Umhlaza webele

Umhlaza wamabele ngumhlaza oqala kwizicubu zebele. Zimbini iintlobo eziphambili zomhlaza wamabele:

• I-Ductal carcinoma iqala kwiityhubhu (imibhobho) ehambisa ubisi ukusuka esifubeni ukuya kwingono. Uninzi lomhlaza webele lolu hlobo.
• I-Lobular carcinoma iqala kwiindawo zesifuba, ezibizwa ngokuba zii-lobules, ezivelisa ubisi.

Kwiimeko ezinqabileyo, ezinye iintlobo zomhlaza webele zingaqala kwezinye iindawo zesifuba.

Umngcipheko womhlaza webele zizinto ezonyusa ithuba lokuba ube nomhlaza webele.

• Eminye yemingcipheko onokuyilawula, njengokuselwa kotywala. Ezinye, ezinje ngembali yosapho, awukwazi ukuzilawula.
• Eyona miba mngcipheko onayo, kokukhona umngcipheko uyanda. Kodwa, oko akuthethi ukuba uya kuba nomhlaza. Abasetyhini abaninzi abahlakulela umhlaza wamabele abanawo umngcipheko owaziwayo okanye imbali yosapho.
• Ukuqonda umngcipheko wakho kunokukunceda uthathe amanyathelo okwehlisa umngcipheko.

Abanye abantu basetyhini basemngciphekweni omkhulu womhlaza webele ngenxa yeempawu ezithile zemfuza okanye izinto ezahlukeneyo ezinokudluliselwa zisuka kubazali babo.

• Imfuza eyaziwa ngokuba yi-BRCA1 okanye i-BRCA2 inoxanduva lwamatyala amaninzi anomdlavuza webele.
• Isixhobo sokuhlola esinemibuzo malunga nembali yosapho lwakho kunye neyakho sinokunceda umboneleli wakho wezempilo nokuba usemngciphekweni wokuthwala ezi zofuzo.
• Ukuba usemngciphekweni omkhulu, kuvavanyo lwegazi ukubona ukuba uziphethe na izakhi zofuzo.
• Ezinye iintlobo zemfuza zinokukhokelela kumngcipheko owandisiweyo womhlaza wamabele.

Ukufakelwa kwesifuba, ukusebenzisa i-antiperspirants, kunye nokunxiba i-underwire bras ayonyusi umngcipheko womhlaza wamabele. Akukho bungqina bokunxibelelana ngokuthe ngqo phakathi komhlaza wamabele kunye neyeza lokubulala izitshabalalisi.

Umhlaza wamabele wokuqala kwangoko awubangeli zimpawu. Kungenxa yoko le nto iimviwo zebele rhoqo kunye neemammograms zibalulekile, ke umhlaza ongenazimpawu unokufunyanwa kwangoko.

Njengoko umhlaza ukhula, iimpawu zinokubandakanya:

• Isigaqa sebele okanye iqhuma ekhwapheni elinzima, elinemiphetho engalinganiyo, kwaye ngesiqhelo alonzakalisi.
• Guqula ubungakanani, imilo, okanye imvakalelo yebele okanye ingono. Umzekelo, unokuba nobomvu, ukuncipha, okanye ukufunxa okubonakala ngathi lulusu lweorenji.
• Ulwelo olusuka kwingono. Ulwelo lunokuba ligazi, lucace mthubi, luhlaza, okanye lubonakale njengobofu.

Emadodeni, iimpawu zesifo somhlaza wesifuba zibandakanya i-bump yesifuba kunye neentlungu zesifuba kunye nokuthantamisa.

Iimpawu zomhlaza webele ophambili zinokubandakanya:

• Intlungu yethambo
• Intlungu yesifuba okanye ukungonwabi
• Izilonda zolusu
• Ukuvuvukala kwee-lymph nodes kwi-armpit (ecaleni kwesifuba nomhlaza)
• Ukuhla ukusinda

Umboneleli wezempilo uya kubuza malunga neempawu zakho kunye nemingcipheko. Emva koko umboneleli uya kwenza uvavanyo lomzimba. Uviwo lubandakanya omabini amabele, amakhwapha, nendawo yentamo kunye nesifuba.

Abasetyhini bayakhuthazwa ukuba benze iimviwo zokuzihlola amabele inyanga nenyanga. Nangona kunjalo, ukubaluleka kokuzivavanya ngokwakho ekufumaneni umhlaza webele kuyaxoxwa.

Iimvavanyo ezisetyenziselwa ukuxilonga kunye nokubeka iliso kubantu abanomdlavuza webele zingabandakanya:

• Imammografi ukujonga umhlaza wamabele okanye ukunceda ekuchongeni ibumba
• Ubisi lwe-ultrasound ukubonisa ukuba iqhuma liqinile okanye ligcwele ulwelo
• I-biopsy yebele, usebenzisa iindlela ezinje nge-aspiration yenaliti, ukukhokelwa yi-ultrasound, stereotactic, okanye ukuvula
• Isifuba se-MRI ukunceda ukufumanisa bhetele ibele okanye ukuvavanya utshintsho olungaqhelekanga kwimammogram
• I-Sentinel lymph node biopsy ukujonga ukuba umhlaza unwenwele kwii-lymph node
• Uvavanyo lwe-CT ukukhangela ukuba umhlaza usasazekile ngaphandle kwebele
• I-PET scan ukujonga ukuba umhlaza usasazekile

Ukuba ugqirha wakho ufumanisa ukuba unawo umhlaza webele, kuya kwenziwa uvavanyo oluninzi. Oku kubizwa ngokuba yi-staging, ejonga ukuba umhlaza usasazekile. Ukubeka esiteji kunceda ukukhokela unyango kunye nokulandela. Ikunika umbono wokuba ungalindela ntoni kwixesha elizayo.

Amanqanaba omhlaza webele aqala ku-0 ukuya ku-IV. Ukuphakama kwenqanaba, kokukhona umhlaza uqhubela phambili.

Unyango lusekwe kwizinto ezininzi, kubandakanya:

• Uhlobo lomhlaza webele
• Isigaba somhlaza (isiteji sisixhobo ababoneleli bakho abasisebenzisayo ukufumanisa ukuba umhlaza uqhubele phambili kangakanani)
• Nokuba umhlaza ubuthathaka kwihomoni ezithile
• Nokuba umhlaza uvelisa ngaphezulu (overexpresses) iprotein ye-HER2 / neu

Unyango lomhlaza lunokubandakanya:

• Unyango lweHormone.
• I-Chemotherapy, esebenzisa amayeza ukubulala iiseli zomhlaza.
• Ukunyanga ngemitha, esetyenziselwa ukutshabalalisa izicwili ezinomhlaza.
• Utyando lokususa izicwili ezinomhlaza: I-lumpectomy isusa iqhuma lebele. I-Mastectomy isusa konke okanye inxalenye yesifuba kunye nolwakhiwo olusondeleyo. I-lymph node ezikufutshane nazo zingasuswa ngexesha lotyando.
• Unyango ekujoliswe kulo lusebenzisa amayeza ukuhlasela utshintsho lomfuziselo kwiiseli zomhlaza. Unyango lwehormone ngumzekelo wonyango ekujoliswe kulo. Ibhloka iihormoni ezithile ezikhuthaza ukukhula komhlaza.

Unyango lomhlaza lunokuba lwasekhaya okanye lwenkqubo:

• Unyango lwasekhaya lubandakanya kuphela indawo yesifo. Imitha kunye notyando ziindlela zonyango lwasekhaya. Zisebenza kakhulu xa umhlaza ungakhange usasazeke ngaphandle kwebele.
• Unyango lwenkqubo luchaphazela umzimba uphela. I-Chemotherapy kunye nonyango lwehomoni ziindidi zonyango lwenkqubo.

Uninzi lwabasetyhini lufumana indibaniselwano yonyango. Kubafazi abanesifo somhlaza webele wenqanaba I, II, okanye III, eyona njongo iphambili kukunyanga umhlaza kunye nokuwuthintela ukuba ungabuyi (uphindaphinde). Kubafazi abanomdlavuza wenqanaba IV, injongo kukuphucula iimpawu kunye nokubanceda baphile ixesha elide. Kwiimeko ezininzi, inqanaba IV umhlaza wamabele awunyangeki.

• Isigaba 0 kunye ne-ductal carcinoma: I-Lumpectomy kunye ne-radiation okanye i-mastectomy yonyango oluqhelekileyo.
• Isigaba I no-II: I-Lumpectomy kunye ne-radiation okanye i-mastectomy ngokususwa kwe-lymph node yonyango oluqhelekileyo. I-Chemotherapy, unyango lwehomoni, kunye nolunye unyango ekujolise kulo lunokusetyenziswa emva kotyando.
• Isigaba III: Unyango lubandakanya utyando, mhlawumbi lulandelwe ngamachiza ngamayeza, unyango lwehomoni kunye nolunye unyango ekujolise kulo.
• Isigaba IV: Unyango lunokubandakanya utyando, imitha, ichemotherapy, unyango lwehomoni, olunye unyango ekujolise kulo, okanye indibaniselwano yonyango.

Emva konyango, abanye abantu basetyhini bayaqhubeka nokusela amayeza okwexeshana. Bonke abantu basetyhini baqhubeka nokuvavanywa kwegazi, ii-mammograms, kunye nolunye uvavanyo emva konyango ukubeka esweni ukubuya komhlaza okanye ukukhula komnye umhlaza webele.

Abasetyhini abaye bafumana i-mastectomy banokuphinda benze utyando lwebele. Oku kuya kwenziwa nokuba ngexesha le-mastectomy okanye kamva.

Ungaluphelisa uxinzelelo lokugula ngokujoyina iqela lokuxhasa umhlaza. Ukwabelana nabanye abanamava afanayo kunye neengxaki kunokukunceda ungaziva ulilolo.

Entsha, unyango oluphuculweyo luyabanceda abantu abanomhlaza wamabele ukuba baphile ixesha elide. Nokuba unyango lukhona, umhlaza webele unokusasazeka uye kwamanye amalungu omzimba. Ngamanye amaxesha, umhlaza ubuya, nasemva kokuba kususwe lonke ithumba kwaye kufunyaniswe ukuba azinasifo somhlaza kufutshane.

Abanye abantu basetyhini abanomhlaza wamabele bakhula umhlaza wamabele omtsha ongahambelaniyo nethumba lokuqala.

Ukwenza kakuhle kangakanani emva kokuba unyangwe umhlaza wamabele kuxhomekeke kwizinto ezininzi. Okukhona umhlaza wakho uhambele phambili, isiphumo sihlwempuzekile. Eminye imiba ebeka umngcipheko wokuphindaphinda kunye nokuba nokwenzeka kwonyango olunempumelelo kubandakanya:

• Indawo yethumba kunye nokuba sele isasazeke kangakanani
• Nokuba ithumba liyi-receptor ye-hormone eyamkelayo okanye engalunganga
• Iimpawu zokumakisha
• Intetho yeGene
• Ubungakanani besisu kunye nobume
• Ireyithi yokwahlulwa kweseli okanye ukuba ikhula ngokukhawuleza kangakanani ithumba

Emva kokujonga konke oku kungentla, umboneleli wakho unokuxoxa ngomngcipheko wokuphindaphinda komhlaza wamabele.

Unokufumana iziphumo ebezingalindelekanga okanye iingxaki kunyango lomhlaza. Oku kunokubandakanya iintlungu zethutyana okanye ukudumba kwebele kunye neendawo ezingqongileyo. Buza umboneleli wakho malunga neziphumo ebezingalindelekanga zonyango.

Nxibelelana nomboneleli wakho ukuba:

• Unesifuba okanye ikhwapha
• Unencindi yokukhutshwa kwengono

Emva kokunyangwa ngomhlaza webele, tsalela umnikezeli wakho ukuba uphuhlisa iimpawu ezinje:

• Ukukhutshwa kwengono
• Irhashalala ebeleni
• Izigaqa ezintsha ebeleni
• Ukudumba kwindawo
• Intlungu, ngakumbi iintlungu zesifuba, iintlungu zesisu, okanye iintlungu zethambo

Thetha nomboneleli wakho malunga nokuba kufuneka ube ne-mammogram okanye ezinye iimvavanyo kangaphi ukukhusela umhlaza webele. Umhlaza wamabele okuqala ofunyenwe yi-mammogram unethuba elihle lokuphiliswa.

I-Tamoxifen ivunyiwe kuthintelo lomhlaza webele kubafazi abaneminyaka engama-35 nangaphezulu abasengozini enkulu. Xoxa oku nomboneleli wakho.

Abasetyhini abasemngciphekweni omkhulu wesifo somhlaza webele banokujonga ukuthintela (iprophylactic) ye-mastectomy. Olu luqhaqho lokususa amabele ngaphambi kokuba kufunyaniswe umhlaza webele. Abagqatswa abanokubakho baquka:

• Abasetyhini abasele besuswe ibele elinye ngenxa yomhlaza
• Abasetyhini abanembali eyomeleleyo yosapho yomhlaza wamabele
• Abasetyhini abanezakhi zofuzo okanye ukuguqulwa kwemvelo okuphakamisa umngcipheko wesifo somhlaza wesifuba (njenge-BRCA1 okanye i-BRCA2)

Izinto ezininzi ezinobungozi, ezinje ngemfuza kunye nembali yosapho, azinakulawulwa.Kodwa ukwenza utshintsho kwindlela yokuphila esempilweni kunokunciphisa amathuba akho okuba nomhlaza. Oku kubandakanya:

• Ukutya ukutya okusempilweni
• Ukugcina ubunzima obusempilweni
• Ukunciphisa ukusela utywala kwisiselo esi-1 ngosuku

Umhlaza - ibele; I-Carcinoma - ukuhamba; Carcinoma - lobular; DCIS; I-LCIS; Umhlaza webele we-HER2; Umhlaza webele we-ER-positive; Iductal carcinoma in situ; I-Lobular carcinoma in situ

• Isifuba sangaphandle somsila we-radiation - ukukhutshwa
• I-Chemotherapy -yintoni oza kuyibuza ugqirha wakho
• I-lymphedema - ukuzinyamekela
• I-Mastectomy kunye nokwakhiwa kwakhona kwebele-yintoni oza kuyibuza ugqirha wakho
• Mastectomy - ukubhobhoza
• Unyango ngemitha- imibuzo oza kuyibuza ugqirha wakho

• Ibele labasetyhini
• I-biopsy yenaliti yebele
• Vula i-biopsy yebele
• Ukuzivavanya amabele
• Ukuzivavanya amabele
• Ukuzivavanya amabele
• Lumpectomy
• Ukususwa kwesigaqa samabele - uthotho
• Mastectomy - uthotho
• I-Sentinel node biopsy

Makhoul I. Izicwangciso zonyango lomhlaza webele. Ku: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, ii-eds. Isifuba: Ulawulo oluBanzi lwezifo ezinobungozi kunye nezifo ezinobungozi. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2018: isahluko 24.

Kwiwebhusayithi yeZiko loMhlaza weSizwe. Unyango lomhlaza wamabele (umntu omdala) (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/breast/hp/ Unyango-esifo-pdq. Ukuhlaziywa ngoFebruwari 12, 2020. Ifikeleleke ngoFebruwari 25, 2020.

Iwebhusayithi yeNethiwekhi yeCancer epheleleyo yoMhlaza. Isikhokelo sonyango se-NCCN kwi-oncology (izikhokelo ze-NCCN): Umhlaza webele. Inguqulelo 2.2020. www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Ukuhlaziywa ngoFebruwari 5, 2020. Ifikeleleke ngoFebruwari 25, 2020.

Siu AL; Umsebenzi woKhuseleko kwi-US. Ukuvavanywa komhlaza wamabele: Isiteyitimenti sokuCetyiswa kweeNkonzo zoThintelo lwe-US. UAnn Intern Med. Ngo-2016; 164 (4): 279-296. IINKCUKACHA: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.

Umsebenzi woKhuseleko kwi-US, Owens DK, Davidson KW, et al. Uvavanyo lomngcipheko, ukululekwa ngemfuza, kunye nokuvavanywa kwemfuza kumhlaza onxulumene ne-BRCA: INkcazo yeNcomelo yeeNkonzo zoThintelo lwe-US [ukulungiswa okupapashiweyo kubonakala kwiJAMA. Ngo-2019; 322 (18): 1830]. JAMA. Ngo-2019; 322 (7): 652-665. IINKCUKACHA: 31429903 pubmed.ncbi.nlm.nih.gov/31429903/.