Types/breast/paget-breast-fact-sheet

Paget Chirwere cheChipfuva

Chii chinonzi Paget chirwere chezamu?

Chirwere chePaget chezamu (inozivikanwawo sePaget chirwere chezamu uye mammary Paget chirwere) chirwere chisingawanzoitika chegomarara chinosanganisira ganda rezamu uye, kazhinji, denderedzwa rakasviba reganda rakakomberedza, iro rinonzi areola. Vazhinji vanhu vane chirwere chePaget chezamu vane rimwe kana mamwe mapundu mukati mezamu rimwe chete. Aya mamota ezamu anogona kunge ductal carcinoma in situ kana kenza yemazamu inoparadza (1-3).

Chirwere chePaget chezamu chakatumidzwa mushure megumi wezana ramakore rechi19 chiremba wechiBritish Sir James Paget, uyo, muna 1874, akaona hukama pakati pekuchinja munyatso nekenza yemazamu. (Dzimwe hosha dzinoverengeka dzakatumidzwa zita raSir James Paget, kusanganisira Paget chirwere chemabhonzo uye extramammary Paget chirwere, icho chinosanganisira chirwere chePaget chemuviri uye chirwere chePaget chepenisi. Izvi zvimwe zvirwere hazvinei nePaget chirwere chezamu. jira rinokurukura chete Paget chirwere chezamu.)

Maseru anotyisa anozivikanwa sePaget maseru chiratidzo chekutaura chePaget chirwere chezamu. Aya maseru anowanikwa muepidermis (pamusoro pevhu) cheganda rezamu uye areola. Paget maseru anowanzove neakakura, akakomberedza kutaridzika pasi pe microscope; dzinogona kuwanikwa semasero ega kana semapoka madiki emasero mukati meganda.

Ndiani anowana chirwere chePaget chezamu?

Chirwere chePaget chezamu chinoitika mune vese vakadzi nevarume, asi kazhinji zviitiko zvinoitika kuvakadzi. Inenge 1 kusvika ku4 muzana yezviitiko zvese zvegomarara repazamu zvakare zvinosanganisira chirwere chePaget chezamu. Ivhareji zera pakuongororwa makore makumi mashanu nemanomwe, asi chirwere ichi chakawanikwa muvachiri kuyaruka uye muvanhu vane makore makumi masere apfuura (2, 3).

Chii chinokonzera chirwere chePaget chezamu?

Vanachiremba havanyatsonzwisisa kuti chii chinokonzera chirwere chePaget chezamu. Pfungwa inogamuchirwa zvakanyanya ndeyekuti maseru egomarara kubva pabundu mukati mechipfuva anofamba kuburikidza nemukaka wemukaka kuenda kunyini uye areola. Izvi zvaigona kutsanangura kuti nei chirwere chePaget chezamu nemamota mukati mechipfuva chimwe chete chinowanikwa chinowanikwa pamwechete (1, 3).

Pfungwa yechipiri ndeyekuti maseru ari munyini kana areola anova nekenza pachawo (1, 3). Izvi zvinogona kutsanangura kuti nei vanhu vashoma vachikura chirwere chePaget chezamu vasina kana bundu mukati mezamu rimwe chete. Zvakare, zvinokwanisika kuti chirwere chePaget chezamu nemamota mukati mechipfuva chimwe chete chikure chakazvimiririra (1).

Ndezvipi zviratidzo zvePaget chirwere chezamu?

Zviratidzo zvePaget chirwere chezamu zvinowanzokanganiswa neizvo zveimwe isina kunaka ganda mamiriro, senge dermatitis kana eczema (1-3). Zviratidzo izvi zvinogona kusanganisira zvinotevera:

• Kuchema, kurira, kana kutsvuka mumunyatso uye / kana areola

• Rinoyerera, rakakora kana rakakora ganda pane kana kutenderedza munyatso

• Zamu rakapetwa

• Kubuda kubva pazamu rinogona kunge riita yero kana reropa

Nekuti zviratidzo zvekutanga zvePaget chirwere chechipfuva zvinogona kuratidza chimiro cheganda chisina kunaka, uye nekuti chirwere ichi chisingawanzo, chinogona kutadza kuongororwa zvisizvo pakutanga. Vanhu vane chirwere chePaget chezamu vanowanzove vaine zviratidzo kwemwedzi yakati wandei vasati vanyatsoonekwa.

Chirwere chePaget chezamu chinoonekwa sei?

Nyini bhiopsy inobvumidza vanachiremba kunyatso kuongorora chirwere chePaget chezamu. Kune akatiwandei mhando dzenzou biopsy, kusanganisira maitiro anotsanangurwa pazasi.

• Surface biopsy: Girazi rinotsvedza kana chimwe chishandiso chinoshandiswa kupora zvinyoro maseru kubva pamusoro peganda.

• Shave biopsy: Chishandiso chakaita sechisvo chinoshandiswa kubvisa chikamu chepamusoro cheganda.

• Punch biopsy: Chishandiso chakatenderedza chekucheka, chinonzi chibhakera, chinoshandiswa kubvisa chidimbu chakaumbika sedhisiki.

• Wedge biopsy: A scalpel inoshandiswa kubvisa kadiki kadiki kenyama.

Mune zvimwe zviitiko, vanachiremba vanogona kubvisa rese zamu (1). Nyanzvi yezvirwere anoongorora maseru kana zvinyama pasi pe microscope kutsvaga Paget maseru.

Vazhinji vanhu vane chirwere chePaget chezamu vane rimwe kana mamwe mapundu mukati mezamu rimwe chete. Kunze kwekuraira nyini bhiopsy, chiremba anofanira kuita kiriniki yekuongorora zamu kuti aone mapundu kana kumwe kuchinja kwemazamu. Vazhinji vanosvika makumi mashanu muzana yevanhu vane chirwere chePaget chezamu vane bundu repazamu rinogona kunzwikwa mukiriniki yekuongorora zamu. Chiremba anogona kuraira mimwe bvunzo yekuongorora, senge yekuongorora mammogram, bvunzo ye ultrasound, kana magineti resonance imaging scan kuti atsvage mamota anogona kuitika.

Chirwere chePaget chezamu chinorapwa sei?

Kwemakore mazhinji, mastectomy, iine kana isina kubviswa kwema lymph node pasi pe ruoko parutivi rumwe chete rwechifuva (inozivikanwa se axillary lymph node dissection), yaionekwa sekuvhiyiwa kwakajairika kwePaget chirwere chezamu (3, 4). Rudzi urwu rwekuvhiya rwakaitwa nekuti varwere vane chirwere chePaget chezamu vaiwanzo kuwanikwa vaine rimwe kana akawanda mamota mukati mezamu rimwe chete. Kunyangwe dai bundu rimwe chete raivepo, bundu riya raigona kuwanikwa masendimita akati wandei kubva pazamu uye areola uye raisazobviswa nekuvhiya pazamu uye areola chete (1, 3, 4).

Zvidzidzo zvakaratidza, zvisinei, kuti kuvhiya-kuchengetedza zamu uko kunosanganisira kubviswa kwezamu uye areola, kuchiteverwa nerese-zamu radiation radiation, inzira yakachengeteka kune vanhu vane chirwere chePaget chezamu vasina bundu rinobatika muzamu ravo uye ane mamammograms asingaratidze bundu (3-5).

Vanhu vane chirwere chePaget chezamu vane bundu remuzamu uye vane mastectomy vanofanirwa kupihwa sentinel lymph node biopsy kuti vaone kana gomarara rapararira kune axillary lymph node. Kana masero emukenza akawanikwa mune sentinel lymph node (s), kuwedzerwa axillary lymph node kuvhiyiwa kunogona kudikanwa (1, 6, 7). Zvichienderana nedanho uye zvimwe zvinhu zvechisimba zamu bundu (semuenzaniso, kuvapo kana kusavapo kwerymph node kubatanidzwa, estrogen uye progesterone receptors mumasero emota, uye HER2 protein overexpression mumasero emota), adjuvant therapy, inosanganisira chemotherapy uye / kana hormonal therapy, inogonawo kukurudzirwa.

Ndeupi fungidziro kune vanhu vane chirwere chePaget chezamu?

Kufungidzira, kana maonero, kune vanhu vane chirwere chePaget chezamu chinoenderana nezvinhu zvakasiyana, kusanganisira zvinotevera:

• Kunyangwe kana kwete bundu riripo muzamu rakabatwa

• Kana rimwe kana mamwe mamota aripo muzamu rakabatwa, kunyangwe iwo mapundu ari ductal carcinoma in situ kana kenza yemazamu inoparadza.

• Kana kenza yemazamu inopinda irimo muzamu rakabatwa, danho rekenza iyoyo

Kuvapo kwekenza inopinda muzamu rakakanganisika uye kupararira kwegomarara kune lymph node iri padyo inosanganisirwa nekuderera kupona.

Sekureva kweiyo NCI's Surveillance, Epidemiology, uye End Mhedzisiro chirongwa, iyo-makore mashanu kupona kune vakadzi vese muUnited States avo vakawanikwa vaine chirwere chePaget chezamu pakati pe1988 na2001 yaive 82.6 muzana. Izvi zvinofananidzwa nemakore mashanu ekupona kwe 87.1 muzana yevakadzi vanoonekwa vaine chero mhando yekenza yemazamu. Kune vakadzi vane zvese chirwere chePaget chezamu uye kenza inopinda mune rimwe zamu, makore mashanu ekupona kwehukama akaderera nekuwedzera nhanho yekenza (nhanho I, 95.8 muzana; nhanho II, 77.7 muzana; nhanho III, 46.3 muzana; nhanho IV, 14.3 muzana) (1, 3, 8, 9).

Ndedzipi zvidzidzo zvekutsvaga zviri kuitika paPaget chirwere chezamu?

Randomized inodzorwa kiriniki miedzo, inoonekwa se "chiyero chegoridhe" mukutsvaga kwegomarara, zvinonetsa kuitisa chirwere chePaget chezamu nekuti vashoma vanhu vane chirwere ichi (4, 10). Nekudaro, vanhu vane chirwere chePaget chezamu vanogona kuve vanokwanisa kunyoresa mumakiriniki miedzo kuti vaongorore mishonga mitsva yekenza yemazamu kazhinji, nzira nyowani dzekushandisa kurapa kenza yemazamu, kana nzira dzekudzivirira kudzoka kwekenza yemazamu.

Ruzivo nezve yazvino kenza yemazamu kurapwa kiriniki miedzo inowanikwa nekutsvaga NCI's runyorwa rwecancer kliniki miedzo Neimwe nzira, fonera iyo NCI Contact Center pa1-800-4-CANCER (1-800-422-6237) kuti uwane ruzivo nezve kiriniki miedzo kune vanhu vane chirwere chePaget chezamu.

Sarudzo Referensi

1. Harris JR, Lippman ME, Morrow M, Osborne CK, vapepeti. Zvirwere zveChipfuva. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
2. Caliskan M, Gatti G, Sosnovskikh Ini, et al. Chirwere chePaget chezamu: ruzivo rweEuropean Institute of Oncology uye kuongorora zvinyorwa. Kenza Yemazamu Ongororo uye Kurapa 2008; 112 (3): 513-521. [PubMed Abstract]
3. Kanitakis J. Mammary uye extramammary chirwere chePaget. Zvinyorwa zveEuropean Academy yeDermatology uye Venereology 2007; 21 (5): 581-590. [PubMed Abstract]
4. Kawase K, Dimaio DJ, Tucker SL, et al. Chirwere chePaget chezamu: pane basa rekurapa-kuchengetedza zamu. Zvinyorwa zveKuvhiya Oncology 2005; 12 (5): 391-397. [PubMed Abstract]
5. Marshall JK, Griffith KA, Haffty BG, et al. Conservative manejimendi ePaget chirwere chezamu ne radiotherapy: 10- uye 15-gore mhedzisiro. Kenza 2003; 97 (9): 2142-2149. [PubMed Abstract]
6. Sukumvanich P, Bentrem DJ, Cody HS, et al. Basa re sentinel lymph node biopsy muchirwere chePaget chezamu. Annals yekuvhiya Oncology 2007; 14 (3): 1020–1023. [PubMed Abstract]
7. Laronga C, Hasson D, Hoover S, et al. Chirwere chePaget munguva ye sentinel lymph node biopsy. American Nhoroondo yekuvhiya 2006; 192 (4): 481-483. [PubMed Abstract]
8. Anoreva LAG, Eisner MP. Kenza yeMazamu echikadzi. Mune: Ries LAG, Mudiki JL, Keel GE, et al., Vapepeti. SEER Kupona Monograph: Kenza Kupona Pakati Pevakuru: US SEER Chirongwa, 1988-2001, Murwere uye Tumor Hunhu. Bethesda, MD: National Cancer Institute, SEER Chirongwa, 2007. Yakadzorerwa Kubvumbi 10, 2012.
9. Chen CY, Zuva LM, Anderson BO. Paget chirwere chezamu: kuchinja maitiro ezviitiko, kiriniki mharidzo, uye kurapwa muUS Cancer 2006; 107 (7): 1448-1458. [PubMed Abstract]
10. Joseph KA, Ditkoff BA, Estabrook A, et al. Kurapa sarudzo dzechirwere chePaget: imwe institution inogara kwenguva refu yekutevera-yekudzidza. Chifuva Chinyorwa 2007; 13 (1): 110-111. [PubMed Abstract]