Types/breast/paget-breast-fact-sheet

Matenda a Paget a M'mawere

Kodi matenda a Paget a m'mawere ndi otani?

Matenda a paget (omwe amadziwikanso kuti Paget matenda a nipple ndi mammary Paget matenda) ndi khansa yosawerengeka yokhudzana ndi khungu la nsagwada ndipo, nthawi zambiri, khungu lozungulira mozungulira, lomwe limatchedwa areola. Anthu ambiri omwe ali ndi matenda a Paget a m'mawere amakhalanso ndi chotupa chimodzi kapena zingapo mkati mwa bere lomwelo. Zotupa za m'mawerezi mwina ndi ductal carcinoma in situ kapena khansa ya m'mawere yowopsa (1-3).

Matenda a paget pachifuwa amatchulidwa ndi dokotala waku Britain waku Britain Sir James Paget, yemwe, mu 1874, adazindikira ubale womwe ulipo pakati pa kusintha kwa msana ndi khansa ya m'mawere. (Matenda ena angapo adatchulidwa ndi Sir James Paget, kuphatikiza Paget matenda a mafupa ndi extramammary Paget matenda, omwe amaphatikizapo matenda a Paget a maliseche ndi Paget a mbolo. Matenda enawa sakhudzana ndi matenda a Paget a m'mawere. pepalali limafotokoza za matenda a Paget a m'mawere okha.)

Maselo owopsa otchedwa Paget cell ndi chizindikiro chodziwika cha matenda a Paget a m'mawere. Maselowa amapezeka mu khungu (pamwamba pake) la khungu la nipple ndi areola. Maselo obisala nthawi zambiri amakhala ndi mawonekedwe akulu, ozungulira pansi pa microscope; atha kupezeka ngati maselo amodzi kapena ngati magulu ang'onoang'ono amkati mwa khungu.

Ndani amatenga matenda a Paget a m'mawere?

Matenda a paget amabere amapezeka mwa amayi ndi abambo, koma nthawi zambiri amapezeka azimayi. Pafupifupi 1 mpaka 4 peresenti ya milandu yonse ya khansa ya m'mawere imaphatikizaponso matenda a Paget a m'mawere. Zaka zapakati pazomwe amapezeka ndi zaka 57, koma matendawa amapezeka mwa achinyamata komanso mwa anthu azaka zopitilira 80 (2, 3).

Nchiyani chimayambitsa matenda a Paget a m'mawere?

Madokotala samvetsetsa zomwe zimayambitsa matenda a mabere a Paget. Chikhulupiriro chovomerezeka kwambiri ndikuti maselo a khansa ochokera pachotupa mkati mwa bere amayenda kudzera mkatikati mwa mkaka kupita kunsonga ndi areola. Izi zitha kufotokoza chifukwa chake matenda a Paget a m'mawere ndi zotupa mkati mwa bere lomwelo zimapezeka nthawi zonse limodzi (1, 3).

Lingaliro lachiwiri ndilakuti maselo am'mabele kapena areola amakhala ndi khansa paokha (1, 3). Izi zitha kufotokoza chifukwa chake anthu ochepa amakhala ndi matenda a Paget pachifuwa osakhala ndi chotupa mkati mwa bere lomwelo. Kuphatikiza apo, kutheka kuti matenda a Paget a m'mawere ndi zotupa mkati mwa bere lomwelo zimadzipangira palokha (1).

Kodi zizindikiro za matenda a mabere a Paget ndi ziti?

Zizindikiro za matenda a Paget a m'mawere nthawi zambiri amalakwitsa chifukwa cha zovuta zina za khungu, monga dermatitis kapena chikanga (1-3). Zizindikirozi zitha kuphatikizira izi:

• Kuyabwa, kumva kulasalasa, kapena kufiira mu nsafu ndi / kapena areola

• Khungu lophwanyika, lotupa, kapena lokulira kapena mozungulira mawere

• Nipple wathyathyathya

• Kutuluka kuchokera ku nipple komwe kumatha kukhala kwachikasu kapena kwamagazi

Chifukwa zizindikiro zoyambirira za matenda a Paget pachifuwa zitha kuwonetsa khungu labwino, ndipo chifukwa matendawa ndi ochepa, amatha kuzindikira molakwika poyamba. Anthu omwe ali ndi matenda a Paget a m'mawere nthawi zambiri amakhala ndi zizindikilo kwa miyezi ingapo asanakwaniritsidwe.

Kodi matenda a Paget a m'mawere amapezeka bwanji?

Nipple biopsy imalola madokotala kuzindikira molondola matenda a Paget a m'mawere. Pali mitundu ingapo yamabele, kuphatikiza njira zomwe zafotokozedwazi.

• Zolemba pamwambapa: Galasi lotsekemera kapena chida china chimagwiritsidwa ntchito kupukuta pang'ono khungu pakhungu.

• Shave biopsy: Chida chonga lumo chimagwiritsidwa ntchito kuchotsa pamwamba pakhungu.

• Punch biopsy: Chida chozungulira chozungulira, chotchedwa nkhonya, chimagwiritsidwa ntchito kuchotsa chidutswa chokhala ngati chimbale.

• Wedge biopsy: Scalpel imagwiritsidwa ntchito kuchotsa pang'ono tinthu tating'onoting'ono.

Nthawi zina, madokotala amatha kuchotsa mawere onse (1). Katswiri wa matendawa amayang'ana maselo kapena minofu pansi pa microscope kuti ayang'ane maselo a Paget.

Anthu ambiri omwe ali ndi matenda a Paget a m'mawere amakhalanso ndi chotupa chimodzi kapena zingapo mkati mwa bere lomwelo. Kuphatikiza pa kuyitanitsa kachilombo koyambitsa mawere, adotolo amayenera kuyesa mayeso a m'mawere kuti awone ngati ali ndi zotupa kapena mabere ena. Pafupifupi 50 peresenti ya anthu omwe ali ndi matenda a Paget a m'mawere ali ndi chotupa cha m'mawere chomwe chimamvekera poyesa mawere. Dokotala atha kuyitanitsa zina zowunika, monga diagnostic mammogram, kuyesa kwa ultrasound, kapena kujambulitsa kwa maginito kuti ayang'ane zotupa (1, 2).

Kodi matenda a Paget am'mimba amathandizidwa bwanji?

Kwa zaka zambiri, mastectomy, kapena osachotsa ma lymph node pansi pa mkono kumbali yomweyo ya chifuwa (yotchedwa axillary lymph node dissection), imadziwika ngati opaleshoni yokhazikika ya matenda a Paget a m'mawere (3, 4). Kuchita opaleshoni kotereku kumachitika chifukwa odwala omwe ali ndi matenda a Paget a m'mawere nthawi zambiri amapezeka kuti ali ndi chotupa chimodzi kapena zingapo mkati mwa bere lomwelo. Ngakhale panali chotupa chimodzi chokha, chotupacho chimatha kupezeka masentimita angapo kuchokera ku nipple ndi areola ndipo sichingachotsedwe ndi opareshoni ya nipple ndi areola yokha (1, 3, 4).

Kafukufuku wasonyeza, komabe, kuti opaleshoni yosamalira bere yomwe imaphatikizapo kuchotsedwa kwa nipple ndi areola, yotsatiridwa ndi chithandizo cha mawere onse, ndi njira yabwino kwa anthu omwe ali ndi matenda a Paget a m'mawere omwe alibe chotupa pachifuwa ndipo mammograms ake sawulula chotupa (3-5).

Anthu omwe ali ndi matenda a Paget omwe ali ndi chotupa cha m'mawere ndipo ali ndi mastectomy ayenera kupatsidwa sentinel lymph node biopsy kuti awone ngati khansara yafalikira ku ma lymph node a axillary. Ngati maselo a khansa amapezeka mu sentinel lymph node (s), pamafunika opaleshoni yayikulu kwambiri ya axillary lymph node (1, 6, 7). Kutengera siteji ndi zina zotupa pachiberekero cha m'mawere (mwachitsanzo, kupezeka kapena kupezeka kwa ma lymph node, maestrogen ndi progesterone receptors m'maselo a chotupacho, ndi HER2 protein overexpression m'maselo a chotupacho), chithandizo chothandizira, chokhala ndi chemotherapy ndi / kapena mankhwala a mahomoni, amathanso kulimbikitsidwa.

Kodi chidziwitso chotani cha anthu omwe ali ndi matenda a Paget a m'mawere?

Kulosera, kapena malingaliro, a anthu omwe ali ndi matenda a Paget a m'mawere zimadalira zinthu zosiyanasiyana, kuphatikizapo izi:

• Kaya chotupa chilipo m'mawere okhudzidwa kapena ayi

• Ngati chotupa chimodzi kapena zingapo zilipo mu bere lomwe lakhudzidwa, kaya zotupazo ndi ductal carcinoma in situ kapena khansa ya m'mawere yoopsa

• Ngati khansa ya m'mawere yowonongeka ilipo mu bere lomwe lakhudzidwa, gawo la khansara

Kupezeka kwa khansa yowopsa pachifuwa chokhudzidwa ndikufalikira kwa khansa kumalo am'mimba apafupi kumalumikizidwa ndi kupulumuka.

Malinga ndi pulogalamu ya NCI's Surveillance, Epidemiology, and End Results, kupulumuka kwa zaka 5 kwa azimayi onse ku United States omwe amapezeka ndi matenda a Paget a m'mawere pakati pa 1988 ndi 2001 anali 82.6%. Izi zikufanizira ndi kupulumuka kwa zaka 5 kwapakati pa 87.1% kwa azimayi omwe amapezeka ndi khansa ya m'mawere yamtundu uliwonse. Kwa amayi omwe ali ndi matenda onse a Paget a m'mawere ndi khansa yowopsa pachifuwa chomwecho, kupulumuka kwa zaka 5 kunachepa ndikukula kwa khansa (gawo I, 95.8 peresenti; gawo II, 77.7 peresenti; gawo III, 46.3 peresenti; gawo IV, 14.3 peresenti) (1, 3, 8, 9).

Ndi kafukufuku uti amene akuchitika pa matenda a Paget a m'mawere?

Kuyesedwa kwamankhwala kosasinthidwa, komwe kumawerengedwa kuti ndi "golide" pakufufuza za khansa, kumakhala kovuta kuchitira matenda a Paget a m'mawere chifukwa ndi ochepa omwe ali ndi matendawa (4, 10). Komabe, anthu omwe ali ndi matenda a Paget m'mawere atha kukhala oyenera kulembetsa m'mayeso azachipatala kuti awunikire mankhwala atsopano a khansa ya m'mawere, njira zatsopano zogwiritsira ntchito mankhwala omwe ali ndi khansa ya m'mawere, kapena njira zopewera kuyambiranso khansa ya m'mawere.

Zambiri zamayeso amakono omwe amathandizira khansa ya m'mawere amapezeka posaka mndandanda wa mayeso am'magazi a NCI. Kapenanso, itanani NCI Contact Center ku 1-800-4-CANCER (1-800-422-6237) kuti mumve zambiri zamayesero azachipatala a anthu omwe ali ndi matenda a Paget a m'mawere.

Zolemba Zosankhidwa

1. Harris JR, Lippman ME, Morrow M, Osborne CK, akonzi. Matenda Akumimba. Wolemba 4. Philadelphia: Lippincott Williams & Wilkins; 2009.
2. Caliskan M, Gatti G, Sosnovskikh I, et al. (Adasankhidwa) Matenda a Paget a m'mawere: zomwe zinachitikira European Institute of Oncology ndikuwunikanso zolembazo. Kafukufuku wa Khansa ya m'mawere ndi Chithandizo chake 2008; 112 (3): 513-521. [Adasankhidwa]
3. Kanitakis J. Mammary ndi matenda owonjezera a Paget. Zolemba za European Academy of Dermatology and Venereology 2007; 21 (5): 581-590. [Adasankhidwa]
4. Kawase K, DJ wa Dimaio, Tucker SL, et al. Matenda a Paget a m'mawere: pali udindo wothandizira kuteteza m'mawere. Zolengeza za Opaleshoni ya Oncology 2005; 12 (5): 391--397. [Adasankhidwa]
5. Marshall JK, Griffith KA, Haffty BG, ndi al. Kusamalira mosamala matenda a Paget a m'mawere ndi radiotherapy: zotsatira za 10- ndi 15 wazaka. Khansa 2003; 97 (9): 2142-2149. [Adasankhidwa]
6. Sukumvanich P, DJ wa Bentrem, Cody HS, et al. Udindo wa sentinel lymph node biopsy mu matenda a Paget a m'mawere. Zolengeza za Opaleshoni ya Oncology 2007; 14 (3): 1020–1023. [Adasankhidwa]
7. Laronga C, Hasson D, Hoover S, ndi al. Matenda a Paget munthawi ya sentinel lymph node biopsy. American Journal of Opaleshoni 2006; 192 (4): 481–483. [Adasankhidwa]
8. Amalira LAG, MP wa Eisner. Khansa ya m'mawere achikazi. Mu: Ries LAG, Young JL, Keel GE, et al., Okonza. Monitor Kupulumuka Monograph: Khansa Kupulumuka Pakati Akuluakulu: US SEER Program, 1988-2001, Patient and Tumor Characteristics. Bethesda, MD: National Cancer Institute, SEER Program, 2007. Inabwezeretsanso Epulo 10, 2012.
9. Chen CY, Sun LM, Anderson BO. Matenda a Paget a m'mawere: kusintha kwa magwiridwe antchito, mawonekedwe azachipatala, ndi chithandizo ku US Cancer 2006; 107 (7): 1448-1458. [Adasankhidwa]
10. Joseph KA, Ditkoff BA, Estabrook A, ndi al. Njira zochiritsira matenda a Paget: bungwe limodzi lokhalo lotsatira lotsatira. Breast Journal 2007; 13 (1): 110–111. [Adasankhidwa]