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Chirwere Chebonde Chekuita

Chii chinonzi kupisa kenza yemazamu?

Kenza yemazamu yekuzvimba chirwere chisingawanzo uye chine hukasha umo masero ekenza anovharira lymph midziyo muganda rezamu. Rudzi urwu rwegomarara repazamu rwunodaidzwa kuti "kuzvimba" nekuti chipfuva chinowanzoita kunge chakazvimba uye chakatsvuka, kana kuti chinopisa.

Kenza yemazamu yekuzvimba haiwanzoitika, kuverenga 1 kusvika ku5 muzana yekenza dzese dzemazamu dzinoonekwa muUnited States. Kazhinji kenza yemazamu inopomarara inokanganisa ductal carcinomas, zvinoreva kuti vakagadzira kubva kumasero anoteedzera mukaka wemukaka wezamu uye ndokuzopararira kupfuura madhiri.

Kenza yemazamu yekuzvimba inofambira mberi nekukurumidza, kazhinji mune nyaya yemavhiki kana mwedzi. Pakuongororwa, kenza yemazamu inoputira ingangove yechikamu chechitatu kana chechina chirwere, zvichienderana nekuti masero ekenza akapararira chete kune ma lymph node ari padyo kana kune mamwe matukisi zvakare.

Zvimwe zvinoitwa nekenza yemazamu inoputira inosanganisira zvinotevera:

• Inofananidzwa nemamwe marudzi ekenza yemazamu, kenza yemazamu inoputira inowanzoonekwa pazera diki.

• Kenza yemazamu yekuzvimba inowanzoitika uye inoonekwa pazera diki muvakadzi vemuAfrica kupfuura vakadzi vachena.

• Zvirwere zvekuzvimba zvemazamu zvinowanzoitika hormone receptor zvisina kunaka, zvinoreva kuti havagone kurapwa nemahomoni ekurapa, senge tamoxifen, iyo inopesana nekukura kwemaseru ekenza akafuridzirwa neestrogen.

• Kenza yemazamu yekuzvimba inowanzoitika kune vakadzi vakafuta kupfuura vakadzi vane huremu hwese.

Sedzimwe mhando dzekenza yemazamu, kenza yemazamu inoputira inogona kuitika mune varume, asi kazhinji pazera rekare kupfuura mune vakadzi.

Ndezvipi zviratidzo zvegomarara repazamu rekuzvimba?

Zviratidzo zvekenza yemazamu inokanganisa inosanganisira kuzvimba (edema) uye kutsvuka (erythema) izvo zvinokanganisa chetatu kana kupfuura zamu. Ganda rezamu rinogona zvakare kuoneka repingi, rakatsvukuruka nepepuru, kana rakakuvara. Uye zvakare, iro ganda rinogona kunge riine makoronga kana kuita kunge akakwenenzverwa, seganda reorenji (inonzi peau d'orange). Zviratidzo izvi zvinokonzerwa nekuwanda kwemvura (lymph) muganda rezamu. Kuwedzera kwemvura kunoitika nekuti maseru emukenza akavhara ma lymph lymph mukati meganda, ichidzivirira kuyerera kweiyo lymph kuburikidza nematinji. Dzimwe nguva chipfuva chinogona kunge chiine bundu rakasimba rinogona kunzwiwa panguva yemuviri kuongorora, asi kazhinji bundu harigone kunzwikwa.

Zvimwe zviratidzo zvekenza yemazamu inokanganisa inosanganisira kuwedzera nekukurumidza mukukura kwemazamu; kunzwa kwekurema, kupisa, kana hunyoro muzamu; kana zamu rakachinjika (rakatarisa mukati). Kuzvimba lymph node kunogona zvakare kunge kuripo pasi peruoko, padyo necollarbone, kana ese ari maviri.

Izvo zvakakosha kuti uzive kuti izvi zviratidzo zvinogona zvakare kuve zviratidzo zveimwe hosha kana mamiriro, senge hutachiona, kukuvara, kana imwe mhando yekenza yemazamu yakasimukira munharaunda imomo. Nechikonzero ichi, vakadzi vane gomarara repazamu rinopisa vanowanzo kuve nekunonoka kuongororwa kwechirwere chavo.

Kenza yemazamu inoputika inoonekwa sei?

Kenza yechipfuva yemazamu inogona kunge yakaoma kuongorora. Kazhinji, hapana bundu iro rinogona kunzwiwa panguva yemuviri kuongorora kana kuona mune yekuongorora mammogram. Uye zvakare, vakadzi vazhinji vanoonekwa vane huturu hwekenza yemazamu vane dense yemazamu tishu, izvo zvinoita kuti gomarara rionekwe mune yekuongorora mammogram yakaoma. Zvakare, nekuti kenza yemazamu inoputira ine hasha, inogona kusimuka pakati pekurongwa mammograms uye kufambira mberi nekukurumidza. Zviratidzo zvegomarara repazamu rekuzvimba zvinogona kukanganisa izvo zve mastitis, inova chirwere chezamu, kana chimwe chimiro chekenza yemazamu yepamberi.

Kubatsira kudzivirira kunonoka mukuongororwa uye mukusarudza nzira yekurapa yakanakisa, boka renyanzvi renyika dzese rakaburitsa nhungamiro yekuti vanachiremba vangaziva sei uye vatange gomarara repazamu rinopisa nenzira kwayo. Kurudziro yavo yakapfupikiswa pazasi.

Minimum zviyero zvekuongororwa kwechirwere chekenza yemazamu zvinosanganisira zvinotevera:

• Kutanga nekukurumidza kweiyo erythema (kutsvuka), edema (kuzvimba), uye peau d'orange chitarisiko (ganda rakakomberedzwa kana rakapetwa) uye / kana kusadziya kwechifuva, kana kana pasina bundu rinogona kunzwika.

• Zviratidzo zvataurwa pamusoro izvi zvave zviripo kwemwedzi isingasviki mitanhatu.

• Erythema inovhara chinenge chetatu chezamu.

• Pakutanga biopsy sampuli kubva pazamu rakakanganiswa rinoratidza invasive carcinoma.

Kuenderera mberi nekuongororwa kwetishu kubva pazamu rakakanganisika kunosanganisira kuyedza kuona kana masero ekenza aine mahormone receptors (estrogen uye progesterone receptors) kana aine huwandu hwakakura kupfuura huwandu hwese hweHER2 geni uye / kana HER2 protein (HER2-positive kenza yemazamu. ).

Kufungidzira uye kuyedza bvunzo zvinosanganisira zvinotevera:

• Yekuongorora mammogram uye iyo ultrasound yezamu uye yedunhu (padyo) lymph node

• PET scan kana CT scan uye bone scan kuti uone kana gomarara rapararira kune dzimwe nhengo dzemuviri

Kunyatsoongororwa uye kuiswa kwechirwere chekenza yemazamu kunobatsira vanachiremba kukudziridza chirongwa chakanakisa chekurapa uye kufungidzira zvingangoitika chirwere ichi. Varwere vanoonekwa kuti vane gomarara repazamu rinopisa vangangoda kubvunza chiremba anoona nezvechirwere ichi.

Kenza yemazamu inoputika inorapwa sei?

Kenza yemazamu yekuzvimba inowanzo kurapwa kutanga ne systemic chemotherapy kubatsira kudzikisira bundu, uye nekuvhiya kubvisa bundu, kuchiteverwa ne radiation radiation. Iyi nzira yekurapa inonzi nzira ye multimodal. Zvidzidzo zvakaona kuti vakadzi vane gomarara repazamu rinozvimba avo vanorapwa neiyo multimodal nzira vane mhinduro dzakanaka kurapa uye kurarama kwenguva refu. Marapirwo anoshandiswa munzira dzakasiyana siyana anogona kusanganisira iwo anotsanangurwa pazasi.

• Neoadjuvant chemotherapy: Rudzi urwu rwe chemotherapy runopihwa usati wavhiyiwa uye kazhinji rinosanganisira zvese anthracycline nemitero yemitero. Vanachiremba vanowanzo kurudzira kuti angangoita matanhatu maekisheni eeoadjuvant chemotherapy kupihwa mukati memwedzi mina kusvika kumitanhatu bundu risati rabviswa, kunze kwekunge chirwere ichi chichienderera mberi panguva ino uye vanachiremba vafunga kuti kuvhiya hakufanirwe kunonoka.

• Targeted Therapy: Inopisa kenza yemazamu inowanzo kuburitsa yakakura kupfuura yakajairwa huwandu hweiyo HER2 protein, zvinoreva kuti mishonga yakadai sa trastuzumab (Herceptin) inotarisa protein iyi inogona kushandiswa kurapa. Anti-HER2 kurapwa kunogona kupihwa zvese sechikamu cheiyoojujujuid therapy uye mushure mekuvhiyiwa (adjuvant therapy).

• Hormone therapy: Kana masero echikadzi echirwere chekenza ane mazamu, hormone therapy ndeimwe nzira yekurapa. Zvinodhaka zvakadai tamoxifen, iyo inodzivirira estrogen kubva mukusunga kune yayo receptor, uye aromatase inhibitors senge letrozole, iyo inovharira kugona kwemuviri kugadzira estrogen, inogona kukonzera esrogen-inoenderana nekenza maseru emukenza kuti arege kukura uye kufa.

• Kuvhiya: Iyo yakajairwa kuvhiyiwa kwechirwere chekenza yemazamu ndeye yakachinjwa radical mastectomy. Kuvhiya uku kunosanganisira kubviswa kwese zamu rakabatwa uye mazhinji kana ese ma "lymph node" ari pasi peruoko rwepedyo. Kazhinji, kumisikidzwa pamusoro pemhasuru yepasi pechipfuva kunobviswawo, asi mhasuru dzechipfuva dzinochengetedzwa. Dzimwe nguva, zvakadaro, iyo diki chipfuva mhasuru (pectoralis diki) inogona kubviswa, futi.

• Radiation Therapy: Post-mastectomy radiation kurapwa kune chipfuva madziro pazasi pezamu rakabviswa chikamu cheyakajairika che multimodal kurapa kwekupomhodza kenza yemazamu. Kana mukadzi akagashira trastuzumab asati avhiyiwa, anogona kuramba achiigamuchira panguva yekurapwa kwemwaranzi yekuvhiya. Kugadzira chipfuva kunogona kuitwa mumadzimai ane gomarara repazamu rinopisa, asi, nekuda kwekukosha kwerapi radiation pakurapa chirwere ichi, nyanzvi dzinowanzokurudzira kunonoka kuvakwazve.

• Adjuvant therapy: Adjuvant systemic therapy inogona kupihwa mushure mekuvhiyiwa kuti kuderedze mukana wekenza zvakare. Iyi kurapa inogona kusanganisira yekuwedzera chemotherapy, hormone therapy, yakanangwa kurapa (senge trastuzumab), kana kumwe kusanganiswa kwemishonga iyi.

Ndezvipi fungidziro yevarwere vane gomarara repazamu rinopisa?

Kufungidzira, kana kungangoitika, kune murwere anoonekwa aine gomarara kunowanzoonekwa semukana wekuti kenza irapwa zvinobudirira uye kuti murwere achapora zvachose. Zvakawanda zvinhu zvinogona kukanganisa kufungidzira kwemurwere wekenza, kusanganisira mhando uye nzvimbo yekenza, danho rechirwere, zera remurwere uye hutano hwakazara, uye nemabatirwo anoitwa chirwere chemurwere.

Nekuti kenza yemazamu inoputira inowanzo kukura nekukurumidza uye ichipararira zvine hukasha kune dzimwe nhengo dzomuviri, vakadzi vanoonekwa kuti vane chirwere ichi, kazhinji, havagone sekureba sevakadzi vanoonekwa vaine mamwe marudzi ekenza yemazamu.

Izvo zvakakosha kuti urambe uchifunga, zvisinei, kuti manhamba ekupona akavakirwa pahuwandu hwevarwere uye kuti kufungidzirwa kweumwe mukadzi kunogona kuve kuri nani kana kutonyanya, zvichienderana nehunhu hwake hunhu uye nhoroondo yekurapa. Vakadzi vane gomarara repazamu rinopisa vanokurudzirwa kuti vataure nachiremba wavo nezve fungidziro yavo, vachipihwa mamiriro avo chaiwo.

Kuenderera mberi kwekutsvagisa, kunyanya padanho remamorekuru, kuchawedzera kunzwisisa kwedu kwekuti chirwere chegomarara repamazamu chinotanga nekufambira mberi. Ruzivo urwu runofanira kugonesa kuvandudzwa kwemishonga mitsva uye fungidziro dzechokwadi kune vakadzi vanoonekwa vaine chirwere ichi. Izvo zvakakosha, saka, kuti vakadzi vanoonekwa kuti vane hutachiona hwekenza yemazamu vanotaura nachiremba wavo nezve sarudzo yekupinda mukuyedzwa kwekiriniki.

Ndeapi makiriniki ekuedzwa aripo kune vakadzi vane hutachiona hwekenza yemazamu?

NCI inotsigira kuyedzwa kwemakiriniki ekurapwa kutsva kwemarudzi ese ekenza, pamwe nemiedzo inoedza nzira dziri nani dzekushandisa kurapa kuripo. Kutora chikamu mumakiriniki ekuedzwa isarudzo yevarwere vazhinji vane gomarara repazamu rinozvimba, uye vese varwere vane chirwere ichi vanokurudzirwa kufunga nezvekurapa mukuedzwa kwekiriniki

Tsananguro dzemakiriniki anoramba achienderera kune vanhu vane gomarara repazamu rinopisa anogona kuwanikwa nekutsvaga runyorwa rweNCI rwekenza kiriniki miedzo. Rondedzero yeNCI yekenza kiriniki miedzo inosanganisira ese maNCI-anotsigirwa makiriniki miedzo iri kuitika muUnited States neCanada, kusanganisira iyo NIH Clinical Center muBethesda, MD. Kuti uwane ruzivo nezve nzira yekutsvaga iyo rondedzero, ona Rubatsiro Kuwana NCI-Inotsigirwa Clinical Miedzo.

Vanhu vanofarira kutora chikamu mukutongwa kwekiriniki vanofanirwa kutaura nachiremba wavo. Ruzivo nezve kiriniki yekuedzwa rwunowanikwa kubva kuNCI's Cancer Information Service pa1-800–4-CANCER (1-800–422-6237) uye mubhukwana reNCI Kutora Chikamu muCancer Cancer Research Research. Ruzivo rwekuwedzera nezve zvemakiriniki ekuedzwa zviripo online.

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