhulira chifukwa amanyadira zomwe akumana nazo komanso mawonekedwe awo atsopano," ofalitsa nkhani anandiuza. "Anthu omwe amadzikayikira amakhala kutali ndi anthu owonekera."

Zachidziwikire kuti pali azimayi ambiri kunja uko omwe akukhutira ndi zisankho zomwe adapanga. Chaka chatha ndidafunsa wailesi yaku Britain komanso mtolankhani Victoria Derbyshire. Anali ndi khansa yofanana kwambiri ndi ine, chotupa cha lobular chomwe chinali 66 mm pofika nthawi yomwe chimapezeka, ndipo anasankha kuchita mastectomy ndikumanganso mawere.

Anasankhanso chomera m'malo momangidwanso ndi DIEP chifukwa chomera ndi njira yofulumira komanso yosavuta yomangidwanso, ngakhale kuti siwachilengedwe monga opaleshoni yomwe ndidasankha. Victoria samva kuti mabere ake amamutanthauzira: ali kumapeto ena kwa ine. Amasangalala kwambiri ndi chisankho chomwe adapanga. Ndikumvetsa chisankho chake, ndipo amatha kumvetsetsa changa.

Chithandizo cha khansa ya m'mawere chikukula kwambiri.

Zosintha zovuta kwambiri zimayenera kuyezedwa zomwe zikugwirizana ndi matendawa, njira zamankhwala, momwe mayi akumvera ndi thupi lake, komanso malingaliro ake pachiwopsezo. Zonsezi ndichinthu chabwino - koma zikhala bwino kwambiri, m'malingaliro mwanga, pakakhala zokambirana zowona mtima pazomwe mastectomy imatha kuchita komanso sangathe kuchita.

Kuyang'ana zomwe zapezedwa posachedwa, zakhala zikuchitika kuti azimayi ochulukirapo omwe ali ndi khansa pachifuwa chimodzi akusankha ma mastectomy awiri. Pakati pa 1998 ndi 2011 ku US, mitengo ya mastectomy iwiri pakati pa amayi omwe ali ndi khansa pachifuwa chimodzi chokha.

Kuwonjezeka kudawonekeranso ku England pakati pa 2002 ndi 2009: mwa azimayi omwe adachitidwa kansa yoyamba ya m'mawere, kuchuluka kwa mastectomy kawiri.

Koma kodi umboni ukugwirizana ndi izi? Kuwunika kwa Cochrane mu 2010 kumaliza motere: "Kwa azimayi omwe adakhala ndi khansa pachifuwa chimodzi (motero amakhala pachiwopsezo chachikulu chotenga khansa yoyamba mu linalo) kuchotsa bere lina (contralateral prophylactic mastectomy kapena CPM) kumachepetsa kuchepa kwa khansa pachifuwa china, koma palibe umboni wokwanira wosonyeza kuti izi zimathandizira kupulumuka. ”

Kuwonjezeka kwa US kuyenera, mwa zina, kukhala chifukwa cha momwe ndalama zimathandizira - amayi omwe ali ndi inshuwaransi yabwino amakhala ndi ufulu wambiri. Ma mastectomies awiri amathanso kukhala njira yosangalatsa kwa ena chifukwa kumangidwanso kwambiri ku US kumachitika pogwiritsa ntchito ma implants m'malo mwa minofu ya thupi la wodwalayo - ndipo kuyika mu bere limodzi lokha kumatulutsa zotsatira zosakanikirana.

"Koma," akutero MacNeill, "kuwirikiza kawiri kuchitidwa opaleshoni kumatanthauza kuopsa kowirikiza - ndipo sikopindulitsa kawiri." Ndikumangidwanso, osati mastectomy palokha, komwe kumakhala ndi zoopsazi.

Pakhoza kukhalanso ndi kusokonezeka kwamaganizidwe a mastectomy ngati njira. Pali kafukufuku wosonyeza kuti azimayi omwe adachitidwapo opaleshoniyi, pomangidwanso kapena osamangidwanso, amamva kuwawa kwawo, ukazi komanso kugonana.

Malinga ndi National Mastectomy and Breast Reconstruction Audit yaku England mu 2011, mwachitsanzo, azimayi anayi pa khumi aliwonse ku England adakhutitsidwa ndi momwe amawonekera opanda maliseche atachotsedwa maliseche popanda kumanganso, kufika pa asanu ndi mmodzi mwa khumi mwa iwo omwe adamangidwanso nthawi yomweyo.

Koma kuseketsa zomwe zikuchitika kwa amayi pambuyo pa mastectomy ndizovuta.

Diana Harcourt, pulofesa wa mawonekedwe ndi zamaganizidwe azaumoyo ku University of West of England, wagwira ntchito zambiri ndi azimayi omwe adachitapo khansa ya m'mawere. Amanena kuti ndizomveka bwino kuti mayi yemwe adachitidwa maliseche safuna kumva kuti walakwitsa.

Iye anati: “Ngakhale amayi atadwaladwala, amakonda kudzitsimikizira kuti njira ina yotereyi ikanakhala yoyipa kwambiri. "Koma palibe kukayika kuti kumakhudza kwambiri momwe mayi amamvera ndi thupi lake komanso mawonekedwe ake.

"Kugonana ndi kumangidwanso sikumangochitika kamodzi kokha - simumangolephera ndipo ndizomwezo. Ndi chochitika chofunikira ndipo mumakhala ndi zotsatira zake kwamuyaya. Ngakhale kumangidwanso kwabwino sikudzakhalanso ngati kubwezanso bere lanu. ”

Kwa, mastectomy yathunthu inali njira yovomerezeka yagolide ya khansa ya m'mawere. Kuyamba koyamba kuchitira opaleshoni yosamalira m'mawere kunachitika m'ma 1960. Njirayi idapita patsogolo, ndipo mu 1990, US National Institutes of Health idapereka chitsogozo cholimbikitsa lumpectomy kuphatikiza radiotherapy kwa azimayi omwe ali ndi khansa ya m'mawere yoyambirira. Zinali "zabwino chifukwa zimapatsa moyo wofanana ndi kutsekeka kwa ziwalo zonse zapakati komanso zoteteza kwinaku mukuteteza bere".

Zaka zapitazi, kafukufuku wina wasonyeza kuti lumpectomy kuphatikiza radiotherapy zitha kubweretsa zotsatira zabwino kuposa mastectomy. Mwachitsanzo, ku California kudayang'ana amayi pafupifupi 190,000 omwe ali ndi khansa ya m'mawere imodzi (gawo 0 mpaka III). Kafukufukuyu, wofalitsidwa mu 2014, adawonetsa kuti ma mastectomy amitundu iwiri samalumikizidwa ndi kufa pang'ono kuposa lumpectomy ndi radiation. Ndipo njira zonsezi zinali ndi anthu ochepa kufa kuposa unilateral mastectomy.

Tinayang'ana odwala 129,000. Idanenanso kuti lumpectomy kuphatikiza radiotherapy "atha kukhala osankhidwa mwa odwala khansa ya m'mawere ambiri" omwe kuphatikiza kwake kapena mastectomy kungakhale koyenera.

Koma imakhalabe chithunzi chosakanikirana. Pali mafunso omwe adafunsidwa ndi kafukufukuyu ndi enanso, kuphatikiza momwe angathanirane ndi zinthu zosokoneza, komanso momwe mawonekedwe a odwala omwe amaphunzirira angakhudzire zotsatira zawo.

Sabata yatha kuchotsedwa kwa mastectomy, ndidabwereranso kuchipatala kukachotsa lumpectomy.

Ndinali wodwala inshuwaransi payekha. Ngakhale ndikadalandira chisamaliro chimodzimodzi pa NHS, kusiyana komwe kungakhalepo sikunayenera kudikirira nthawi yayitali kuti ayambitsenso ntchitoyo.

Ndinali kumalo ochitira opareshoni osakwana maola awiri, ndinapita kunyumba m'basi pambuyo pake, ndipo sindinkafunika kumwa mankhwala opha ululu amodzi. Pomwe lipoti la dotolo wokhudzana ndi minofu yomwe idachotsedwa idawulula ma cell a khansa moyandikira m'mphepete mwake, ndidabwereranso lumpectomy yachiwiri. Pambuyo pa ichi, m'mbali mwake munali momveka.

Lumpectomies nthawi zambiri amakhala ndi radiotherapy. Izi nthawi zina zimawonedwa ngati zovuta, chifukwa zimafunikira kupita kuchipatala kwa masiku asanu pasabata kwa milungu itatu kapena isanu ndi umodzi. Yalumikizidwa ndi kutopa komanso kusintha kwa khungu, koma zonse zomwe zimawoneka ngati mtengo wocheperako wolipira bere langa.

Chodabwitsa china pakukula kwamankhwala opatsirana pogonana ndikuti zamankhwala zikupita patsogolo zomwe zikuchepetsa kufunikira kwa opareshoni yayikulu, ngakhale ndi zotupa zazikulu za m'mawere. Pali magawo awiri ofunikira: woyamba ndi opaleshoni yamagetsi, pomwe lumpectomy imagwiridwa nthawi yomweyo ndikumangidwanso. Dokotala wochotsa matendawa amachotsa khansara kenako amakonzanso minofu ya m'mawere kuti asamatuluke kapena kuthira, monga momwe zimachitikira ndi ziphuphu zam'mbuyomu.

Wachiwiri akugwiritsa ntchito chemotherapy kapena mankhwala a endocrine kuti achepetse chotupacho, zomwe zikutanthauza kuti opaleshoniyi singakhale yovuta kwambiri. M'malo mwake, MacNeill ali ndi odwala khumi ku Marsden omwe asankha kuti asachite opareshoni iliyonse chifukwa zotupa zawo zimawoneka kuti zasowa atalandira mankhwala. "Tili ndi nkhawa pang'ono chifukwa sitikudziwa zamtsogolo, koma awa ndi azimayi omwe amadziwa bwino kwambiri, ndipo takhala tikukambirana momasuka, moona mtima," akutero. "Sindingalimbikitse izi, koma nditha kuzichirikiza."

Sindimadziona ngati wopulumuka khansa ya m'mawere, ndipo sindimakhala ndi nkhawa kuti khansa ibwerera. Itha, kapena mwina - kuda nkhawa sikungapange kusiyana kulikonse. Ndikachotsa zovala zanga usiku kapena kumalo ochitira masewera olimbitsa thupi, thupi lomwe ndili nalo ndi thupi lomwe ndakhala nalo nthawi zonse. MacNeill adadula chotupacho - chomwe chidakhala 5.5 cm, osati 10 cm - kudzera pobowola pa areola yanga, chifukwa chake ndilibe chilonda chowoneka. Kenako adakonzanso minofu ya m'mawere, ndipo mimbayo ndiosazindikirika.

Ndikudziwa kuti ndakhala ndi mwayi. Chowonadi ndi chakuti sindikudziwa zomwe zikadachitika zikadakhala kuti tidapitilira ndi mastectomy. Chibadwa changa, chomwe chingandisiye ndimavuto amisala, chikadakhala cholakwika. Ndikadakhala bwino pambuyo pathupi langa latsopano. Koma izi ndikudziwa: Sindingakhale pamalo abwino kuposa momwe ndiliri pano. Ndipo ndikudziwanso kuti amayi ambiri omwe anali ndi ziwalo zoberekera zimawavuta kuti adziphatikize okha ndi thupi lomwe amakhala pambuyo pa opaleshoni.

Zomwe ndapeza ndikuti mastectomy siyokhayo, njira yabwino kapena yolimba mtima yolimbana ndi khansa ya m'mawere. Chofunikira ndikumvetsetsa momwe mankhwala angakwaniritsire komanso sangakwanitse, chifukwa chake chisankho chomwe mungapange sichikhazikika pazowona zomwe sizinafufuzidwe koma pakuwunika moyenera zomwe zingatheke.

Chofunikanso kwambiri ndichakuti kuzindikira kuti kukhala wodwala khansa, ngakhale ndiwowopsa, sikukutulutsani udindo wanu wosankha. Anthu ambiri amaganiza kuti dokotala angawauze zomwe ayenera kuchita. Chowonadi ndichakuti kusankha kulikonse kumabwera ndi mtengo, ndipo munthu yekhayo amene pamapeto pake angalembe zabwino ndi zoyipa, ndikupanga chisankho, si dokotala wanu. Ndinu.

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