Ukuqonda iNqanaba loMhlaza weSifuba

Umxholo

• Umhlaza webele ubekwa njani?
• Athini amanqanaba omhlaza wamabele?
• Inqanaba 0
• Inqanaba 1
• Inqanaba 2
• Inqanaba 3
• Inqanaba 4
• Umhlaza webele oqhelekileyo
• Ngaba isigaba somhlaza wamabele sichaphazela iimpawu?
• Ukulindela ubomi kwinqanaba
• Izinketho zonyango ngezigaba
• Inqanaba 0
• Amanqanaba 1, 2, no-3
• Inqanaba 4
• Ukuxolelwa kunye nomngcipheko wokuphindeka
• Ukuthatha

Umhlaza webele ngumhlaza oqala kwii-lobules, iidombolo, okanye izicwili ezinxibelelanayo zebele.

Umhlaza webele uhlelwe ukusuka kwi-0 kuye kwi-4. Inqanaba libonisa ubungakanani be-tumor, ukubandakanyeka kwe-lymph node, kunye nokuba umhlaza usasazeke kangakanani. Ezinye izinto, ezinje ngemeko yokwamkela i-hormone kunye nenqanaba le-tumor, nazo ziye zafakwa kwinqanaba.

Olu lwazi lubalulekile ekwenzeni izigqibo zonyango kunye nokuqonda umbono wakho ngokubanzi.

Qhubeka ufunda ukuze ufunde ukuba umhlaza webele uhlelwa njani, ukuba luchaphazela njani unyango, kunye nento onokuyilindela.

Umhlaza webele ubekwa njani?

Ugqirha unokurhanela umhlaza wamabele emva kovavanyo lomzimba, i-mammogram, okanye olunye uvavanyo lokucinga. Banokucebisa i-biopsy, ekuphela kwendlela yokuqinisekisa isifo somhlaza wamabele.

Ugqirha uya kusebenzisa iziphumo ezivela kwi-biopsy yakho ukunikezela inqanaba "leklinikhi".

Emva kotyando lokususa ithumba, ugqirha wakho uya kuba nakho ukwabelana ngolwazi oluthe kratya nawe malunga nokubandakanyeka kwe-lymph node, kunye neengxelo ezongezelelweyo zezifo.

Ngelo xesha, ugqirha wakho uya kunika inqanaba elichanekileyo "le-pathologic" usebenzisa isikali se-TNM. Nalu ulwahlulo lwento ethethwa nguT, N, no-M:

T inxulumene nobukhulu bethumba.

• I-TX. Ithumba alinakuvavanywa.
• T0. Akukho bungqina bethumba lokuqala.
• Tis. Ithumba ayikakhuli ibe sisicubu sebele esisempilweni (in situ).
• T1, T2, T3, T4. Okukhona liphezulu eli nani, kokukhona esiba likhulu ithumba okanye kokukhona sihlasele izicwili zamabele.

U-N Inxulumene nokubandakanyeka kwe-lymph node.

• NX. I-lymph node ezikufutshane azikwazi ukuvavanywa.
• HAYI. Akukho kubandakanyeka kwe-lymph node ekufutshane.
• N1, N2, N3. Ukuphakama kwenani, ukubandakanyeka ngakumbi kwe-lymph node.

M Inxulumene ne-metastasis ngaphandle kwebele.

• MX. Ayikwazi kuvavanywa.
• M0. Akukho bungqina be-metastasis ekude.
• M1. Umhlaza unwenwele kwiindawo ezikude zomzimba.

Iindidi zidityanisiwe ukufumana inqanaba, kodwa ezi zinto zinokuchaphazela nokuhlelwa:

• inqanaba lokwamkela i-estrogen
• isimo seprogesterone receptor
• Isimo se-HER2 / neu

Kwakhona, amathumba abekwa kwinqanaba le-1 ukuya kwi-3 ngokusekwe kwindlela engaqhelekanga ngayo iiseli zomhlaza. Ephakamileyo ibakala, kokukhona liya kukhula kwaye lisasazeke.

Athini amanqanaba omhlaza wamabele?

Inqanaba 0

Umhlaza webele ongafunekiyo ubandakanya i-ductal carcinoma in situ (DCIS). Iiseli ezingaqhelekanga azingenanga kwizicubu ezikufutshane.

Inqanaba 1

Isigaba 1 sahlulwe sangamanqanaba 1A kunye no-1B.

Kwinqanaba 1A umhlaza webele, ithumba lilingana ukuya kwiisentimitha ezi-2, kodwa akukho kubandakanyeka kwe-lymph node.

Ngomhlaza wesifuba webele 1B, ithumba lingaphantsi kweesentimitha ezi-2, kodwa kukho amaqela amancinci eeseli zomhlaza kwii-lymph node ezikufutshane.

Inqanaba 1B lomhlaza webele likwabelwe ukuba akukho thumba, kodwa kukho amaqela amancinci eeseli zomhlaza kwii-lymph node.

Phawula: Ukuba ithumba yi-estrogen receptor- okanye iprogesterone receptor-positive, inokubekwa njenge-1A.

Inqanaba 2

Inqanaba 2 lahlulwe ngokwamanqanaba 2A kunye 2B.

Inqanaba 2A labelwe nayiphi na kwezi zilandelayo:

• akukho thumba, kodwa indawo enye ukuya kwezintathu ezinde phantsi kwengalo okanye kufutshane nethambo lesifuba ziqulathe iiseli zomhlaza
• ithumba ukuya kwiisentimitha ezi-2, kunye nomhlaza kwii-lymph node phantsi kwengalo
• ithumba phakathi kweesentimitha ezi-2 ukuya kwezi-5, kodwa akukho kubandakanywa kwe-lymph node

Phawula: Ukuba ithumba ine-HER2-positive kunye ne-estrogen receptor- kunye neprogesterone receptor-positive, inokuhlelwa njengenqanaba 1A.

Inqanaba 2B labelwe enye yezi zinto zilandelayo:

• ithumba phakathi kweesentimitha ezi-2 ukuya kwezi-5, kunye namaqoqo amancinci omhlaza kwindawo enye ukuya kwezintathu ezikufuphi
• I-tumor enkulu kuneesentimitha ezi-5, kodwa akukho kubandakanyeka kwe-lymph node

Phawula: Ukuba ithumba ine-HER2-positive kunye ne-estrogen receptor- kunye neprogesterone receptor-positive, inokuhlelwa njengenqanaba loku-1.

Inqanaba 3

Inqanaba 3 lahlulwe ngokwamanqanaba 3A, 3B, kunye 3C.

Inqanaba 3A labelwe enye yezi zinto zilandelayo:

• umhlaza kwii-lymph node ezikufutshane ezine ukuya kwezilithoba, kunye okanye ngaphandle kwethumba
• ithumba enkulu kuneesentimitha ezi-5, kunye namaqela amancinci eeseli zomhlaza kwii-lymph node

Phawula: Ukuba ithumba elingaphezulu kweesentimitha ezi-5 likwibanga lesi-2, i-estrogen receptor-, iprogesterone receptor-, kunye ne-HER2-positive, kunye nomhlaza ufumaneka kwii-lymph node ezine ukuya kwezilithoba ezingaphantsi, inokuhlelwa njenge-1B.

Kwinqanaba le-3B, i-tumor ifikelele eludongeni lwesifuba, kunye nomhlaza unokuba:

• isasazeka okanye yaphuke kulusu
• isasazeka ukuya kwii-lymph nodes ezilithoba phantsi kwengalo okanye kufutshane nethambo lesifuba

Phawula: Ukuba i-tumor i-estrogen receptor-positive kunye ne-progesterone receptor-positive, inokuhlelwa njengeSigaba 1 okanye 2 kuxhomekeke kwibakala le-tumor. Umhlaza webele wokudumba uhlala ubuncinci kwinqanaba le-3B.

Kwinqanaba le-3C, akunakubakho thumba ebeleni. Kodwa ukuba ikho, inokuba ifikelele kudonga lwesifuba okanye ulusu lwebele, kunye:

• I-10 okanye ngaphezulu kwee-lymph node
• Izidumbu ezikufutshane nekhola
• Izakhi zofuzo ezantsi kwengalo kunye nakufutshane nesifuba

Inqanaba 4

Isigaba 4 sithathwa njengomhlaza webele ophucukileyo, okanye umhlaza webele we-metastatic. Oku kuthetha ukuba sele isasazekile kwiindawo ezikude zomzimba.Umhlaza ubakho emiphungeni, kwingqondo, kwisibindi, okanye emathanjeni.

Umhlaza webele oqhelekileyo

Umhlaza obuya emva konyango oluyimpumelelo ngumhlaza wamabele ophindaphindiweyo.

Ngaba isigaba somhlaza wamabele sichaphazela iimpawu?

Usenokungabi nazimpawu de ithumba likhulu ngokwaneleyo ukuba lingaziva. Ezinye iimpawu zokuqala zinokubandakanya utshintsho kubungakanani okanye ukumila kwebele okanye kwingono, ukukhutshwa kwingono, okanye iqhuma phantsi kwengalo.

Iimpawu ezizayo zixhomekeke apho umhlaza usasazeke khona kwaye ungabandakanya:

• Ukuphelelwa ngumdla wokutya
• ukuhla ukusinda
• ukuqhawukelwa ngumphefumlo
• ukukhohlela
• intloko ebuhlungu
• umbono kabini
• iintlungu zethambo
• ubuthathaka bemisipha
• inyongo

Ukulindela ubomi kwinqanaba

Nokuba kwahlulwe ngokwamanqanaba, kunzima ukumisela ixesha lokuphila lomntu onomhlaza wamabele ngenxa yoku kulandelayo:

• Zininzi iintlobo zomhlaza wamabele, kwaye ziyahluka kwinqanaba labo lokuba ndlongondlongo. Abanye bajolise kunyango, ngelixa abanye bengenalo.
• Unyango oluyimpumelelo luxhomekeke kubudala, ezinye iingxaki zempilo, kunye nonyango olukhethayo.
• Amaxabiso okusinda aqikelelwa kubantu abafunyaniswe kwiminyaka eyadlulayo. Unyango luqhubela phambili ngokukhawuleza, ukuze ube nokuphila ubomi obungcono kunabantu abafunyaniswe kwiminyaka emihlanu eyadlulayo.

Kungenxa yoko le nto kungafanelekanga ukuba uthathe amanani apheleleyo ngentliziyo. Ugqirha wakho unokukunika umbono ongcono wento onokuyilindela ngokusekwe kwiprofayili yakho yezempilo.

Inkqubo yoPhononongo, i-Epidemiology, kunye neNkqubo yeZiphumo zokuGqibela (SEER) ayilandeleli amazinga okusinda komhlaza webele ngohlobo okanye ngokwamanqanaba e-0 ukuya kwi-4. Isilinganiselo sokusinda xa kuthelekiswa nabantu abanomhlaza wamabele kubantu ngokubanzi.

Oku kulandelayo yi-SEER yeminyaka emihlanu yokuma kwamaxabiso asekwe kubasetyhini abafunyaniswe phakathi ko-2009 no-2015:

Izinketho zonyango ngezigaba

Inqanaba yinto ebalulekileyo ekuqwalaseleni unyango, kodwa zikhona ezinye, ezinje:

• uhlobo lomhlaza webele
• ithumba grade
• i-estrogen receptor kunye ne-progesterone receptor status
• Isimo se-HER2
• ubudala nokuba sele uyekile ukuya exesheni
• impilo iyonke

Ugqirha wakho uyakuqwalasela konke oku xa ecebisa unyango. Uninzi lwabantu lufuna indibaniselwano yonyango.

Inqanaba 0

• Utyando olugcina amabele (lumpectomy). Ugqirha wakho uya kususa izicubu ezingaqhelekanga kunye nomncinci omncinci wezicubu ezinempilo.
• Mastectomy. Ugqirha wakho uya kulisusa lonke ibele kwaye, kwezinye iimeko, jonga iindawo ezikufutshane ezinomhlaza.
• Unyango ngemitha. Olu nyango lunokucetyiswa ukuba une-lumpectomy.
• Utyando lokwakha kwakhona amabele. Unokucwangcisa le nkqubo kwangoko okanye ngomnye umhla.
• Unyango lweHormone (tamoxifen okanye aromatase inhibitor). Ugqirha wakho unokulucebisa olu nyango xa i-DCIS i-estrogen receptor- okanye iprogesterone receptor-positive.

Amanqanaba 1, 2, no-3

• i-lumpectomy okanye i-mastectomy kunye nokususwa kwee-lymph node ezikufutshane ukujonga umhlaza
• ukwakhiwa kwakhona kwamabele kwangoko okanye kamva
• Unyango lwe-radiation, ngakumbi ukuba ukhethe i-lumpectomy ngaphezulu kwe-mastectomy
• ichemotherapy
• Unyango lwehomoni ye-estrogen receptor-positive kunye neprogesterone receptor-positive cancer cancer
• iziyobisi ekujoliswe kuzo ezinje nge-trastuzumab (Herceptin) okanye i-pertuzumab (Perjeta) ye-HER2-positive cancer

Inqanaba 4

• ichemotherapy yokunciphisa amathumba okanye ukukhula kancinci kwethumba
• utyando lokususa amathumba okanye ukunyanga iimpawu
• unyango ngemitha yokunciphisa iimpawu
• iziyobisi ekujoliswe kuzo ze-estrogen receptor-, progesterone receptor-, okanye i-HER2-positive cancer cancer
• amayeza okuphelisa iintlungu

Ngalo naliphi na inqanaba, unokukwazi ukuthatha inxaxheba kuvavanyo lweklinikhi. Ezi zifundo zinokubonelela ngokufikelela kunyango olusaphuhliswayo. Buza ugqirha wakho malunga novavanyo lweklinikhi olunokuba lulungele wena.

Ukuxolelwa kunye nomngcipheko wokuphindeka

Ukuxolelwa ngokupheleleyo kuthetha ukuba zonke iimpawu zomhlaza zimkile.

Ngamanye amaxesha, iiseli zomhlaza ezishiye ngasemva emva konyango ekugqibeleni zenza amathumba amatsha. Umhlaza unokuphinda ubuye ekuhlaleni, kwingingqi, okanye kwiindawo ezikude. Ngelixa oku kunokwenzeka nanini na, kungaphakathi kwiminyaka emihlanu yokuqala.

Emva kokugqiba unyango, ukubeka iliso rhoqo kufuneka kubandakanya ukutyelela ugqirha, iimvavanyo zokucinga, kunye nokuvavanywa kwegazi ukujonga iimpawu zomhlaza.

Ukuthatha

Umhlaza webele uhlelwe ukusuka kwi-0 kuye kwi-4. Nje ukuba wazi uhlobo kunye nenqanaba, iqela lakho lokhathalelo lwempilo liza kusebenza nawe ukukhetha elona cebo lilungileyo lokwenza.