Types/breast/patient/male-breast-treatment-pdq

Chithandizo cha Khansa ya M'mawere Amuna

Zambiri Zokhudza Khansa ya M'mawere Amuna

MFUNDO ZOFUNIKA

• Khansa ya m'mawere yamwamuna ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a m'mawere.

• Mbiri ya banja la khansa ya m'mawere ndi zinthu zina zitha kuwonjezera chiopsezo cha abambo khansa ya m'mawere.

• Khansa ya m'mawere yamwamuna nthawi zina imayamba chifukwa cha kusintha kwa majini.

• Amuna omwe ali ndi khansa ya m'mawere nthawi zambiri amakhala ndi zotupa zomwe zimamveka.

• Kuyesa komwe kumayesa mawere kumagwiritsidwa ntchito kuzindikira (kupeza) ndikuzindikira khansa ya m'mawere mwa amuna.

• Ngati khansa ipezeka, amayesedwa kuti aphunzire za maselo a khansa.

• Kupulumuka kwa amuna omwe ali ndi khansa ya m'mawere ndikofanana ndi kupulumuka kwa amayi omwe ali ndi khansa ya m'mawere.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Khansa ya m'mawere yamwamuna ndi matenda omwe ma cell owopsa (khansa) amapangidwa m'matumba a m'mawere.

Khansa ya m'mawere imatha kuchitika mwa amuna. Khansa ya m'mawere imatha kupezeka mwa amuna amisinkhu iliyonse, koma nthawi zambiri imapezeka mwa amuna azaka zapakati pa 60 ndi 70. Khansa ya m'mawere yamwamuna imakhala yochepera 1% mwa milandu yonse ya khansa ya m'mawere.

Mitundu yotsatirayi ya khansa ya m'mawere imapezeka mwa amuna:

• Kulowetsa ductal carcinoma: Khansa yomwe yafalikira kupyola ma cell olowera mabere. Uwu ndiye mtundu wofala kwambiri wa khansa ya m'mawere mwa amuna.

• Ductal carcinoma in situ: Maselo achilendo omwe amapezeka mkatikati mwa njira; amatchedwanso intraductal carcinoma.

• Khansa ya m'mawere yotupa: Mtundu wa khansa momwe bere limawoneka lofiira komanso lotupa ndikumamva kutentha.

• Matenda a paget of the nipple: Chotupa chomwe chakula kuchokera pamadontho pansi pa nsagwada pamwamba pa nkhonoyo.

Lobular carcinoma in situ (maselo osadziwika omwe amapezeka mu lobes kapena magawo ena a bere), omwe nthawi zina amapezeka mwa akazi, sanawonekere mwa amuna.

Anatomy ya chifuwa chamwamuna. Nipple ndi areola amawonetsedwa kunja kwa bere. Ma lymph node, minofu yamafuta, timadontho, ndi mbali zina zamkati mwa bere zimawonetsedwanso.

Mbiri ya banja la khansa ya m'mawere ndi zinthu zina zitha kuwonjezera chiopsezo cha abambo khansa ya m'mawere.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo. Zowopsa za khansa ya m'mawere mwa amuna zimatha kukhala izi:

• Kuchiza ndi mankhwala a radiation ku bere lanu / pachifuwa.

• Kukhala ndi matenda olumikizidwa ndi kuchuluka kwa estrogen m'thupi, monga cirrhosis (matenda a chiwindi) kapena Klinefelter syndrome (matenda amtundu).

• Kukhala ndi wachibale mmodzi kapena angapo omwe adachitapo khansa ya m'mawere.

• Kusintha masinthidwe amitundu monga BRCA2.

Khansa ya m'mawere yamwamuna nthawi zina imayamba chifukwa cha kusintha kwa majini.

Majini omwe ali m'maselo amanyamula choloŵa chomwe amalandira kuchokera kwa makolo a munthu. Khansa ya m'mawere yobadwa nayo imapanga pafupifupi 5% mpaka 10% ya khansa yonse ya m'mawere. Mitundu ina yosinthika yokhudzana ndi khansa ya m'mawere, monga BRCA2, imafala kwambiri m'mitundu ina. Amuna omwe ali ndi jini yosinthidwa yokhudzana ndi khansa ya m'mawere ali ndi chiopsezo chowonjezeka cha matendawa.

Pali mayeso omwe amatha kuzindikira (kupeza) majini osinthidwa. Mayesero amtunduwu nthawi zina amachitika kwa mabanja omwe ali ndi chiopsezo chachikulu cha khansa. Onani zidule za zotsatirazi kuti mumve zambiri:

• Genetics ya Khansa ya m'mawere ndi Gynecologic

• Kuteteza Khansa ya m'mawere

• Kuyeza Khansa Ya m'mawere

Amuna omwe ali ndi khansa ya m'mawere nthawi zambiri amakhala ndi zotupa zomwe zimamveka.

Ziphuphu ndi zizindikilo zina zimatha kuyambitsidwa ndi khansa ya m'mawere yamwamuna kapena zina. Funsani dokotala ngati muli ndi izi:

• Kutupa kapena kukhathamira mkati kapena pafupi ndi bere kapena malo okhala ndi mikono.

• Kusintha kukula kapena mawonekedwe a bere.

• Kukhazikika pakhungu la m'mawere.

• Nipple anatembenukira mkati mwa bere.

• Madzi ochokera kunsonga, makamaka ngati ali wamagazi.

• Khungu lofiira, lofiira, kapena lotupa pachifuwa, nipple, kapena areola (mdima wakhungu mozungulira nsonga).

• Zofooka m'chifuwa zomwe zimawoneka ngati khungu la lalanje, lotchedwa peau d'orange.

Kuyesa komwe kumayesa mawere kumagwiritsidwa ntchito kuzindikira (kupeza) ndikuzindikira khansa ya m'mawere mwa amuna.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito:

• Kuwunika kwakuthupi ndi mbiri: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikiza kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Clinical breast test (CBE): Kuyesedwa kwa bere ndi dokotala kapena katswiri wina wazachipatala. Dokotala amamva mosamala mabere ndi pansi pa mikono chifukwa cha zotumphukira kapena china chilichonse chomwe chimawoneka chachilendo.

Mammogram: X-ray ya m'mawere.

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba kapena ziwalo zamkati ndikupanga mawonekedwe. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake.

• MRI (magnetic resonance imaging): Njira yomwe imagwiritsa ntchito maginito, mawailesi, komanso kompyuta kuti ipange zithunzi zingapo za mabere onse. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kuchuluka kwazinthu zosazolowereka (zakumwamba kapena zochepa) kungakhale chizindikiro cha matenda.

• Biopsy: Kuchotsa kwa maselo kapena ziphuphu kotero kuti amatha kuwonedwa ndi microscope ndi wodwalayo kuti aone ngati ali ndi khansa. Pali mitundu inayi ya ma biopsies omwe angayang'anire khansa ya m'mawere:

• Chisankho chodabwitsa: Kuchotsa mtanda wonse wa minofu.

• Incopal biopsy: Kuchotsa gawo limodzi kapena chotupa cha mnofu.

• Core biopsy: Kuchotsa minofu pogwiritsa ntchito singano yayikulu.

• Zabwino-singano aspiration (FNA) biopsy: Kuchotsa minofu kapena madzi pogwiritsa ntchito singano yopyapyala.

Ngati khansa ipezeka, amayesedwa kuti aphunzire za maselo a khansa.

Zosankha zamankhwala abwino zimachokera ku zotsatira za mayeso awa. Mayesowa amapereka chidziwitso cha:

• Khansara imatha kukula msanga.

• Ndizotheka bwanji kuti khansara ifalikira mthupi lonse.

• Mankhwala ena angagwire ntchito bwino.

• Khansa imatha kubwereranso (kubwerera).

Mayesowa ndi awa:

• Mayeso a Estrogen ndi progesterone receptor: Kuyesa kuyeza kuchuluka kwa zotengera za estrogen ndi progesterone (mahomoni) mumisempha ya khansa. Ngati pali zowonjezera za estrogen ndi progesterone kuposa zachilendo, khansara amatchedwa estrogen ndi / kapena progesterone receptor positive. Khansara yamtunduwu imatha kukula msanga. Zotsatira zoyeserera zikuwonetsa ngati chithandizo choletsa estrogen ndi progesterone chitha kuletsa khansa kukula.

• Kuyesa kwa HER2: Kuyesa kwa labotale kuti mupeze kuchuluka kwa majini a HER2 / neu komanso kuchuluka kwa mapuloteni a HER2 / neu omwe amapangidwa munthawi ya mnofu. Ngati pali mitundu yambiri ya HER2 / neu kapena kuchuluka kwa mapuloteni a HER2 / neu kuposa mwakale, khansara amatchedwa HER2 / neu positive. Khansara yamtunduwu imatha kukula msanga ndipo imatha kufalikira mbali zina za thupi. Khansara imatha kuchiritsidwa ndi mankhwala omwe amalimbana ndi mapuloteni a HER2 / neu, monga trastuzumab ndi pertuzumab.

Kupulumuka kwa amuna omwe ali ndi khansa ya m'mawere ndikofanana ndi kupulumuka kwa amayi omwe ali ndi khansa ya m'mawere.

Kupulumuka kwa amuna omwe ali ndi khansa ya m'mawere ndi kofanana ndi kwa amayi omwe ali ndi khansa ya m'mawere pomwe gawo lawo lodziwika ndilofanana. Khansa ya m'mawere mwa amuna, komabe, imapezeka pambuyo pake. Khansa yomwe imapezeka pambuyo pake imatha kuchira.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Gawo la khansa (kukula kwa chotupacho komanso ngati chili m'mawere kokha kapena chafalikira kumatenda am'mimba kapena malo ena m'thupi).

• Mtundu wa khansa ya m'mawere.

• Estrogen-receptor ndi progesterone-receptor level mu chotupa.

• Kaya khansa imapezekanso m'mawere ena.

• Msinkhu wamwamuna ndi thanzi lake lonse.

• Kaya khansa yapezeka kumene kapena yabwereranso (bwererani).

Magawo a Khansa ya M'mawere Amuna

MFUNDO ZOFUNIKA

• Khansa ya m'mawere itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa bere kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

• Mu khansa ya m'mawere, gawo limadalira kukula ndi malo omwe ali ndi chotupacho, kufalikira kwa khansa kumalo am'mimba oyandikira kapena ziwalo zina za thupi, kalasi yamatenda, komanso ngati pali ma biomarker ena.

• Njira ya TNM imagwiritsidwa ntchito pofotokoza kukula kwa chotupa choyambirira komanso kufalikira kwa khansa kumatope oyandikira kapena ziwalo zina za thupi.

• Chotupa (T). Kukula ndi malo a chotupacho.

• Lymph mfundo (N). Kukula ndi malo am'mimba momwe khansa yafalikira.

• Metastasis (M). Kufalikira kwa khansa kumadera ena a thupi.

• Njira yoyikirayo imagwiritsidwa ntchito pofotokozera momwe chotupa cha m'mawere chingakule ndikufalikira mofulumira.

• Kuyesa kwa biomarker kumagwiritsidwa ntchito kuti mudziwe ngati maselo a khansa ya m'mawere ali ndi zolandilira.

• Ndondomeko ya TNM, dongosolo loyika, komanso mawonekedwe a biomarker amaphatikizidwa kuti apeze gawo la khansa ya m'mawere.

• Lankhulani ndi dokotala wanu kuti mudziwe momwe khansa yanu ya m'mawere ilili komanso momwe amagwiritsidwira ntchito pokonzekera chithandizo chabwino kwambiri kwa inu.

• Chithandizo cha khansa ya m'mawere yamwamuna chimadalira gawo lina la matendawa.

Khansa ya m'mawere itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa bere kapena mbali zina za thupi.

Khansa ya m'mawere itapezeka, amayesedwa kuti apeze ngati maselo a khansa afalikira mkati mwa bere kapena mbali zina za thupi. Izi zimatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo. Khansa ya m'mawere mwa amuna imayendetsedwa chimodzimodzi ndi akazi. Kufalikira kwa khansa kuchokera pachifuwa kupita kumatenda am'mimba komanso ziwalo zina za thupi kumawoneka chimodzimodzi mwa abambo ndi amai.

Mayeso ndi njira zotsatirazi zitha kugwiritsidwa ntchito pokonza:

• Sentinel lymph node biopsy: Kuchotsa kwa sentinel lymph node panthawi yochita opareshoni. Sentinel lymph node ndiye njira yoyamba yam'magulu am'magazi kuti alandire madzi m'mimba kuchokera pachotupa choyambirira. Ndi lymph node yoyamba yomwe khansa imafalikira kuchokera ku chotupa choyambirira. Mankhwala a radioactive ndi / kapena utoto wabuluu amabayidwa pafupi ndi chotupacho. Katunduyu kapena utoto umadutsa m'mitsempha yam'mimba kupita kumalo am'mimba. Nthenda yoyamba yolandila mankhwala kapena utoto imachotsedwa. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa sapezeka, mwina sikofunikira kuchotsa ma lymph node ambiri. Nthawi zina, sentinel lymph node imapezeka m'magulu angapo am'magulu.

• X-ray pachifuwa : X-ray ya ziwalo ndi mafupa mkati mwa chifuwa. X-ray ndi mtundu wa mphamvu yamphamvu yomwe imatha kupyola thupi ndikupita mufilimu, ndikupanga chithunzi cha madera omwe ali mthupi.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi, zojambulidwa mosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography.

• Kujambula mafupa: Njira yowunika ngati pali magawo omwe amagawa mwachangu, monga maselo a khansa, m'mafupa. Katundu wocheperako kwambiri wa jakisoni amalowetsedwa mumtsempha ndikuyenda m'magazi. Zinthu zowononga nyukiliya zimasonkhanitsa m'mafupa omwe ali ndi khansa ndipo imadziwika ndi sikani.

• PET scan (positron emission tomography scan): Njira yopezera maselo oyipa mthupi. Gulu laling'ono la shuga (radio) limabayidwa mumtsempha. Chojambulira cha PET chimazungulira thupi ndikupanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo otupa owopsa amawonekera pachithunzichi chifukwa amakhala otanganidwa ndipo amatenga shuga wambiri kuposa momwe maselo amachitira.

Pali njira zitatu zomwe khansa imafalikira mthupi.

Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

• Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

• Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

• Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati khansa ya m'mawere imafalikira mpaka fupa, maselo a khansa omwe ali m'mafupawo ndi maselo a khansa ya m'mawere. Matendawa ndi khansa ya m'mawere, osati khansa ya m'mafupa.

Mu khansa ya m'mawere, gawo limadalira kukula ndi malo omwe ali ndi chotupacho, kufalikira kwa khansa kumalo am'mimba oyandikira kapena ziwalo zina za thupi, kalasi yamatenda, komanso ngati pali ma biomarker ena.

Kuti mukonzekere chithandizo chabwino kwambiri ndikumvetsetsa momwe mungadziwire, ndikofunikira kudziwa gawo la khansa ya m'mawere.

Pali mitundu itatu yamagulu a khansa ya m'mawere:

• Clinical Prognostic Stage imagwiritsidwa ntchito koyamba kupangira gawo la odwala onse kutengera mbiri yazaumoyo, kuyesa thupi, kuyerekezera kulingalira (ngati kwachitika), ndi ma biopsies. The Clinical Prognostic Stage ikufotokozedwa ndi dongosolo la TNM, grade grade, ndi biomarker status (ER, PR, HER2). Pazipatala, mammography kapena ultrasound amagwiritsidwa ntchito poyang'ana ma lymph node ngati ali ndi khansa.

• Gawo lodziwitsa za matendawa limagwiritsidwa ntchito kwa odwala omwe akuchitidwa opaleshoni ngati chithandizo chawo choyamba. Gawo la Pathological Prognostic Stage limakhazikitsidwa pazidziwitso zonse zamankhwala, momwe zimakhalira ndi biomarker, komanso zotsatira zoyesa zasayansi kuchokera kumatumba am'mimba ndi ma lymph node omwe amachotsedwa pakuchita opaleshoni.

• Gawo la Anatomic limatengera kukula ndi kufalikira kwa khansa monga momwe tafotokozera ndi dongosolo la TNM. Anatomic Stage imagwiritsidwa ntchito m'malo ena padziko lapansi komwe kuyesa kwa biomarker sikupezeka. Sigwiritsidwe ntchito ku United States.

Njira ya TNM imagwiritsidwa ntchito pofotokoza kukula kwa chotupa choyambirira komanso kufalikira kwa khansa kumatope oyandikira kapena ziwalo zina za thupi.

Kwa khansa ya m'mawere, dongosolo la TNM limafotokoza chotupacho motere:

Chotupa (T). Kukula ndi malo a chotupacho.

Makulidwe a zotupa nthawi zambiri amayesedwa mu milimita (mm) kapena masentimita. Zinthu zomwe zingagwiritsidwe ntchito posonyeza kukula kwa chotupa mu mm ndi monga: cholembera chakuthwa (1 mm), cholembera chatsopano (2 mm), chofufutira pamwamba pensulo (5 mm), nsawawa (10 mm), a chiponde (20 mm), ndi mandimu (50 mm).

• TX: Chotupa choyambirira sichingayesedwe.

• T0: Palibe chizindikiro cha chotupa choyambirira m'mawere.

• Matenda: Carcinoma in situ. Pali mitundu iwiri ya bere carcinoma in situ:

• Tis (DCIS): DCIS ndi momwe ma cell osazolowereka amapezeka m'mbali mwa bere. Maselo achilendo sanafalikire kunja kwa ngalandeyo kumatenda ena a m'mawere. Nthawi zina, DCIS imatha kukhala khansa ya m'mawere yomwe imatha kufalikira kumatenda ena. Pakadali pano, palibe njira yodziwira kuti ndi zilonda ziti zomwe zitha kuwononga.

• Tis (Matenda a Paget): Matenda a paget a nipple ndimavuto omwe khungu lachilendo limapezeka m'maselo a khungu ndipo amatha kufalikira ku areola. Sichikonzedwa molingana ndi dongosolo la TNM. Ngati matenda a Paget NDI khansa ya m'mawere yomwe ilipo, njira ya TNM imagwiritsidwa ntchito poyambitsa khansa ya m'mawere.

• T1: Chotupacho chili ndi mamilimita 20 kapena ochepera. Pali magawo anayi a chotupa cha T1 kutengera kukula kwa chotupacho:

• T1mi: chotupacho ndi 1 millimeter kapena ocheperako.

• T1a: chotupacho ndi chachikulu kuposa 1 millimeter koma osaposa 5 millimeter.

• T1b: chotupacho chimakhala chachikulu kuposa mamilimita 5 koma osaposa mamilimita 10.

• T1c: chotupacho ndi chachikulu kuposa mamilimita 10 koma osaposa 20 millimeters.

• T2: Chotupacho chimakhala chachikulu kuposa mamilimita 20 koma osaposa mamilimita 50.

• T3: Chotupacho ndi chachikulu kuposa mamilimita 50.

• T4: Chotupacho chimafotokozedwa kuti ndi chimodzi mwa izi:

• T4a: chotupacho chakula mpaka kukhoma pachifuwa.

• T4b: chotupacho chakula mpaka pakhungu — chilonda chakhazikika pamwamba pakhungu pa bere, timinatumba tating'onoting'ono tomwe timapanga pachifuwa chimodzimodzi ndi chotupa choyambirira, ndipo / kapena pali kutupa kwa khungu pabere .

• T4c: chotupacho chakula mpaka kukhoma pachifuwa komanso pakhungu.

• T4d: Khansa ya m'mawere yotupa-gawo limodzi mwa magawo atatu kapena kuposerapo pakhungu pa bere ndi lofiira komanso lotupa (lotchedwa peau d'orange).

Lymph mfundo (N). Kukula ndi malo am'mimba momwe khansa yafalikira.

Pamene ma lymph node amachotsedwa ndi opareshoni ndikuphunziridwa ndi microscope ndi katswiri wamatenda, njira yamagwiritsidwe ntchito imagwiritsa ntchito kufotokozera ma lymph node. Magawo am'magazi amfotokozedwe pansipa.

• NX: Ma lymph node sangayesedwe.

• N0: Palibe chizindikiro cha khansa m'matumba am'mimba, kapena timagulu tating'onoting'ono ta maselo a khansa osaposa mamilimita 0,2 m'matumba am'mimba.

• N1: Khansa imanenedwa kuti ndi imodzi mwazinthu izi:

• N1mi: khansara yafalikira ku axillary (armpit area) lymph node ndipo ndi yayikulu kuposa mamilimita 0.2 koma osaposa 2 millimeters.

• N1a: khansara yafalikira mpaka 1 mpaka 3 axillary lymph node ndipo khansa imodzi mwazomwe zimakhala zazikulu kuposa 2 millimeters.

• N1b: khansa yafalikira ku ma lymph node pafupi ndi chifuwa cha bere mbali yomweyo ya thupi ngati chotupa choyambirira, ndipo khansayo ndi yayikulu kuposa milimita 0.2 ndipo imapezeka ndi sentinel lymph node biopsy. Khansa sichipezeka mu ma axillary lymph node.

• N1c: khansara yafalikira mpaka 1 mpaka 3 axillary lymph node ndipo khansa imodzi mwazomwe zimakhala zazikulu kuposa 2 millimeters.

Khansara imapezekanso ndi sentinel lymph node biopsy mu ma lymph node pafupi ndi chifuwa cha bere mbali yomweyo ya thupi ngati chotupa choyambirira.

• N2: Khansa imanenedwa kuti ndi imodzi mwazinthu izi:

• N2a: khansara yafalikira ku ma 4 mpaka 9 axillary lymph node ndipo khansa imodzi mwazomwe zimakhala zazikulu kuposa 2 millimeters.

• N2b: khansa yafalikira ku ma lymph node pafupi ndi chifuwa cha m'mawere ndipo khansa imapezeka poyesa kujambula. Khansa sichipezeka m'mazira am'mimba mwa sentinel lymph node biopsy kapena lymph node dissection.

• N3: Khansa imanenedwa kuti ndi imodzi mwazinthu izi:

• N3a: khansara yafalikira mpaka ma 10 kapena kuposa ma axillary lymph node ndipo khansa imodzi mwazomwe zimakhala zazikulu kuposa 2 millimeters, kapena khansa yafalikira ku ma lymph node pansi pa kolala.

• N3b: khansara yafalikira mpaka 1 mpaka 9 axillary lymph node ndipo khansa imodzi mwazomwe zimakhala zazikulu kuposa 2 millimeters. Khansa yafalikiranso ku ma lymph node pafupi ndi chifuwa cha m'mawere ndipo khansa imapezeka poyesa kujambula;

kapena

khansara yafalikira ku ma 4 mpaka 9 axillary lymph node ndi khansa mulimodzi mwamatenda akulu kuposa 2 millimeter. Khansara yafalikiranso ku ma lymph node pafupi ndi chifuwa cha bere mbali yomweyo ya thupi ngati chotupa choyambirira, ndipo khansayo ndi yayikulu kuposa milimita 0.2 ndipo imapezeka ndi sentinel lymph node biopsy.

• N3c: khansa yafalikira ku ma lymph node pamwamba pa kolala mbali yomweyo ya thupi ngati chotupa choyambirira.

Ma lymph node akafufuzidwa pogwiritsa ntchito mammography kapena ultrasound, amatchedwa staging staging. Magawo azam'mimba samatchulidwa pano.

Metastasis (M). Kufalikira kwa khansa kumadera ena a thupi.

• M0: Palibe chisonyezo chakuti khansara yafalikira mbali zina za thupi.

• M1: Khansa yafalikira mbali zina za thupi, nthawi zambiri mafupa, mapapo, chiwindi, kapena ubongo. Ngati khansara yafalikira kumatenda akutali, khansa yomwe imapezeka m'mimba imaposa mamilimita 0,2.

Njira yoyikirayo imagwiritsidwa ntchito pofotokozera momwe chotupa cha m'mawere chingakule ndikufalikira mofulumira.

Dongosolo loyikiramo limafotokoza chotupa potengera momwe ma cell a khansa ndi minofu zimawonekera pansi pa microscope komanso momwe ma cell a khansa amatha kukula ndikufalikira mwachangu. Maselo a khansa otsika kwambiri amawoneka ngati maselo abwinobwino ndipo amakula ndikufalikira pang'onopang'ono kuposa ma cell apamwamba a khansa. Pofotokoza momwe maselo a khansa ndi minofu yake ilili yovuta, wodwalayo adzaunika zinthu zitatu izi:

• Kuchuluka kwa chotupacho kumakhala ndi timitsempha ta m'mawere.

• Kukula ndi mawonekedwe a mtima m'maselo otupa.

• Maselo akugawana omwe alipo, omwe ndi muyeso wa momwe ma chotupa a chotupa amakulira ndikugawana mwachangu.

Pa chilichonse, wodwalayo amapatsa 1 mpaka 3; mphambu wa "1" amatanthauza kuti maselo ndi zotupa zimawoneka ngati maselo abwinobwino ndi minofu, ndipo mphambu wa "3" amatanthauza kuti ma cell ndi minofu zimawoneka zachilendo kwambiri. Zotsatira zachigawo chilichonse zimaphatikizidwa kuti mupeze zigoli zonse pakati pa 3 ndi 9.

Sukulu zitatu ndizotheka:

• Chiwerengero chonse cha 3 mpaka 5: G1 (Gulu lotsika kapena kusiyanitsidwa bwino).

• Chiwerengero chonse cha 6 mpaka 7: G2 (Gulu lapakatikati kapena kusiyanitsidwa pang'ono).

• Chiwerengero chonse cha 8 mpaka 9: G3 (Gulu lapamwamba kapena losiyanitsidwa bwino).

Kuyesa kwa biomarker kumagwiritsidwa ntchito kuti mudziwe ngati maselo a khansa ya m'mawere ali ndi zolandilira.

Maselo abere athanzi, ndi ma cell ena a khansa ya m'mawere, ali ndi ma receptors (biomarkers) omwe amalumikizana ndi mahomoni a estrogen ndi progesterone. Mahomoni amenewa amafunika kuti maselo athanzi, komanso maselo ena a khansa ya m'mawere, kuti akule ndikugawana. Kuti muwone ngati opangira ma biomarkers, zitsanzo za minofu yomwe ili ndi maselo a khansa ya m'mawere amachotsedwa panthawi yopanga opaleshoni kapena opaleshoni. Zitsanzozo zimayesedwa mu labotale kuti ziwone ngati ma cell a khansa ya m'mawere ali ndi estrogen kapena progesterone receptors.

Mtundu wina wa receptor (biomarker) womwe umapezeka pamwamba pamaselo onse a khansa ya m'mawere umatchedwa HER2. Ma HER2 receptors amafunika kuti maselo a khansa ya m'mawere akule ndikugawana.

Pa khansa ya m'mawere, kuyesa kwa biomarker kumaphatikizapo izi:

• Estrogen receptor (ER). Ngati maselo a khansa ya m'mawere ali ndi zotengera za estrogen, ma cell a khansa amatchedwa ER positive (ER +). Ngati ma cell a khansa ya m'mawere alibe ma estrogen receptors, ma cell a khansa amatchedwa ER negative (ER-).

• Progesterone receptor (PR). Ngati maselo a khansa ya m'mawere ali ndi mapulogalamu a progesterone, maselo a khansa amatchedwa PR positive (PR +). Ngati maselo a khansa ya m'mawere alibe ma progesterone receptors, ma cell a khansa amatchedwa PR negative (PR-).

• Kukula kwa khungu kwa anthu kwamtundu wa 2 receptor (HER2 / neu kapena HER2). Ngati maselo a khansa ya m'mawere ali ndi zikuluzikulu kuposa zolandirira za HER2 pamtunda wawo, maselo a khansa amatchedwa HER2 positive (HER2 +). Ngati maselo a khansa ya m'mawere ali ndi HER2 yofanana pamtunda, maselo a khansa amatchedwa HER2 negative (HER2-). Khansa ya m'mawere ya HER2 + imatha kukula ndikugawana mwachangu kuposa khansa ya m'mawere ya HER2.

Nthawi zina maselo a khansa ya m'mawere amatha kufotokozedwa kuti ndi opanda chiyembekezo kapena katatu.

• Katatu kolakwika. Ngati maselo a khansa ya m'mawere alibe zotengera za estrogen, progesterone receptors, kapena zokulirapo kuposa zolandirira za HER2, ma cell a khansa amatchedwa katatu katatu.

• Katatu katsimikizika. Ngati maselo a khansa ya m'mawere ali ndi zotengera za estrogen, progesterone receptors, komanso zokulirapo kuposa zolandirira za HER2, ma cell a khansa amatchedwa katatu katatu.

Ndikofunikira kudziwa kuti estrogen receptor, progesterone receptor, ndi HER2 receptor status kuti asankhe mankhwala abwino kwambiri. Pali mankhwala omwe amatha kuyimitsa olandila kuti asamangirire mahomoni a estrogen ndi progesterone ndikuletsa khansa kukula. Mankhwala ena atha kugwiritsidwa ntchito kutsekereza ma HER2 receptors pamwambapa maselo a khansa ya m'mawere ndikuletsa khansa kukula.

Ndondomeko ya TNM, dongosolo loyika, komanso mawonekedwe a biomarker amaphatikizidwa kuti apeze gawo la khansa ya m'mawere.

Nazi zitsanzo zitatu zomwe zimaphatikiza dongosolo la TNM, dongosolo loyika, komanso mawonekedwe a biomarker kuti mupeze gawo la khansa ya m'mawere ya Pathological Prognostic ya mayi yemwe chithandizo chake choyamba chinali opaleshoni:

Ngati chotupacho chili ndi mamilimita 30 (T2), sichinafalikire ku ma lymph node (N0), sichinafalikire kumadera akutali a thupi (M0), ndipo ndi:

• Gulu 1

• HER2 +

• ER-

• PR-

Khansara ndi gawo IIA.

Ngati chotupacho chili ndi mamilimita 53 (T3), chafalikira mpaka 4 mpaka 9 axillary lymph node (N2), sichinafalikire mbali zina za thupi (M0), ndipo ndi:

• Gulu 2

• HER2 +

• ER +

• PR-

Chotupacho ndi gawo IIIA.

Ngati chotupacho chili ndi mamilimita 65 (T3), chafalikira ku 3 axillary lymph nodes (N1a), chafalikira m'mapapu (M1), ndipo ndi:

• Gulu 1

• HER2 +

• ER-

• PR-

Khansara ndi gawo IV.

Lankhulani ndi dokotala wanu kuti mudziwe momwe khansa yanu ya m'mawere ilili komanso momwe amagwiritsidwira ntchito pokonzekera chithandizo chabwino kwambiri kwa inu.

Pambuyo pa opareshoni, dokotala wanu alandila lipoti laza matenda lomwe limafotokoza kukula ndi malo a chotupacho, kufalikira kwa khansa kumalo am'mimba apafupi, chotupa, komanso ngati kuli ma biomarkers. Lipoti la kudwala ndi zotsatira zina zoyesedwa zimagwiritsidwa ntchito kuti mudziwe khansa yanu ya m'mawere.

Muyenera kuti muli ndi mafunso ambiri. Funsani dokotala wanu kuti akufotokozereni momwe masitepe amagwiritsidwira ntchito posankha njira zabwino zochizira khansa yanu komanso ngati pali mayesero azachipatala omwe angakhale oyenera kwa inu.

Chithandizo cha khansa ya m'mawere yamwamuna chimadalira gawo lina la matendawa.

Pazomwe mungachite pakuthandizira gawo I, gawo lachiwiri, gawo IIIA, ndi khansa ya m'mawere yothandizira IIIC, onani Khansa ya M'mawere Yoyambirira / Yopezeka / Yogwira Ntchito.

Kuti mupeze chithandizo cha khansa yomwe yabwereranso pafupi ndi komwe idayamba, onani Cancoregional Recurrent Male Breast Cancer

Kuti mupeze chithandizo cha khansa ya m'mawere ya khansa ya m'mawere kapena khansa ya m'mawere yomwe yabwereranso mbali zina za thupi, onani Khansa ya M'mawere ya Metastatic in Men.

Khansa Yotupa Ya m'mawere Amuna

Mu khansa yotupa ya m'mawere, khansa yafalikira pakhungu la m'mawere ndipo bere limawoneka lofiira komanso lotupa ndipo limamva kutentha. Kufiira ndi kutentha kumachitika chifukwa maselo a khansa amatseka zotengera zam'mimba pakhungu. Khungu la bere limatha kuwonetseranso mawonekedwe opindika otchedwa peau d'orange (ngati khungu la lalanje). Mwina sipangakhale zotupa zilizonse m'mawere zomwe zingamveke. Khansa ya m'mawere yotupa ikhoza kukhala gawo IIIB, gawo IIIC, kapena gawo IV.

Khansa Ya m'mawere Yamwamuna Yomwe Imakhalapo

Khansa yapamtima yaposachedwa ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwereranso m'mawere, m'chifuwa, kapena mbali zina za thupi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo kwa amuna omwe ali ndi khansa ya m'mawere.

• Mitundu isanu yamankhwala omwe amagwiritsidwa ntchito pochizira amuna omwe ali ndi khansa ya m'mawere:

• Opaleshoni

• Chemotherapy

• Thandizo la mahomoni

• Thandizo la radiation

• Chithandizo chofuna

• Chithandizo cha khansa ya m'mawere yamphongo chingayambitse zovuta.

Pali mitundu yosiyanasiyana ya chithandizo kwa amuna omwe ali ndi khansa ya m'mawere.

Pali mitundu yosiyanasiyana ya chithandizo kwa amuna omwe ali ndi khansa ya m'mawere. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI. Kusankha chithandizo choyenera kwambiri cha khansa ndichisankho chomwe chimakhudza gulu la odwala, banja, komanso zamankhwala.

Mitundu isanu yamankhwala omwe amagwiritsidwa ntchito pochizira amuna omwe ali ndi khansa ya m'mawere:

Opaleshoni

Kuchita maopareshoni kwa amuna omwe ali ndi khansa ya m'mawere nthawi zambiri kumakhala kosintha kwakukulu kwa mastectomy (kuchotsa mawere, ma lymph node ambiri pansi pa mkono, kulumikizana paminyewa ya pachifuwa, ndipo nthawi zina mbali ya minofu yapachifuwa).

Kusintha kwakukulu kwa mastectomy. Mzere wokhala ndi madontho umawonetsa komwe mawere onse ndi ma lymph node amachotsedwa. Gawo lina la chifuwa cholumikizira pachifuwa amathanso kuchotsedwa.

Opaleshoni yosunga bere, opareshoni yochotsa khansa koma osati bere lomwe, imagwiritsidwanso ntchito kwa amuna ena omwe ali ndi khansa ya m'mawere. Lumpectomy imachitika kuchotsa chotupacho (chotupa) ndi minofu yaying'ono yozungulira. Thandizo la radiation limaperekedwa pambuyo pa opareshoni kuti aphe maselo amtundu uliwonse a khansa omwe atsala.

Opaleshoni yosunga bere. Mizere yamawangamawanga ikuwonetsa dera lomwe lili ndi chotupacho chomwe chachotsedwa ndi zina mwa ma lymph node zomwe zingachotsedwe.

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, chiwalo, kapena thupi ngati pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera).

Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa. Chemotherapy yokhazikika imagwiritsidwa ntchito pochiza khansa ya m'mawere mwa amuna.

Onani Mankhwala Ovomerezeka a Khansa ya m'mawere kuti mumve zambiri.

Thandizo la mahomoni

Thandizo la mahomoni ndi mankhwala a khansa omwe amachotsa mahomoni kapena amalepheretsa zochita zawo ndikuletsa maselo a khansa kuti asakule. Mahomoni ndi zinthu zopangidwa ndi tiziwalo timene timatuluka m'thupi ndipo timafalikira m'magazi. Mahomoni ena amatha kupangitsa khansa kukula. Ngati kuyesa kukuwonetsa kuti ma cell a khansa ali ndi malo omwe mahomoni amatha kulumikiza (receptors), mankhwala osokoneza bongo, opareshoni, kapena mankhwala a radiation amagwiritsidwa ntchito pochepetsa mahomoni kapena kuwaletsa kugwira ntchito.

Mankhwala a mahormone okhala ndi tamoxifen nthawi zambiri amaperekedwa kwa odwala omwe ali ndi khansa ya m'mawere ya estrogen-receptor ndi progesterone-receptor komanso kwa odwala omwe ali ndi khansa ya m'mawere (khansa yomwe yafalikira mbali zina za thupi).

Thandizo la mahormone lokhala ndi aromatase inhibitor limaperekedwa kwa amuna ena omwe ali ndi khansa ya m'mawere. Aromatase inhibitors amachepetsa estrogen ya thupi potseka ma enzyme otchedwa aromatase kuti asasinthe androgen kukhala estrogen. Anastrozole, letrozole, ndi exemestane ndi mitundu ya aromatase inhibitors.

Hormone therapy yokhala ndi luteinizing hormone-release hormone (LHRH) agonist imaperekedwa kwa amuna ena omwe ali ndi khansa ya m'mawere. Agonist a LHRH amakhudza gland pituitary, yomwe imayang'anira kuchuluka kwa testosterone ndi machende. Amuna omwe amatenga agonists a LHRH, chifuwa cha pituitary chimauza machende kuti achepetse testosterone. Leuprolide ndi goserelin ndi mitundu ya agonists a LHRH.

Mitundu ina yamankhwala othandizira mahomoni imaphatikizapo megestrol acetate kapena anti-estrogen therapy, monga fulvestrant.

Onani Mankhwala Ovomerezeka a Khansa ya m'mawere kuti mumve zambiri.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation lakunja limagwiritsidwa ntchito pochiza khansa ya m'mawere yamphongo.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa mankhwala omwe amagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti azindikire ndikuukira maselo amtundu wa khansa osawononga maselo abwinobwino. Thandizo la monoclonal antibody, tyrosine kinase inhibitors, cyclin-dependent kinase inhibitors, ndi mammalian chandamale cha rapamycin (mTOR) inhibitors ndi mitundu yazithandizo zochizira amuna omwe ali ndi khansa ya m'mawere.

Thandizo la monoclonal antibody limagwiritsa ntchito ma antibodies opangidwa mu labotore kuchokera ku mtundu umodzi wa chitetezo chamthupi. Ma antibodies awa amatha kuzindikira zinthu zomwe zili m'maselo a khansa kapena zinthu zabwinobwino zomwe zingathandize ma cell a khansa kukula. Ma antibodies amalumikizana ndi zinthuzo ndikupha ma cell a khansa, amalepheretsa kukula kwawo, kapena amalepheretsa kufalikira. Ma antibodies a monoclonal amaperekedwa mwa kulowetsedwa. Angagwiritsidwe ntchito okha kapena kunyamula mankhwala osokoneza bongo, poizoni, kapena zinthu zowononga radio kupita kuma cell a khansa. Ma antibodies a monoclonal amagwiritsidwanso ntchito ndi chemotherapy ngati mankhwala owonjezera (chithandizo chomwe chimaperekedwa pambuyo pa opaleshoni kuti muchepetse chiopsezo kuti khansa ibwererenso).

Mitundu ya mankhwala a monoclonal antibody ndi awa:

• Trastuzumab ndi antioclonal antibody yomwe imatchinga zomwe zimayambitsa kukula kwa protein HER2.

• Pertuzumab ndi antioclonal antibody yomwe itha kuphatikizidwa ndi trastuzumab ndi chemotherapy pochiza khansa ya m'mawere.

• Ado-trastuzumab emtansine ndi antioclonal antibody yolumikizidwa ndi mankhwala a khansa. Izi zimatchedwa anti-drug conjugate. Itha kugwiritsidwa ntchito kuchiza amuna omwe ali ndi khansa ya m'mawere yolandila yomwe imafalikira mbali zina za thupi.

Ma Tyrosine kinase inhibitors amalimbana ndi mankhwala omwe amaletsa zizindikilo zofunika kuti zotupa zikule. Lapatinib ndi tyrosine kinase inhibitor yomwe ingagwiritsidwe ntchito pochiza amuna omwe ali ndi khansa ya m'mawere.

Ma cyclin-dependent kinase inhibitors amathandizidwa ndi mankhwala omwe amaletsa mapuloteni otchedwa cyclin-dependent kinases, omwe amachititsa kukula kwa maselo a khansa. Palbociclib ndi cyclin-dependent kinase inhibitor yomwe imagwiritsidwa ntchito pochiza amuna omwe ali ndi khansa ya m'mawere.

Cholinga cha mamalia cha rapamycin (mTOR) chimalepheretsa puloteni yotchedwa mTOR, yomwe imalepheretsa maselo a khansa kukula ndikuletsa kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula.

Onani Mankhwala Ovomerezeka a Khansa ya m'mawere kuti mumve zambiri.

Chithandizo cha khansa ya m'mawere yamphongo chingayambitse zovuta.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Njira Zothandizira Kuchiza Khansa Ya m'mawere Amuna

M'chigawo chino

• Khansa Yam'mawere Oyambirira / Yopezeka / Yogwira Ntchito

• Khansa Yam'mabere Amuna Omwe Amapezeka Nthawi Zonse

• Khansara Ya M'mawere Mwa Amuna

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Khansa ya m'mawere mwa amuna imachitiridwa chimodzimodzi ndi khansa ya m'mawere mwa amayi. (Onani chidule cha pa Chithandizo cha Khansa ya M'mawere (Wamkulu) kuti mumve zambiri.)

Khansa Yam'mawere Oyambirira / Yopezeka / Yogwira Ntchito

Chithandizo cha khansa ya m'mawere yoyambirira, yakomweko, kapena yotheka ingaphatikizepo izi:

Opaleshoni Yoyamba

Chithandizo cha amuna omwe amapezeka ndi khansa ya m'mawere nthawi zambiri chimasinthidwa kwambiri mastectomy.

Opaleshoni yosunga bere ndi lumpectomy yotsatiridwa ndi mankhwala a radiation itha kugwiritsidwa ntchito kwa amuna ena.

Thandizo Lothandiza

Chithandizo chomwe chimaperekedwa pambuyo pa opareshoni pomwe maselo a khansa sangathe kuwonanso amatchedwa adjuvant therapy. Ngakhale adotolo atachotsa khansa yonse yomwe imawoneka panthawi yochita opareshoni, wodwalayo atha kupatsidwa mankhwala a radiation, chemotherapy, hormone therapy, ndi / kapena chithandizo chofunikira atachitidwa opareshoni, kuyesa kupha maselo aliwonse a khansa omwe angakhale kumanzere.

• Zosowa: Kwa amuna omwe khansa yake sinayende bwino (khansa siyinafalikire kumatenda am'mimba), chithandizo chothandizira chikuyenera kuganiziridwa chimodzimodzi ndi mayi yemwe ali ndi khansa ya m'mawere chifukwa palibe umboni woti kuyankha mankhwala ndikosiyana amuna ndi akazi.

• Chosavomerezeka: Kwa amuna omwe khansa yake ndiyabwino (khansa yafalikira kumatenda am'mimba), chithandizo chothandizira chitha kuphatikizira izi:

• Chemotherapy.

• Thandizo la mahomoni ndi tamoxifen (kuletsa zotsatira za estrogen) kapena kangapo, aromatase inhibitors (kuchepetsa kuchuluka kwa estrogen m'thupi).

• Chithandizo chojambulidwa ndi antioclonal antibody (trastuzumab kapena pertuzumab).

Mankhwalawa akuwoneka kuti amawonjezera kupulumuka kwa amuna monga momwe amachitira ndi akazi. Kuyankha kwa wodwala kuchipatala kumadalira ngati pali zotengera za mahomoni (mapuloteni) pachotupacho. Khansa yambiri ya m'mawere mwa amuna imakhala ndi izi. Mankhwala a mahomoni nthawi zambiri amalimbikitsidwa kwa odwala khansa ya m'mawere, koma imatha kukhala ndi zovuta zambiri, kuphatikiza kutentha ndi kusowa mphamvu (kulephera kukhala ndi erection yokwanira kugonana).

Khansa Yam'mabere Amuna Omwe Amapezeka Nthawi Zonse

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Kwa amuna omwe ali ndi matenda omwe amabwera kwanuko (khansa yomwe yabwerera kudera laling'ono mutalandira chithandizo), njira zamankhwala ndi izi:

• Opaleshoni.

• Thandizo la radiation kuphatikiza chemotherapy.

Khansara Ya M'mawere Mwa Amuna

Njira zochiritsira khansa ya m'mawere (khansa yomwe yafalikira kumadera akutali a thupi ingaphatikizepo izi:

Thandizo la mahomoni

Amuna omwe angopezeka kuti ali ndi khansa ya m'mawere yamafuta yomwe imalandira zabwino kapena ngati cholandilira sichidziwika, chithandizo chingaphatikizepo:

• Mankhwala a Tamoxifen.

• Aromatase inhibitor therapy (anastrozole, letrozole, kapena exemestane) wokhala ndi agonist wa LHRH kapena wopanda. Nthawi zina cyclin-dependent kinase inhibitor therapy (palbociclib) amaperekedwanso.

Amuna omwe zotupa zawo zimakhala ndi cholandilira kapena chosalandira mahomoni chosadziwika, chofalikira kumafupa kapena minofu yofewa kokha, ndipo omwe amathandizidwa ndi tamoxifen, chithandizo chitha kuphatikizira:

• Thandizo la Aromatase inhibitor kapena wopanda LHRH agonist.

• Mankhwala ena a mahomoni monga megestrol acetate, estrogen kapena mankhwala a androgen, kapena mankhwala a anti-estrogen monga fulvestrant.

Chithandizo chofuna

Amuna omwe ali ndi khansa ya m'mawere yomwe imalandira mahomoni olandila mahomoni ndipo sanayankhe mankhwala ena, njira zomwe mungaphatikizepo ndi monga:

• Trastuzumab, lapatinib, pertuzumab, kapena mTOR inhibitors.

• Mankhwala opatsirana pogonana ndi ado-trastuzumab emtansine.

• Cyclin-dependent kinase inhibitor therapy (palbociclib) pamodzi ndi letrozole.

Amuna omwe ali ndi khansa ya m'mawere yomwe ili ndi HER2 / neu zabwino, chithandizo chitha kuphatikizira:

• Njira zochiritsira monga trastuzumab, pertuzumab, ado-trastuzumab emtansine, kapena lapatinib.

Chemotherapy

Amuna omwe ali ndi khansa ya m'mawere yomwe imayambitsa matenda a hormone receptor, sanayankhe mankhwala a mahomoni, afalikira ku ziwalo zina kapena amachititsa zizindikiro, chithandizo chingaphatikizepo:

• Chemotherapy ndi mankhwala amodzi kapena angapo.

Opaleshoni

• Chiwerewere chonse cha amuna omwe ali ndi zotupa za m'mawere zotseguka kapena zopweteka. Thandizo la radiation lingaperekedwe pambuyo pa opaleshoni.

• Kuchita opaleshoni kuchotsa khansa yomwe yafalikira ku ubongo kapena msana. Thandizo la radiation lingaperekedwe pambuyo pa opaleshoni.

• Kuchita opaleshoni kuchotsa khansa yomwe yafalikira m'mapapu.

• Kuchita opaleshoni yokonza kapena kuthandiza kuthandizira mafupa ofooka kapena osweka. Thandizo la radiation lingaperekedwe pambuyo pa opaleshoni.

• Kuchita opaleshoni kuti achotse madzi omwe asonkhana m'mapapu kapena pamtima.

Thandizo la radiation

• Chithandizo cha ma radiation kumafupa, ubongo, msana, bere, kapena khoma pachifuwa kuti muchepetse zizindikiritso ndikukhala ndi moyo wabwino.

• Strontium-89 (radionuclide) kuti athetse ululu wa khansa yomwe yafalikira m'mafupa mthupi lonse.

Njira zina zamankhwala

Njira zina zothandizira khansa ya m'mawere ndi monga:

• Mankhwala osokoneza bongo ndi bisphosphonates kapena denosumab kuti achepetse matenda am'mafupa ndi ululu khansa ikafalikira kufupa. (Onani chidule cha pa Cancer Pain kuti mumve zambiri za bisphosphonates.)

• Mayesero azachipatala akuyesa mankhwala osokoneza bongo, mankhwala atsopano, ndi njira zatsopano zoperekera chithandizo.

Kuti mudziwe zambiri za khansa ya m'mawere amuna

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudza khansa ya m'mawere yaamuna, onani izi:

• Khansa ya m'mawere Tsamba

• Mankhwala Ovomerezeka a Khansa Ya m'mawere

• Thandizo la Hormone la Khansa ya m'mawere

• Njira Zochizira Khansa

• Kuyesedwa Kwachibadwa kwa Ma Syndromes Obadwa Ndi Khansa

• Kusintha kwa BRCA: Kuopsa kwa Khansa ndi Kuyesa Kwachibadwa

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira