Mhando / zamu / murwere / mukuru / zamu-kurapwa-pdq

Kurapa Kenza Yezamu (Mukuru) Shanduro

Ruzivo Ruzhinji Nezve Kenza Yezamu

PFUNGWA DZINOKOSHA

• Gomarara repazamu chirwere icho chinotyisa (gomarara) maseru anoumba munyama dzechipfuva.

• Nhoroondo yemhuri yekenza yemazamu uye zvimwe zvinhu zvinowedzera njodzi yekenza yemazamu.

• Gomarara repazamu dzimwe nguva rinokonzerwa nekuzvarwa nhaka kwemajini (shanduko).

• Iko kushandiswa kwemimwe mishonga nezvimwe zvinhu zvinoderedza njodzi yekenza yemazamu.

• Zviratidzo zvegomarara repazamu zvinosanganisira bundu kana shanduko muzamu.

• Kuyedza kunoongorora mazamu kunoshandiswa kuona (kutsvaga) uye kuongorora gomarara repazamu.

• Kana gomarara rikawanikwa, kuongororwa kunoitwa kuongorora masero ekenza.

• Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Gomarara repazamu chirwere icho chinotyisa (gomarara) maseru anoumba munyama dzechipfuva.

Chipfuva chakagadzirwa nemakwenzi uye mapaipi. Zamu rega rega rine zvikamu gumi neshanu kusvika makumi maviri zvinonzi makobvu. Lobe rimwe nerimwe rine zvikamu zvidiki zvakawanda zvinonzi makoori. Lobules anopera mune akati wandei madiki mababu anogona kugadzira mukaka. Iwo makobvu, makobiri, uye mababu akabatanidzwa neatetepu machena anonzi mapaipi.

Anatomy yezamu revakadzi. Zamu uye areola zvinoratidzwa kunze kwezamu. Iyo maLymph node, makobvu, makobiri, ducts, uye zvimwe zvikamu zvemukati mezamu zvinoratidzwa zvakare.

Zamu rega rega rinewo tsinga dzeropa uye lymph lymph. Iyo yemidziyo yemidziyo inotakura inenge isina ruvara, mvura yemvura inonzi lymph. Lymph midziyo inotakura lymph pakati pema lymph node. MaLymph node madiki, akaumbwa-akaumbwa bhinzi anowanikwa mumuviri wese. Ivo vanosefa lymph uye vanochengeta machena masero eropa ayo anobatsira kurwisa hutachiona nezvirwere. Mapoka ema lymph node anowanikwa pedyo nezamu muaxilla (pasi peruoko), pamusoro pekora, uye muchipfuva.

Rudzi rwakajairika rwegomarara repazamu iductal carcinoma, iyo inotanga mumasero emadhiri. Gomarara iro rinotanga mumakomba kana makobhu anonzi lobular carcinoma uye anowanzo kuwanikwa mumazamu ese ari maviri kupfuura mamwe marudzi ekenza yemazamu. Kenza yemazamu yekuzvimba imhando isingazivikanwe yekenza yemazamu umo chipfuva chinodziya, chakatsvuka uye chakazvimba.

Ona zvinotevera pfupiso dze kuti uwane rumwe ruzivo nezve kenza yemazamu:

• Kenza Yemazamu Kudzivirira

• Kenza Yezamu Kuongorora

• Kurapa Kenza Yezamu Panguva Yepamuviri

• Kurapa Kenza Yezamu

• Yehucheche Chipfuva Kenza Kurapwa

Nhoroondo yemhuri yekenza yemazamu uye zvimwe zvinhu zvinowedzera njodzi yekenza yemazamu.

Chero chipi zvacho chinowedzera mukana wako wekutora chirwere chinonzi njodzi chinhu. Kuva nenjodzi hazvireve kuti uchawana gomarara; kusava nenjodzi hazvireve kuti hauzobatwe negomarara. Taura nachiremba wako kana iwe uchifunga kuti ungave uri panjodzi yekenza yemazamu.

Njodzi dzinokonzera kenza yemazamu dzinosanganisira zvinotevera:

• Nhoroondo yega yekenza yemazamu inopinda, ductal carcinoma in situ (DCIS), kana lobular carcinoma in situ (LCIS).

• Nhoroondo yega yebenign (noncancer) chirwere chechipfuva.

• Nhoroondo yemhuri yekenza yemazamu mune yekutanga-degree hama (amai, mwanasikana, kana hanzvadzi).

• Shanduko dzakagarwa mu BRCA1 kana BRCA2 magene kana mune mamwe majini anowedzera njodzi yekenza yemazamu.

• Chipfuva chemazamu chakakora pane mammogram.

• Kufumurwa kwemazamu tishu kune estrogen inogadzirwa nemuviri. Izvi zvinogona kukonzerwa ne:

• Kutevera kumucheche.

• Kukwegura pakuzvarwa kwekutanga kana kusatombozvara.

• Kutanga kuenda kumwedzi panguva inotevera.

• Kutora mahormone senge estrogen inosanganiswa neprogestin yezviratidzo zvekuguma kuenda kumwedzi.

• Kurapa ne radiation radiation kuzamu / chifuva.

• Kunwa doro.

• Kufutisa.

Kukwegura ndiyo njodzi huru kune vakawanda kanzira. Mukana wekubata cancer unowedzera paunenge uchikura.

NCI's Breast Cancer Risk Assessment Chishandiso inoshandisa zvinhu zvine njodzi kumukadzi kuti afungidzire njodzi yake yekenza yemazamu mukati memakore mashanu anotevera uye kusvika pamakore makumi mapfumbamwe. Ichi chishandiso chepamhepo chinofanirwa kushandiswa nemupi wezvehutano. Kuti uwane rumwe ruzivo nezve njodzi yekenza yemazamu, fonera 1-800-4-CANCER.

Gomarara repazamu dzimwe nguva rinokonzerwa nekuzvarwa nhaka kwemajini (shanduko).

Magen'a ari mumasero anotakura ruzivo rwenhaka runogamuchirwa kubva kuvabereki vemunhu. Kenza yemazamu yenhaka inoita zvikamu zvishanu kubva muzana kusvika kugumi muzana yekenza yemazamu. Mamwe majeni akachinjika ane chekuita nekenza yemazamu anowanzoitika mune mamwe madzinza.

Vakadzi vane mamwe majini ekuchinja, senge BRCA1 kana BRCA2 shanduko, vane njodzi yakawedzera yekenza yemazamu. Vakadzi ava zvakare vane njodzi yakawedzera yekenza yeovari, uye vanogona kuve nenjodzi yekuwedzera yevamwe kanzira. Varume vane geni rakachinjika rine chekuita nekenza yemazamu vane zvakare njodzi yekuwedzera yekenza yemazamu. Kuti uwane rumwe ruzivo, ona pfupiso ye pamusoro peMurume Chipfuva Cancer Kurapa.

Pane bvunzo dzinogona kuona (tsvaga) dzakachinjika magene. Aya magene ekuyedza anowanzoitirwa nhengo dzemhuri dzine njodzi huru yegomarara. Ona pfupiso ye paGenetics yeMazamu neGynecologic Cancers kuti uwane rumwe ruzivo.

Iko kushandiswa kwemimwe mishonga nezvimwe zvinhu zvinoderedza njodzi yekenza yemazamu.

Chero chipi zvacho chinoderedza mukana wako wekuwana chirwere chinonzi chinhu chinodzivirira.

Zvidziviriro zvekenza yemazamu zvinosanganisira zvinotevera:

• Kutora chero cheanotevera:

• Estrogen-chete hormone kurapwa mushure mehutachiona.

• Kusarudza estrogen receptor modulators (SERMs).

• Aromatase inhibitors.

• Kuderera kuburitswa kwemazamu tishu kune estrogen inogadzirwa nemuviri. Izvi zvinogona kuva mhedzisiro ye:

• Kubata pamuviri kwekutanga.

• Kuyamwisa.

• Kuwana kurovedza muviri kwakakwana.

• Kuve nechero yeanotevera maitiro:

• Mastectomy yekuderedza njodzi yekenza.

• Oophorectomy yekuderedza njodzi yekenza.

• Ovarian ablation.

Zviratidzo zvegomarara repazamu zvinosanganisira bundu kana shanduko muzamu.

Izvi nezvimwe zviratidzo zvinogona kukonzerwa nekenza yemazamu kana nemamwe mamiriro. Tarisa nachiremba wako kana iwe uine chero chinotevera:

• Bundu kana kuunyana mukati kana padyo nezamu kana munzvimbo yepasi.

• Shanduko muhukuru kana chimiro chezamu.

• Dimple kana kubanda muganda rezamu.

• Zamu rakatendeukira mukati muchipfuva.

• Fluid, kunze kwemukaka wemukaka, kubva munyatso, kunyanya kana iine ropa.

• Scaly, tsvuku, kana kuzvimba ganda pazamu, minyatso, kana areola (nzvimbo ine rima yeganda rakakomberedza munyatso).

• Dimples muzamu rinotaridzika seganda reorenji, inonzi peau d'orange.

Kuyedza kunoongorora mazamu kunoshandiswa kuona (kutsvaga) uye kuongorora gomarara repazamu.

Tarisa nachiremba wako kana iwe ukaona chero shanduko mumazamu ako. Iyi inotevera bvunzo uye maitiro anogona kushandiswa:

• Kuongorora kwemuviri uye nhoroondo yehutano: Kuongororwa kwemuviri kutarisa zviratidzo zvehutano, kusanganisira kuongorora zviratidzo zvehosha, zvakadai semapundu kana chero chinhu chinoratidzika sechisina kujairika. Nhoroondo yemaitiro ehutano hwemurwere uye kurwara kwakapfuura uye kurapwa kuchatorwawo.

• Clinical zamu bvunzo (CBE): Kuongororwa kwezamu nachiremba kana imwe nyanzvi yehutano. Chiremba anonyatsonzwa mazamu uye pasi pemaoko emapundu kana chero chinhu chinoratidzika senge chisina kujairika.

• Mammogram: X-ray yezamu.

Mammography. Chipfuva chakatsindirwa pakati pamahwendefa maviri. MaX-ray anoshandiswa kutora mifananidzo yemazamu tishu.

• Ultrasound bvunzo: Maitiro umo ma-high-energy ruzha mafungu (ultrasound) anodonhedzwa kubva mukati memukati nyama kana nhengo uye anoita maungira. Maungira anoumba mufananidzo wemuviri munyama unonzi sonogram. Mufananidzo wacho unogona kudhindwa kuti utariswe gare gare.

• MRI (magnetic resonance imaging): Maitiro anoshandisa magineti, masaisai eredhiyo, uye komputa kugadzira yakateedzana mifananidzo yakajeka yemazamu ese. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).

• Ropa kemesitiri zvidzidzo: Maitiro umo muyedzo weropa unoongororwa kuyera huwandu hwezvimwe zvinhu zvakaburitswa muropa nenhengo uye nyama munyama. Chinhu chisina kujairika (chakakwirira kana chakaderera pane zvakajairwa) chiyero chechinhu chinogona kunge chiri chiratidzo chechirwere.

• Biopsy: Kubviswa kwemasero kana zvinyama kuitira kuti vagone kutariswa pasi pe microscope nachiremba wekutarisa zviratidzo zvecancer. Kana bundu muzamu rikawanikwa, biopsy inogona kuitwa.

Kune marudzi mana ebiopsy anoshandiswa kuongorora kenza yemazamu:

• Excisional biopsy: Kubviswa kwebundu rese rezvinyama.

• Incisional biopsy: Kubviswa kwechikamu chebundu kana sampuro yetishu.

• Core biopsy: Kubviswa kwetishu uchishandisa tsono yakafara.

• Yakanaka-tsono aspiration (FNA) biopsy: Kubviswa kwetissue kana fluid, uchishandisa tsono nhete.

Kana gomarara rikawanikwa, kuongororwa kunoitwa kuongorora masero ekenza.

Sarudzo pamusoro pekurapa kwakanakisa dzinoenderana nezvakabuda mukuyedzwa uku. Iyo bvunzo inopa ruzivo nezve:

• kuti kenza ingakurumidze kukura sei.

• zvingangoita sei kuti gomarara ripararire nemuviri.

• mamwe marapirwo anogona kushanda sei.

• kenza yakadii kudzokazve (kudzoka).

Miedzo inosanganisira zvinotevera:

• Estrogen uye progesterone receptor bvunzo: Chiyero chekuyera huwandu hweestrogen uye progesterone (mahormone) ma receptors mune kenza tishu. Kana paine akawanda esrogen uye progesterone receptors kupfuura zvakajairwa, kenza inonzi estrogen uye / kana progesterone receptor yakanaka. Rudzi urwu rwekenza yemazamu inogona kukura nekukurumidza. Mhedzisiro yekubvunzwa inoratidza kuti kurapwa kwekuvhara estrogen uye progesterone kunogona kumisa kenza kubva mukukura.

• Epidermal yekukura kwechinhu mhando 2 receptor (HER2 / neu) bvunzo: Kuongororwa kwerabhoritari kuyera kuti mangani majini eHER2 / neu aripo uye kuti mapuroteni eHER2 / neu akagadzirwa sei mumuenzaniso wetissue. Kana paine mamwe maHER2 / neu majini kana mazinga epamusoro eHER2 / neu protein kupfuura zvakajairwa, kenza inonzi HER2 / neu yakanaka. Rudzi urwu rwegomarara repazamu runogona kukura nekukurumidza uye runogona kutekeshera kune dzimwe nhengo dzemuviri. Iyo kenza inogona kurapwa nemishonga inotarisa iyo HER2 / neu protein, senge trastuzumab uye pertuzumab.

• Multigene bvunzo: Kwayedza umo masampuli etinyama anodzidziswa kutarisa zvinoitwa nemajini mazhinji panguva imwe chete. Iyi bvunzo inogona kubatsira kufungidzira kana gomarara richizopararira kune dzimwe nhengo dzemuviri kana kudzoka (kudzoka).

Kune akawanda marudzi emhando dzakawanda bvunzo. Iyi inotevera miedzo yakawanda yakadzidzwa mumakiriniki ekuedzwa:

• Oncotype DX: Bvunzo iyi inobatsira kufungidzira kuti kenza yepazamu yekutanga-iri estrogen receptor yakanaka uye node isina kunaka ichapararira kune dzimwe nhengo dzomuviri. Kana njodzi yekuti gomarara richapararira yakakura, chemotherapy inogona kupihwa kudzikisa njodzi.

• MammaPrint: Kuongororwa kwerabhoritari umo chiitiko chemageneti makumi manomwe akasiyana anotariswa mumatumbu ekenza yemazamu evakadzi vane gomarara remazamu rinokanganisa risingazopararira kune lymph node kana rakapararira kusvika kumatatu kana mashoma emakiromendi. Chikamu chekuita kwemajini aya chinobatsira kufungidzira kuti gomarara repazamu richapararira kune dzimwe nhengo dzomuviri here kana kudzoka. Kana iyo bvunzo ikaratidza kuti njodzi yekuti gomarara ichapararira kana kudzoka yakakwira, chemotherapy inogona kupihwa kudzikisa njodzi.

Kubva pane bvunzo idzi, kenza yemazamu inorondedzerwa seimwe yedzinotevera mhando:

• Hormone receptor yakanaka (estrogen uye / kana progesterone receptor yakanaka) kana hormone receptor isina (estrogen uye / kana progesterone receptor isina).

• HER2 / neu yakanaka kana HER2 / neu isina.

• Triple isina (estrogen receptor, progesterone receptor, uye HER2 / neu isina).

Ruzivo urwu runobatsira chiremba kusarudza kuti ndeapi marapirwo achashanda zvakanyanya kukenza yako.

Zvimwe zvinhu zvinokanganisa kufungidzira (mukana wekupora) uye sarudzo dzekurapa.

Kufungidzira uye sarudzo dzekurapa dzinoenderana nezvinotevera:

• Chikamu checancer (saizi yemota uye kana iri muzamu chete kana yakapararira kune lymph node kana dzimwe nzvimbo mumuviri).

• Rudzi rwekenza yemazamu.

• Estrogen receptor uye progesterone receptor nhanho mumatumbu tishu.

• Epidermal yekukura kwechinhu mhando 2 receptor (HER2 / neu) nhanho mumatumbu emota.

• Kunyangwe iro bundu remarara rakapetwa katatu zvisina kunaka (masero asina maestrogen receptors, progesterone receptors, kana mazinga akakwirira eHER2 / neu).

• Kukurumidza sei bundu riri kukura.

• Zvingangodaro kuti bundu iri rinogona kudzoka (kudzoka).

• Zera remukadzi, hutano huzhinji, uye chinzvimbo chekuenda kumwedzi (kunyangwe mukadzi achiri kuenda kumwedzi).

• Kunyangwe kenza ichangobva kuongororwa kana kuti yadzokazve (dzoka).

Matanho eCancer yeCancer

PFUNGWA DZINOKOSHA

• Mushure mekunge kenza yemazamu yaonekwa, kuongororwa kunoitwa kuti uone kana masero ekenza apararira mukati mechipfuva kana kune zvimwe zvikamu zvemuviri.

• Pane nzira nhatu dzinopararira negomarara mumuviri.

• Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

• Mukenza yemazamu, nhanho inoenderana nesaizi nenzvimbo yethumba rekutanga, kupararira kwegomarara kune lymph node dziri padyo kana zvimwe zvikamu zvemuviri, gomarara gamu, uye kana paine vamwe biomarkers varipo.

• Iyo TNM sisitimu inoshandiswa kurondedzera saizi yeturu yekutanga uye nekupararira kwegomarara kune lymph node dziri padyo kana zvimwe zvikamu zvemuviri.

• Bundu (T). Kukura uye nzvimbo yebundu.

• Lymph Nzvimbo (N). Kukura uye nzvimbo yemakirini maapo kenza yapararira.

• Metastasis (M). Kupararira kwekenza kune dzimwe nhengo dzomuviri.

• Iyo grading system inoshandiswa kurondedzera kuti inokurumidza sei bundu remuzamu rinogona kukura nekupararira.

• Biomarker kuyedza kunoshandiswa kutsvaga kana maseru ekenza yemazamu aine mamwe ma receptors.

• Iyo TNM system, iyo grading system, uye biomarker chinzvimbo chakabatanidzwa kutsvaga iro gomarara repazamu.

• Taura nachiremba wako kuti uone chinhanho chako chekenza yemazamu uye kuti inoshandiswa sei kuronga kurapwa kwakanyanya kwauri.

• Kurapa kwekenza yemazamu kunoenderana padanho rechirwere.

Mushure mekunge kenza yemazamu yaonekwa, kuongororwa kunoitwa kuti uone kana masero ekenza apararira mukati mechipfuva kana kune zvimwe zvikamu zvemuviri.

Maitiro anoshandiswa kutsvaga kuti gomarara rapararira mukati mezamu here kana kune mamwe mativi emuviri anonzi staging. Ruzivo rwakaunganidzwa kubva munzira yekugadzwa rinotara danho rechirwere. Izvo zvakakosha kuti uzive nhanho kuitira kuronga kurapwa. Mhedzisiro yemimwe bvunzo inoshandiswa kuongorora gomarara repazamu inoshandiswa zvakare kuratidza chirwere. (Ona iyo Ruzivo Ruzhinji chikamu.)

Iyi inotevera bvunzo uye maitiro zvakare anogona kushandiswa mune yekuratidzira maitiro:

• Sentinel lymph node biopsy: Kubviswa kweiyo sentinel lymph node panguva yekuvhiyiwa. Iyo sentinel lymph node ndiyo yekutanga lymph node muboka rema lymph node ekugamuchira lymphatic drainage kubva kune yekutanga bundu. Iyo yekutanga lymph node kenza ingangopararira ichienda kubva kune yekutanga bundu. Chinhu chine radioactive uye / kana dhayi yebhuruu inorohwa padyo nebundu. Icho chinhu kana dhayi inoyerera kuburikidza nemakiromita ducts kuenda kune ma lymph node. Iyo yekutanga lymph node yekugamuchira chinhu kana dhayi inobviswa. Nyanzvi yezvirwere anoona tishu pasi pe microscope kutsvaga maseru ekenza. Kana masero emukenza asingawanikwe, zvinogona kunge zvisiri kudikanwa kubvisa mamwe ma "lymph node". Dzimwe nguva, sentinel lymph node inowanikwa mune anopfuura rimwe boka renzvimbo.

• Chest x-ray: X-ray yenhengo nemapfupa mukati mechipfuva. X-ray imhando yesimba remagetsi rinogona kupfuura nemuviri uye kupinda mufirimu, richiita mufananidzo wenzvimbo dziri mukati memuviri.

• CT scan (CAT scan): Maitiro anoita akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, inotorwa kubva kumakona akasiyana. Mifananidzo yacho inogadzirwa nekombuta yakabatana neiyo x-ray muchina. Dhayi inogona kuiswa jekiseni kana kumedzwa kubatsira nhengo kana zvinyama kuratidza zvakajeka. Iyi nzira inonziwo computed tomography, computerized tomography, kana komputa axial tomography.

• Bone scan: Maitiro ekutarisa kana paine nekukurumidza kupatsanura masero, senge kenza maseru, mupfupa. Chinhu chidiki kwazvo che radioactive chakabayiwa mutsinga uye chinofamba neropa. Iyo radioactive zvinhu inounganidza mumapfupa nekenza uye inoonekwa ne scanner.

• PET scan (positron emission tomography scan): Iyo nzira yekuwana yakaipa malonda maseru mumuviri. Chishoma che radioactive glucose (shuga) inoiswa mutsinga. Iyo PET scanner inotenderera yakatenderedza muviri uye inogadzira mufananidzo wepo glucose iri kushandiswa mumuviri. Malignant tumarara maseru anoratidza kupenya mumufananidzo nekuti anoshanda uye anotora glucose yakawanda kupfuura zvinoita maseru akajairwa.

Pane nzira nhatu dzinopararira negomarara mumuviri.

Kenza inogona kupararira kuburikidza nematinji, iyo lymph system, uye neropa:

• Tishu. Kenza inopararira kubva kwayakatanga nekukura ichipinda munzvimbo dziri pedyo.

• Lymph maitiro. Kenza inopararira kubva kwayakatanga nekupinda muiyo lymph system. Kenza inofamba nemumidziyo yema lymph ichienda kune dzimwe nhengo dzemuviri.

• Ropa. Kenza inopararira kubva payakatanga nekupinda muropa. Kenza inofamba nemidzi yeropa ichienda kune dzimwe nhengo dzemuviri.

Gomarara rinogona kutapukira kubva kwarakatanga kuenda kune dzimwe nhengo dzemuviri.

Kana kenza ikapararira kune chimwe chikamu chemuviri, inonzi metastasis. Cancer maseru anotsemuka kubva kwaakatanga (iro bundu rekutanga) uye achifamba kuburikidza neye lymph system kana ropa.

• Lymph maitiro. Gomarara rinopinda mu "lymph system", rinofamba nemumidziyo ye "lymph", uye rinogadzira bundu (metastatic tumor) mune chimwe chikamu chemuviri.

• Ropa. Kenza inopinda muropa, inofamba nemutsinga dzeropa, yoita bundu (metastatic tumor) mune chimwe chikamu chemuviri.

Iyo metastatic bundu irwo rudzi rwecancer seyakanyanya bundu. Semuenzaniso, kana gomarara repazamu richipararira kusvika pfupa, masero ekenza ari mupfupa ndiwo chaiwo maseru ekenza yemazamu. Chirwere igomarara repazamu, kwete gomarara repfupa.

Mukenza yemazamu, nhanho inoenderana nesaizi nenzvimbo yethumba rekutanga, kupararira kwegomarara kune lymph node dziri padyo kana zvimwe zvikamu zvemuviri, gomarara gamu, uye kana paine vamwe biomarkers varipo.

Kuti uronge kurapa kwakanyanya uye unzwisise kufungidzira kwako, zvakakosha kuti uzive danho rekenza yemazamu.

Kune matatu marudzi emakenza emukaka ezamu mapoka.

• Clinical Prognostic Stage inoshandiswa kutanga kugovera nhanho yevarwere vese zvichibva pahutano hwehupenyu, bvunzo dzemumuviri, bvunzo dzekufungidzira (kana zvaitwa), uye biopsies. Iyo Clinical Prognostic Stage inotsanangurwa neiyo TNM system, bundu rebundu, uye biomarker chinzvimbo (ER, PR, HER2). Mukiriniki staging, mammography kana ultrasound inoshandiswa kutarisa ma lymph node kune zviratidzo zvecancer.

• Pathological Prognostic Stage inozoshandiswa kune varwere vanovhiyiwa senzira yavo yekutanga kurapwa. Iyo Pathological Prognostic Stage yakavakirwa pane zvese zvekiriniki ruzivo, biomarker chinzvimbo, uye murabhoritari bvunzo mhedzisiro kubva pazamu tishu uye lymph node dzakabviswa panguva yekuvhiyiwa.

• Anatomic Stage inoenderana nesaizi uye kupararira kwegomarara sekutsanangurwa kwazvakaitwa neTNM system. Iyo Anatomic Stage inoshandiswa mune dzimwe nzvimbo dzepasi uko biomarker kuyedza isingawanikwe. Haisi kushandiswa muUnited States.

Iyo TNM sisitimu inoshandiswa kurondedzera saizi yeturu yekutanga uye nekupararira kwegomarara kune lymph node dziri padyo kana zvimwe zvikamu zvemuviri. Nezve kenza yemazamu, iyo TNM system inotsanangura bundu seinotevera:

Bundu (T). Kukura uye nzvimbo yebundu.

Saizi yemamota inowanzo kuyerwa mumamilimita (mm) kana masendimita. Zvakajairika zvinhu zvinogona kushandiswa kuratidza bundu kukura mum mm zvinosanganisira: inopinza penzura poindi (1 mm), krayoni nyowani poindi (2 mm), penzura-pamusoro paser (5 mm), pizi (10 mm), a nzungu (20 mm), uye lime (50 mm).

• TX: Bundu rekutanga harigone kuongororwa.

• T0: Hapana chiratidzo chebundu rekutanga muzamu.

• Tis: Carcinoma mu situ. Kune maviri marudzi eamuzamu carcinoma mu situ:

• Tis (DCIS): DCIS mamiriro mune masero asina kujairika anowanikwa mune yekumonera pombi yemazamu. Iwo maseru asina kujairika haana kupararira kunze kwedhiri kune mamwe materu ari muzamu. Mune zvimwe zviitiko, DCIS inogona kuve inopinda kenza yemazamu iyo inokwanisa kupararira kune mamwe matishu. Panguva ino, hapana nzira yekuziva kuti ndeapi maronda anogona kuve anopinda.

• Tis (Chirwere chePaget): Chirwere chePaget chekono mamiriro ayo masero asina kujairika anowanikwa mumasero eganda rezamu uye anogona kupararira kune areola. Haina kuratidzwa zvinoenderana neTNM system. Kana chirwere chePaget KANA gomarara remazamu risingaoneki riripo, iyo TNM sisitimu inoshandiswa kuratidza iyo inopinda kenza yemazamu.

• T1: Bundu iri mamirimita makumi maviri kana diki. Iko kune mana subtypes eiyo T1 bundu zvinoenderana nehukuru hwebundu.

• T1mi: bundu iri 1 millimeter kana diki.

• T1a: bundu rakakura kupfuura millimeter rimwe asi risina kukura kupfuura mamirimita mashanu.

• T1b: bundu rakakura kupfuura mamirimita mashanu asi risingakure kupfuura mamirimita gumi.

• T1c: bundu rakakura kupfuura mamirimita gumi asi risiri rakakura kupfuura mamirimita makumi maviri.

• T2: Bundu rakakura kupfuura mamirimita makumi maviri asi risingasvike mamirimita makumi mashanu.

• T3: Bundu rakakura kupfuura mamirimita makumi mashanu.

• T4: Bundu rinotsanangurwa seimwe yeanotevera:

• T4a: bundu rakura kuita rusvingo rwechipfuva.

• T4b: bundu rakura kuita ganda-chironda chakaumbwa pamusoro peganda pachipfuva, tumabundu tudiki tumarara twakaumbwa muzamu rimwe chetero sebundu rekutanga, uye / kana kune kuzvimba kweganda pazamu .

• T4c: bundu rakura kuita chipfuva madziro uye ganda.

• T4d: kenza yemazamu inopinza - chetatu kana kupfuura cheganda pazamu rakatsvuka uye kuzvimba (kunodaidzwa kuti peau d'orange).

Lymph Nzvimbo (N). Kukura uye nzvimbo yemakirini maapo kenza yapararira.

Kana ma "lymph node" abviswa nekuvhiyiwa uye achidzidzwa pasi pe microscope nana pathologist, pathologic staging inoshandiswa kurondedzera lymph node. Iyo pathologic staging ye lymph node inotsanangurwa pazasi.

• NX: Iyo lymph node haigone kuongororwa.

• N0: Hapana chiratidzo checancer mune ma lymph node, kana masumbu madiki emakenza maseru asina kukura kupfuura mamirimita e2,2 mune ma lymph node.

• N1: Kenza inotsanangurwa seimwe yeanotevera:

• N1mi: kenza yapararira kune axillary (armpit nzvimbo) lymph node uye yakakura kudarika 0.2 millimeter asi isina kukura kupfuura 2 millimeter.
• N1a: kenza yakapararira kusvika kune 1 kusvika ku3 axillary lymph nodes uye kenza mune imwe chete yema lymph node yakakura kudarika mamirimita maviri.
• N1b: kenza yakapararira kuma lymph node padhuze nepachipfuva padivi rimwe chemuviri sedumbu rekutanga, uye gomarara rakakura kudarika mamirimita 0.2 uye rinowanikwa nesentinel lymph node biopsy. Kenza haina kuwanikwa mune axillary lymph node.

• N1c: kenza yakapararira kusvika kune 1 kusvika ku3 axillary lymph nodes uye kenza mune imwe chete yema lymph node yakakura kudarika mamirimita maviri.

Gomarara rinowanikwawo nesentinel lymph node biopsy mune maLymph node padyo nepachipfuva chechipfuva kudivi rimwe chete remuviri sedumbu rekutanga.

• N2: Cancer inotsanangurwa seimwe yeanotevera:

• N2a: kenza yapararira kusvika pamakumi mana kusvika mapfumbamwe axillary lymph node uye gomarara mune imwe chete yema lymph node yakakura kudarika mamirimita maviri.
• N2b: kenza yakapararira kuma lymph node padhuze nepachipfuva uye gomarara rinowanikwa nemuyedzo wekufungidzira. Kenza haiwanikwe mune axillary lymph node ne sentinel lymph node biopsy kana lymph node dissection.

• N3: Kenza inotsanangurwa seimwe yeanotevera:

• N3a: gomarara rapararira kusvika gumi kana kupfuura maekisero emakirini uye gomarara mune imwe yeanomamota akakura kupfuura mamirimita maviri, kana gomarara rapararira kune node node pazasi pekora.

• N3b: kenza yakapararira kusvika kune 1 kusvika ku9 axillary lymph node uye kenza mune imwe chete yema lymph node yakakura kudarika mamirimita maviri. Gomarara rakapararira kuma lymph nodes padhuze nepazamu uye gomarara rinowanikwa nemuyedzo wekufungidzira;

kana

gomarara rapararira kusvika pamakumi mana kusvika mapfumbamwe maaxillary lymph node uye gomarara mune imwe chete yema lymph node yakakura kudarika mamirimita maviri. Gomarara rakapararira kuma lymph node padyo nepachipfuva padivi pemuviri sedumbu rekutanga, uye gomarara rakakura kudarika mamirimita 0.2 uye rinowanikwa nesentinel lymph node biopsy.

• N3c: kenza yakapararira kuma lymph node pamusoro pekora kune rumwe rutivi rwemuviri sedumbu rekutanga.

Kana ma "lymph node" akaongororwa achishandisa mammography kana ultrasound, inonzi kiriniki yekuratidzira. Iyo kiriniki yekuratidzira kwema lymph node haina kutsanangurwa pano.

Metastasis (M). Kupararira kwekenza kune dzimwe nhengo dzomuviri.

• M0: Hapana chiratidzo chekuti gomarara rapararira kune dzimwe nhengo dzemuviri.

• M1: Kenza yakapararira kune zvimwe zvikamu zvemuviri, kazhinji mapfupa, mapapu, chiropa, kana huropi. Kana gomarara rapararira kune ma "lymph node" ari kure, iyo kenza iri munzvimbo dzemarefu yakakura kudarika mamirimita 0,2. Kenza inonzi metastatic cancer cancer.

Iyo grading system inoshandiswa kurondedzera kuti inokurumidza sei bundu remuzamu rinogona kukura nekupararira.

Iyo grading system inotsanangura bundu rinotarisana nekusagadzikana kwemasero ekenza uye zvinyama zvinotaridzika pasi pe microscope uye nekukurumidza maseru ekenza angangokura nekupararira. Masero emukenza epasi-giredhi anotaridzika kunge maseru akajairwa uye anowanzo kukura nekupararira zvishoma nezvishoma pane maseru emukenza epamusoro-giredhi. Kuti urondedzere kusanzwisisika uko maseru emukenza uye zvinyama zviri, chiremba wezvehutano anoongorora zvinotevera zvitatu zvinhu:

• Yakawanda sei yetumhu turu ine yakajairwa mazamu ducts.

• Hukuru uye chimiro chenyukisi mumasero emota.

• Mangani masero ekupatsanura aripo, inova chiyero chekuti mamota maseru ari kukura nekukamurwa zvakadii.

Kune yega yega ficha, iyo pathologist inopa mamaki e1 kusvika ku3; mamakisi e "1" zvinoreva kuti maseru uye zvinyama zvinoonekwa zvakanyanya semasero uye nyama, uye mamakisi e "3" zvinoreva kuti maseru uye zvinyama zvinotaridzika zvakanyanya. Zvibodzwa zvechimwe nechimwe chinhu zvinowedzerwa pamwechete kuti uwane huwandu hwakazara pakati pe3 ne9.

Matatu mamadhi anokwanisika:

• Yakazara mamaki e3 kusvika ku5: G1 (Yakadzika giredhi kana yakanyatso kusiyaniswa).

• Chiyero che6 kusvika ku7: G2 (Giredhi repakati kana kusiyaniswa zvine mwero).

• Yakazara mamaki e8 kusvika 9: G3 (Giredhi repamusoro kana kusiyaniswa zvisina tsarukano).

Biomarker kuyedza kunoshandiswa kutsvaga kana maseru ekenza yemazamu aine mamwe ma receptors.

Maseru ane hutano, uye mamwe maseru ekenza yemazamu, ane ma receptors (biomarkers) anonamira kune mahormone estrogen uye progesterone. Aya mahormone anodiwa kune maseru ane hutano, uye mamwe maseru ekenza yemazamu, kuti akure uye agovane. Kuti utarise ma biomarkers aya, masampuli etinyama ane kenza yemazamu maseru anobviswa panguva yebiopsy kana kuvhiyiwa. Iwo masampuli anoedzwa murabhoritari kuti aone kana maseru ekenza yemazamu aine estrogen kana progesterone receptors.

Imwe mhando yekugamuchira (biomarker) iyo inowanikwa pamusoro peese maseru ekenza yemazamu inonzi HER2. HER2 receptors inodiwa kuti maseru ekenza yemazamu akure uye agovane.

Nezve kenza yemazamu, kuongorora biomarker kunosanganisira zvinotevera:

• Estrogen receptor (ER). Kana masero emukenza emuzamu aine maestrogen receptors, maseru ekenza anonzi ER akanaka (ER +). Kana masero emukenza emuzamu asina maestrogen receptors, maseru egomarara anonzi ER negative (ER-).

• Progesterone receptor (PR). Kana masero ekenza yemazamu aine progesterone receptors, maseru egomarara anonzi PR positive (PR +). Kana masero ekenza yemazamu asina progesterone receptors, maseru ekenza anonzi PR negative (PR-).

• Epidermal yekukura kwechikonzero mhando 2 receptor (HER2 / neu kana HER2). Kana masero ekenza yemazamu aine akakura kupfuura akajairwa huwandu hweHER2 receptors pamusoro payo, maseru ekenza anonzi HER2 akanaka (HER2 +). Kana masero ekenza yemazamu aine huwandu hwakaenzana hweHER2 pamusoro payo, maseru egomarara anonzi HER2 negative (HER2-). HER2 + kenza yemazamu inowanzo kukura uye kupatsanurana nekukurumidza kupfuura HER2- kenza yemazamu.

Dzimwe nguva masero ekenza yemazamu anozotsanangurwa seatatu asina kunaka kana katatu akanaka.

• Katatu zvisina kunaka. Kana masero ekenza yemazamu asina maestrogen receptors, progesterone receptors, kana yakakura kupfuura yakajairwa huwandu hweHER2 receptors, maseru ekenza anonzi katatu asina kunaka.

• Triple yakanaka. Kana masero ekenza yemazamu aine maestrogen receptors, progesterone receptors, uye yakakura kupfuura yakajairwa huwandu hweHER2 receptors, maseru ekenza anonzi katatu akanaka.

Izvo zvakakosha kuti uzive iyo estrogen receptor, progesterone receptor, uye HER2 receptor chinzvimbo kusarudza yakanyanya kurapwa. Kune mishonga inogona kumisa ma receptors kubva kubatanidza mahormone estrogen uye progesterone uye kumisa kenza kubva mukukura. Mimwe mishonga inogona kushandiswa kuvharira maHER2 receptors pamusoro pemasero ekenza yemazamu uye kumisa kenza kubva mukukura.

Iyo TNM system, iyo grading system, uye biomarker chinzvimbo chakabatanidzwa kutsvaga iro gomarara repazamu.

Heano mienzaniso mitatu inosanganisa iyo TNM system, iyo grading system, uye iyo biomarker chinzvimbo chekutsvaga iyo Pathological Prognostic kenza yemazamu nhanho yemukadzi uyo akatanga kurapwa kwaive kuvhiyiwa:

Kana bundu iri riri mamirimita makumi matatu (T2), risina kupararira kune ma "lymph node" ari pedyo (N0), harina kupararira kunzvimbo dziri kure dzomuviri (M0), uye riri:

• Bhuku 1

• HER2 +

• ER-

• PR-

Gomarara idanho IIA.

Kana bundu iri riri mamirimita makumi mashanu nemashanu (T3), rapararira kusvika kumakiromita mana kusvika ku9 emagetsi (N2), harina kupararira kune dzimwe nhengo dzemuviri (M0), uye riri:

• Bhuku 2

• HER2 +

• ER +

• PR-

Bundu iri danho IIIA.

Kana iro bundu saizi iri 65 mamirimita (T3), rapararira kune matatu axillary lymph node (N1a), rapararira kumapapu (M1), uye iri:

• Bhuku 1

• HER2 +

• ER-

• PR-

Iyo kenza chikamu IV (metastatic cancer cancer).

Taura nachiremba wako kuti uone chinhanho chako chekenza yemazamu uye kuti inoshandiswa sei kuronga kurapwa kwakanyanya kwauri.

Mushure mekuvhiyiwa, chiremba wako achagamuchira chirevo chehurwere chinotsanangura kukura uye nzvimbo yethumba rekutanga, kupararira kwegomarara kune ma lymph node ari padyo, gomarara gomo, uye kana paine vamwe biomarkers varipo. Chirevo chehurwere uye mimwe mhedzisiro yekuedzwa inoshandiswa kuona yako cancer cancer.

Iwe unogona kunge uine mibvunzo yakawanda. Kumbira chiremba wako kuti atsanangure mashandisirwo anoshandiswa kusarudza sarudzo dzakanakisa dzekurapa kenza yako uye kana paine kiriniki miedzo ingave yakakunakira iwe.

Kurapa kwekenza yemazamu kunoenderana padanho rechirwere.

Nezve ductal carcinoma in situ (DCIS) sarudzo dzekurapa, ona Ductal Carcinoma muSitu.

Nezve nzira dzekurapa padanho I, nhanho yechipiri, danho IIIA, uye nhanho inoshandisika IIIC kenza yemazamu, ona Pakutanga, Yakawanikwa, kana Inogona Kushanda Breast Cancer.

Nezve nzira dzekurapa padanho IIIB, isingashande danho IIIC, uye inopomhodza gomarara remazamu, ona Nharaunda Yepamberi kana Inoputira Chipfuva Chemazamu.

Nezve nzira dzekurapa kenza yakadzokedzana padyo nenzvimbo payakatanga kuumbwa, ona Locoregional Recurrent Breast Cancer.

Nezve nzira dzekurapa padanho IV (metastatic) kenza yemazamu kana kenza yemazamu yakadzokerazve mune dzimwe nhengo dzemuviri, ona Metastatic Breast Cancer.

Chirwere Chebonde Chekuita

Mukenza yekuzvimba kenza, gomarara rapararira paganda rezamu uye zamu rinotaridzika kutsvuka uye kuzvimba uye rinonzwa kudziya. Kutsvuka uye kudziya kunoitika nekuti maseru egomarara anovhara iyo lymph midziyo muganda. Ganda rezamu rinogona zvakare kuratidza iyo dimpled chitarisiko chinonzi peau d'orange (seganda reorenji). Panogona kunge paine chero mapundu muzamu anogona kunzwika. Inopisa kenza yemazamu inogona kunge iri nhanho IIIB, nhanho IIIC, kana nhanho IV.

Inopisa kenza yemazamu yezamu rekuruboshwe inoratidza peau d'orange uye inverted nyini.

Kanzuru YezveBonde

Gomarara repazamu rinowanzoitika igomarara rakadzokazve (radzoka) mushure mekurapwa. Gomarara rinogona kudzoka muzamu, muganda rechipfuva, mumadziro echipfuva, kana mune ma lymph node ari pedyo.

Kurapa Sarudzo Kuongorora

PFUNGWA DZINOKOSHA

• Kune mhando dzakasiyana dzekurapwa kwevarwere vane gomarara repazamu.

• Mhando nhanhatu dzekurapwa kwakajairika dzinoshandiswa:

• Kuvhiya

• Radiation kurapa

• Chemotherapy

• Hormone kurapa

• Targeted kurapwa

• Immunotherapy

• Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

• Kurapa kenza yemazamu kunogona kukonzera mhedzisiro.

• Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

• Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

• Yekutevera-bvunzo inogona kudikanwa.

Kune mhando dzakasiyana dzekurapwa kwevarwere vane gomarara repazamu.

Mhando dzakasiyana dzekurapa dziripo kune varwere vane gomarara repazamu. Mamwe marapirwo akajairwa (iko kurapwa kwazvino kwashandiswa), uye kumwe kuedzwa mumakiriniki ekuedzwa A kurapwa kiriniki kuyedzwa chidzidzo chekutsvaga chakaitirwa kubatsira kuvandudza marapirwo azvino kana kuwana ruzivo marapirwo matsva evarwere vane gomarara. Kana kiriniki miedzo ikaratidza kuti kurapwa kutsva kuri nani pane kwese kurapwa, kurapwa kutsva kunogona kuve kwakajairwa kurapwa. Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki. Mimwe miedzo yekiriniki yakavhurwa chete kune varwere vasina kutanga kurapwa.

Mhando nhanhatu dzekurapwa kwakajairika dzinoshandiswa:

Kuvhiya

Vazhinji varwere vane gomarara repazamu vanovhiyiwa kubvisa gomarara.

Sentinel lymph node biopsy ndiko kubviswa kweiyo sentinel lymph node panguva yekuvhiyiwa. Iyo sentinel lymph node ndiyo yekutanga lymph node muboka rema lymph node ekugamuchira lymphatic drainage kubva kune yekutanga bundu. Iyo yekutanga lymph node kenza ingangopararira ichienda kubva kune yekutanga bundu. Chinhu chine radioactive uye / kana dhayi yebhuruu inorohwa padyo nebundu. Icho chinhu kana dhayi inoyerera kuburikidza nemakiromita ducts kuenda kune ma lymph node. Iyo yekutanga lymph node yekugamuchira chinhu kana dhayi inobviswa. Nyanzvi yezvirwere anoona tishu pasi pe microscope kutsvaga maseru ekenza. Kana masero emukenza asingawanikwe, zvinogona kunge zvisiri kudikanwa kubvisa mamwe ma "lymph node". Dzimwe nguva, sentinel lymph node inowanikwa mune anopfuura rimwe boka renzvimbo. Mushure meiyo sentinel lymph node biopsy, chiremba anovhiya anobvisa bundu achishandisa kuvhiya kwepamuviri kana mastectomy. Kana masero emukenza akawanikwa, mamwe maLymph node anozobviswa kuburikidza nechero incision. Izvi zvinonzi lymph node dissection.

Mhando dzekuvhiya dzinosanganisira zvinotevera:

• Kuvhiya-mazamu kuchengetedza ndiko kuvhiya kubvisa kenza uye dzimwe nyama zvakaipoteredza, asi kwete zamu pacharo. Chikamu chechipfuva chemadziro chechipfuva chinogona zvakare kubviswa kana gomarara riri padyo naro. Rudzi urwu rwekuvhiya runogona zvakare kunzi lumpectomy, chikamu mastectomy, segmental mastectomy, quadrantectomy, kana chipfuva-chichirega kuvhiya.

Kuvhiya kwepazamu. Bundu uye zvimwe zvakajairika zvinyama zvakakomberedza zvinobviswa, asi kwete zamu pacharo. Dzimwe lymph node pasi peruoko dzinogona kubviswa. Chikamu chechipfuva chemadziro chechipfuva chinogona zvakare kubviswa kana gomarara riri padyo naro.

• Yese mastectomy: Kuvhiya kubvisa iro zamu rese rine cancer. Iyi nzira inonziwo nyore mastectomy. Mamwe emakirini ari munyasi meruoko anogona kubviswa uye kuongororwa gomarara. Izvi zvinogona kuitwa panguva imwechete sekuvhiyiwa kwemazamu kana mushure. Izvi zvinoitwa kuburikidza neakasiyana incision.

Yese (yakapusa) mastectomy. Mutsetse une madonhwe unoratidza panobviswa zamu rose. Dzimwe lymph node pasi peruoko dzinogona zvakare kubviswa.

• Yakagadziridzwa radical mastectomy: Kuvhiya kubvisa iro zamu rese rine kenza, mazhinji ema lymph node ari pasi peruoko, kumisikidzwa pamusoro pemhasuru dzechipfuva, uye dzimwe nguva, chikamu chechipfuva chemadziro emhasuru.

Yakagadziriswa radical mastectomy. Mutsetse une madonhwe unoratidza panobviswa zamu rose uye mamwe ma "lymph node". Chikamu chechipfuva chemadziro mhasuru inogona zvakare kubviswa.

Chemotherapy inogona kupihwa usati wavhiyiwa kubvisa bundu. Kana ikapihwa usati wavhiyiwa, chemotherapy inoderedza bundu uye inoderedza huwandu hweturu hunoda kubviswa panguva yekuvhiyiwa. Mushonga unopihwa usati wavhiyiwa unonzi preoperative therapy kana neoadjuvant therapy.

Mushure mekunge chiremba abvisa kenza yese inoonekwa panguva yekuvhiyiwa, vamwe varwere vanogona kupihwa radiation radiation, chemotherapy, yakanangwa kurapwa, kana iyo hormone kurapwa mushure mekuvhiyiwa, kuuraya chero gomarara maseru akasara. Mushonga wakapihwa mushure mekuvhiyiwa, kudzikisa njodzi yekuti gomarara richadzoka, inonzi postoperative therapy kana adjuvant therapy.

Kana murwere achizove nemastectomy, kuvakwa kwemazamu (kuvhiyiwa kuvakazve chimiro chezamu mushure memastectomy) kunogona kutariswa. Kugadzirwa kwemazamu kunogona kuitwa panguva yemastectomy kana imwe nguva inotevera. Chipfuva chinogadzirwazve chinogona kugadzirwa nemuchu wemurwere (asiri chibereko) kana nekushandisa mapiritsi akazadzwa nesaline kana silicone gel. Asati danho rekutora raiswa, varwere vanogona kufonera Chikafu neDrug Administration's (FDA) Center for Devices uye Radiologic Hutano pa1-888-INFO-FDA (1-888-463-6332) kana kushanyira webhusaiti yeDFA rumwe ruzivo nezvezvipenga zvemazamu.

Radiation kurapa

Radiation kurapa kurapwa kenza iyo inoshandisa yakakwira-simba x-rays kana mamwe marudzi e radiation kuuraya cancer maseru kana kuachengeta iwo kuti asakure. Kune mhando mbiri dze radiation radiation:

• External radiation therapy inoshandisa muchina uri kunze kwemuviri kutumira radiation kune kenza.

• Yemukati radiation kurapwa kunoshandisa radioactive chinhu chakavharirwa mune tsono, mhodzi, waya, kana makateti anoiswa akananga mukati kana padyo nekenza.

Maitiro ekurapwa nemwaranzi anoenderana nerudzi uye nhanho yekenza iri kurapwa. External radiation therapy inoshandiswa kurapa gomarara repazamu. Yemukati radiation kurapwa ne strontium-89 (a radionuclide) inoshandiswa kudzikamisa marwadzo emapfupa anokonzerwa nekenza yemazamu yakapararira kusvika kumapfupa. Strontium-89 inorowa mutsinga uye inoenda pamusoro pemabhonzo. Radiation inosunungurwa uye inouraya cancer maseru mumapfupa.

Chemotherapy

Chemotherapy mushonga wekenza unoshandisa mishonga kumisa kukura kwemasero ekenza, kungave nekuuraya maseru kana nekuamisa iwo kubva pakupatsanuka. Kana chemotherapy ikatorwa nemuromo kana kujowa mutsinga kana mhasuru, mishonga inopinda muropa uye inogona kusvika masero emukenza mumuviri wese (systemic chemotherapy). Kana chemotherapy ikaiswa yakanangana necerebrospinal fluid, nhengo, kana dumbu remuviri senge dumbu, iwo madhiragi anonyanya kukanganisa cancer maseru munzvimbo idzodzo (remunharaunda chemotherapy).

Nzira iyo chemotherapy inopihwa inoenderana nerudzi uye nhanho yekenza iri kurapwa. Systemic chemotherapy inoshandiswa pakurapa kenza yemazamu.

Ona Zvinodhaka Zvinotenderwa Gomarara Rezamu kuti uwane rumwe ruzivo.

Hormone kurapa

Hormone kurapwa kurapa kenza inobvisa mahormone kana ichivhara maitiro avo uye inomisa maseru ekenza kubva mukukura. Mahormone zvinhu zvinogadzirwa nemaronda mumuviri uye zvinotenderera muropa. Mamwe mahormone anogona kukonzera mamwe cancer kuti ikure. Kana bvunzo dzichiratidza kuti maseru egomarara ane nzvimbo dzinogona kubatirira mahormone (receptors), zvinodhaka, kuvhiyiwa, kana kurapwa nemwaranzi kunoshandiswa kudzikisa kugadzirwa kwehormone kana kuvharidzira kushanda. Iyo hormone estrogen, iyo inoita kuti mamwe kanzira yemazamu ikure, inogadzirwa zvakanyanya nemaovari. Kurapa kumisa maovari kubva mukugadzira estrogen kunonzi ovarian ablation.

Hormone therapy ine tamoxifen inowanzo kupihwa kune varwere vane gomarara repazamu rekutanga iro rinogona kubviswa nekuvhiyiwa uye avo vane metastatic kenza yemazamu (cancer yakapararira kune dzimwe nhengo dzemuviri). Hormone kurapwa ne tamoxifen kana estrogens inogona kuita pane maseru muviri wese uye inogona kuwedzera mukana wekuvandudza kenza yemendometri. Vakadzi vanotora tamoxifen vanofanirwa kuita bvunzo dzechiuno gore rega rega kutsvaga chero zviratidzo zvegomarara. Chero kubuda ropa mukati memadzimai, kunze kwekubuda ropa kumwedzi, kunofanirwa kumhan'arwa kuna chiremba nekukurumidza sezvazvinogona.

Hormone therapy ine luteinizing hormone-inosunungura mahormone (LHRH) agonist inopihwa kune vamwe vakadzi ve premenopausal avo vachangoonekwa vaine hormone receptor yakanaka kenza yemazamu. LHRH agonists inoderedza muviri weestrogen uye progesterone.

Hormone Therapy ine aromatase inhibitor inopihwa kune vamwe vakadzi vanoteveraopaopausal vane hormone receptor yakanaka kenza yemazamu. Aromatase inhibitors inoderedza iyo estrogen yemuviri nekuvharidzira enzyme inonzi aromatase kubva pakushandura uyerogenjini kuita estrogen. Anastrozole, letrozole, uye exemestane ndiwo marudzi earomatase inhibitors.

Nekurapwa kwekenza yemazamu yekutanga inogona kubviswa nekuvhiyiwa, mamwe aromatase inhibitors anogona kushandiswa senzira yekurapa panzvimbo peiyo tamoxifen kana mushure memakore maviri kusvika matatu ekushandisa tamoxifen. Nekurapa metastatic kenza yemazamu, aromatase inhibitors iri kuyedzwa mumakiriniki miedzo kuti uienzanise neyehomoni yekurapa ne tamoxifen.

Mumadzimai ane hormone receptor positive kenza yemazamu, angangoita makore mashanu eadjuvant mahormone ekurapa anoderedza njodzi yekuti gomarara rinodzokazve (kudzoka).

Mamwe marudzi ehomoni yekurapa anosanganisira megestrol acetate kana anti-estrogen therapy senge fulvestrant.

Ona Zvinodhaka Zvinotenderwa Gomarara Rezamu kuti uwane rumwe ruzivo.

Targeted kurapwa

Targeted therapy mhando yekurapa inoshandisa zvinodhaka kana zvimwe zvinhu kuti zvione uye kurwisa chaiwo maseru ekenza pasina kukuvadza zvakajairika maseru. Monoclonal antibodies, tyrosine kinase inhibitors, cyclin-dependent kinase inhibitors, mammalian target ye rapamycin (mTOR) inhibitors, uye PARP inhibitors ndiwo marudzi eanotarisirwa marapirwo anoshandiswa pakurapa kenza yemazamu.

Monoclonal antibody therapy ndeye kenza kurapa iyo inoshandisa masoja akagadzirwa murabhoritari, kubva kune imwechete mhando yemasoja ekudzivirira maseru. Aya ma antibodies anokwanisa kuona zvinhu pane cancer cancer kana zvakajairika zvinhu zvinogona kubatsira gomarara maseru kukura. Masoja ekudzivirira chirwere anonamira pazvinhu uye anouraya maseru egomarara, anovharira kukura kwawo, kana kuti aachengetedze kubva pakupararira. Monoclonal antibodies inopihwa nekumisirwa. Inogona kushandiswa yoga kana kutakura zvinodhaka, chepfu, kana zvinhu zvine radioactive zvakanangana nemasero ekenza. Monoclonal antibodies inogona kushandiswa mukubatana nekemotherapy seAdjuvant Therapy.

Mhando dze monoclonal antibody therapy dzinosanganisira zvinotevera:

• Trastuzumab inorwisa monoclonal antibody inovhara mhedzisiro yeiyo yekukura protein protein HER2, iyo inotumira zviratidzo zvekukura kumasero ekenza yemazamu. Inogona kushandiswa nemamwe marapirwo ekurapa HER2 yakanaka kenza yemazamu.

• Pertuzumab inorwisa monoclonal antibody inogona kusanganiswa ne trastuzumab uye chemotherapy yekurapa gomarara repazamu. Inogona kushandiswa kurapa vamwe varwere vane HER2 yakanaka kenza yemazamu ine metastasized (yakapararira kune zvimwe zvikamu zvemuviri). Inogona zvakare kushandiswa senge neoadjuvant kurapa mune varwere vane yemuno vemberi, yekuzvimba, kana yekutanga-nhanho kenza yemazamu. Inogona zvakare kushandiswa seadjuvant kurapwa mune vamwe varwere vane yekutanga-nhanho HER2 yakanaka kenza yemazamu.

• Ado-trastuzumab emtansine inorwisa monoclonal antibody yakabatana nemushonga wekenza. Izvi zvinonzi anti-drug conjugate. Iyo inoshandiswa kurapa HER2 yakanaka kenza yemazamu iyo yakapararira kune dzimwe nhengo dzomuviri kana kudzokazve (kudzoka). Iyo inoshandiswawo seAdjuvant Therapy yekurapa HER2 yakanaka kenza yemazamu kune varwere vane chirwere chinosara mushure mekuvhiyiwa.

• Sacituzumab govitecan inorwisa monoclonal antibody inotakura anticancer mushonga kune bundu. Izvi zvinonzi anti-drug conjugate. Iri kuongororwa kuti irape vakadzi vane gomarara remazamu rakapetwa katatu-rakashata avo vakagamuchira kanenge maviri epamberi chemotherapy regimens.

Tyrosine kinase inhibitors inotarisirwa kurapa mishonga inovhara zviratidzo zvinodiwa kuti mamota akure. Tyrosine kinase inhibitors inogona kushandiswa nemamwe anticancer madhiragi seanobatsira kurapwa. Tyrosine kinase inhibitors inosanganisira zvinotevera:

• Lapatinib ndeye tyrosine kinase inhibitor iyo inovhara mhedzisiro ye HER2 protein uye mamwe mapuroteni mukati memota maseru. Inogona kushandiswa nemimwe mishonga kurapa varwere vane HER2 yakanaka kenza yemazamu iyo yakafambira mberi mushure mekurapwa ne trastuzumab.

• Neratinib ndeye tyrosine kinase inhibitor iyo inovhara mhedzisiro yeiyo HER2 protein uye mamwe mapuroteni mukati memota maseru. Iyo inogona kushandiswa kurapa varwere vane yekutanga-nhanho HER2 yakanaka kenza yemazamu mushure mekurapwa ne trastuzumab.

Cyclin-dependent kinase inhibitors inotarisirwa kurapwa mishonga inovhara mapuroteni anonzi cyclin-dependent kinases, anokonzera kukura kwemasero egomarara. Cyclin-inoenderana kinase inhibitors inosanganisira zvinotevera:

• Palbociclib ndeye cyclin-inoenderana kinase inhibitor inoshandiswa neiyo letrozole yemushonga yekurapa kenza yemazamu iyo estrogen receptor yakanaka uye HER2 isina uye yakapararira kune zvimwe zvikamu zvemuviri. Inoshandiswa mumadzimai anonzi postmenopausal ane kenza isina kurapwa nemushonga wehormone. Palbociclib inogona zvakare kushandiswa neafvestrant mumadzimai ane chirwere chakatowedzera mushure mekurapwa nehomoni yekurapa.

• Ribociclib ndeye cyclin-inoenderana kinase inhibitor inoshandiswa ne letrozole kurapa kenza yemazamu iyo hormone receptor yakanaka uye HER2 isina uye yadzoka kana kupararira kune zvimwe zvikamu zvemuviri. Inoshandiswa mumadzimai anonzi postmenopausal ane kenza isina kurapwa nemushonga wehomoni. Iyo inoshandiswawo nefulvestrant mune postmenopausal vakadzi vane hormone receptor yakanaka uye HER2 isina kenza yemazamu yakapararira kune dzimwe nhengo dzomuviri kana kuti yakadzokazve. Iyo zvakare inoshandiswa mune premenopausal vakadzi vane hormone receptor yakanaka uye HER2 isina kenza yemazamu yakapararira kune dzimwe nhengo dzomuviri kana kuti yakadzokazve.

• Abemaciclib ndeye cyclin-inoenderana kinase inhibitor inoshandiswa kurapa hormone receptor yakanaka uye HER2 isina kenza yemazamu yakafambira mberi kana yakapararira kune dzimwe nhengo dzomuviri. Inogona kushandiswa yoga kana nemamwe madhiragi.

• Alpelisib is cylin-dependent kinase inhibitor inoshandiswa nemushonga fulvestrant kurapa hormone receptor yakanaka uye HER2 isina kenza yemazamu ine imwe geni inoshanduka uye yakafambira mberi kana yapararira kune dzimwe nhengo dzemuviri. Inoshandiswa mumadzimai anonzi postmenopausal ane kenza yemazamu yakanyanya kuwedzera panguva kana mushure mekurapwa nehomoni yekurapa.

Mamia mamalia's rapamycin (mTOR) inhibitors anovharira protein inonzi mTOR, inogona kuchengetedza maseru emukenza kukura uye kudzivirira kukura kwemidziyo yeropa mitsva inoda kukura. mTOR inhibitors inosanganisira zvinotevera:

• Everolimus ndeye mTOR inhibitor inoshandiswa mumadzimai epostmenopausal ane advanced hormone receptor positive kenza yemazamu iyo iri zvakare HER2 isina uye haina kuwana zvirinani nekumwe kurapwa.

PARP inhibitors rudzi rwekurapa kwakanangwa kunodzivirira kugadzirisa kweDNA uye kunogona kukonzera maseru emukenza kufa. PARP inhibitors inosanganisira zvinotevera:

• Olaparib iPARP inhibitor inoshandiswa kurapa varwere vane shanduko muBRCA1 kana BRCA2 geni uye HER2 isina kenza yemazamu yakapararira kune dzimwe nhengo dzomuviri. PARP inhibitor kurapa kuri kuongororwa kuitira kurapwa kwevarwere vane katatu-isina kenza yemazamu.

• Talazoparib iPARP inhibitor inoshandiswa kurapa varwere vane shanduko muBRCA1 kana BRCA2 magene uye HER2 isina gomarara remazamu iro rakasimukira munharaunda kana rapararira kune dzimwe nhengo dzemuviri.

Ona Zvinodhaka Zvinotenderwa Gomarara Rezamu kuti uwane rumwe ruzivo.

Immunotherapy

Immunotherapy kurapwa kunoshandisa immune system yemurwere kurwisa gomarara. Zvinhu zvinogadzirwa nemuviri kana kugadzirwa murabhoritari zvinoshandiswa kusimudzira, kunongedza, kana kudzorera kudzivirira kwemuviri kurwisa kenza. Rudzi rwekurapa kenza urwu rwunonziwo biotherapy kana biologic therapy.

Kune akasiyana marudzi eunonotherapy:

• Immune checkpoint inhibitor therapy: PD-1 ipuroteni iri pamusoro peT maseru ayo anobatsira kuchengetedza mhinduro dzemumuviri. Kana PD-1 yakanamatira kune imwe protein inonzi PDL-1 pane kenza kenza, inomisa iyo T cell kuuraya kenza kenza. PD-1 inhibitors inonamira kuPDL-1 uye inobvumira iwo maseru eT kuuraya maseru ekenza. Atezolizumab iyi PD-1 inhibitor inoshandiswa kurapa kenza yemazamu yakapararira kune dzimwe nhengo dzomuviri.

Immune checkpoint inhibitor. Checkpoint mapuroteni, akadai sePD-L1 pane maseru emota uye PD-1 pane T maseru, anobatsira kuchengetedza mhinduro dzemumuviri. Iko kusungwa kwePD-L1 kusvika PD-1 kunoita kuti masero eT arege kuuraya tumarara maseru mumuviri (kuruboshwe pani). Kuvhara kusunga kwePD-L1 kusvika PD-1 ine immune checkpoint inhibitor (anti-PD-L1 kana anti-PD-1) inobvumira iwo maseru eT kuuraya matumbo maseru (kurudyi pani).

Mhando nyowani dzekurapa dziri kuyedzwa mumakiriniki ekuedzwa.

Ruzivo nezve kiriniki miedzo inowanikwa kubva kuNCI webhusaiti.

Kurapa kenza yemazamu kunogona kukonzera mhedzisiro.

Kuti uwane ruzivo nezve mhedzisiro inotanga panguva yekurapa kenza, ona yedu Side Mhedzisiro peji.

Kumwe kurapwa kwekenza yemazamu kunogona kukonzera mhedzisiro inoenderera kana kuoneka mwedzi kana makore mushure mekurapwa kwapera. Izvi zvinonzi kunonoka kuitika.

Kwapera nguva mhedzisiro ye radiation radiation haina kujairika, asi inogona kusanganisira:

• Kuzvimba kwemapapu mushure mekurapwa nemwaranzi kuchipfuva, kunyanya kana chemotherapy ichipihwa panguva imwe chete.

• Arm lymphedema, kunyanya kana radiation radiation inopihwa mushure me lymph node dissection.

• Mumadzimai ari pasi pemakore makumi mana nemashanu vanogashira radiation pamadziro echifuva mushure memastectomy, panogona kuve nenjodzi yakakwira yekubatwa nekenza yemazamu mune rimwe zamu.

Kwapera nguva mhedzisiro yekemotherapy kunoenderana nemishonga inoshandiswa, asi inogona kusanganisira:

• Kutadza kwemoyo.

• Ropa rinovhara.

• Kukurumidza kuenda kumwedzi.

• Kenza yechipiri, yakadai seleukemia.

Mazuva ekupedzisira mhedzisiro yekurapa kwakanangwa ne trastuzumab, lapatinib, kana pertuzumab inogona kusanganisira:

• Zvinetso zvemwoyo sekutadza kwemoyo.

Varwere vangangoda kufunga nezve kutora chikamu mukutora kiriniki.

Kune vamwe varwere, kutora chikamu mumuedzo wekiriniki inogona kunge iri sarudzo yekurapa yakanyanya kunaka. Kliniki miedzo chikamu chekenza tsvagiridzo. Zvemakiriniki miedzo inoitwa kuti uone kana marapirwo matsva egomarara akachengeteka uye achishanda kana zvirinani pane akajairwa kurapwa.

Mazhinji emazuva ano marapirwo akajairwa ekenza akavakirwa pamavambo emakiriniki ekuedzwa. Varwere vanotora chikamu mukuyedzwa kwekiriniki vanogona kuwana kurapwa kwakaringana kana kuve pakati pevekutanga kurapwa kutsva.

Varwere vanotora chikamu mumiedzo yekiriniki zvakare vanobatsira kugadzirisa marapirwo achaitwa kenza mune ramangwana. Kunyangwe kana miedzo yemakiriniki isinga tangire kumarapirwo matsva anoshanda, anowanzo pindura mibvunzo yakakosha uye anobatsira kufambisira mberi kutsvagurudza.

Varwere vanogona kupinda mumakiriniki miedzo vasati, panguva, kana mushure mekutanga kwavo kenza kurapwa.

Mimwe miedzo yekiriniki inosanganisira chete varwere vasati vagamuchira kurapwa. Mimwe miedzo yekuedza kurapwa kwevarwere vane kenza haina kuve nani. Kune mamwezve emakiriniki miedzo inoedza nzira nyowani dzekumisa cancer kubva kudzokororazve (kudzoka) kana kudzikisira mhedzisiro yemakenza kurapwa.

Kuedzwa kwemakiriniki kuri kuitika munzvimbo zhinji dzenyika. Ruzivo nezve kiriniki miedzo inotsigirwa neNCI inogona kuwanikwa paNCI yekiriniki miedzo yekutsvaga peji rewebhu. Kliniki miedzo inotsigirwa nemamwe masangano inogona kuwanikwa pane yeClinicalTrials.gov webhusaiti.

Yekutevera-bvunzo inogona kudikanwa.

Mimwe miedzo yakaitwa kuongorora gomarara kana kutsvaga danho rekenza inogona kudzokororwa. Dzimwe bvunzo dzinodzokororwa kuitira kuti vaone kuti kurapa kuri kushanda sei. Sarudzo nezvekuti uenderere mberi, shandura, kana kumisa kurapwa kunogona kunge kuchibva pamhedzisiro yeiyi bvunzo.

Mimwe bvunzo ichaenderera ichiitwa nguva nenguva mushure mekunge kurapwa kwapera. Mhedzisiro yeiyi bvunzo inogona kuratidza kana mamiriro ako achinja kana kana gomarara radzoka (dzoka). Iyi bvunzo dzimwe nguva inonzi yekuteedzera-bvunzo kana kuongorora-kumusoro.

Kurapa Sarudzo dzeCancer yeCancer

Muchikamu chino

• Pakutanga, Yakawanirwa mukati, kana Inogona Kushanda Breast Cancer

• Munzvimbo Yepamberi kana Inoputira Bonde Kenza

• Locoregional Yakajairika YeCancer Breast

• Metastatic Breast Kenza

Kuti uwane ruzivo nezve marapirwo akanyorwa pazasi, ona iyo Chikamu Sarudzo Yekutarisa Chikamu.

Pakutanga, Yakawanirwa mukati, kana Inogona Kushanda Breast Cancer

Kurapa kwekenza yemazamu yekutanga, inowanikwa munzvimbo yako, kana inogona kushandiswa inogona kusanganisira zvinotevera:

Kuvhiya

• Kuvhiya-kuchengetedza zamu uye sentinel lymph node biopsy. Kana kenza ikawanikwa mune ma lymph node, iyo lymph node dissection inogona kuitwa.

• Yakagadziriswa radical mastectomy. Kuvhiya kwemazamu ekuvakazve kunogona kuitwa.

Postoperative radiation kurapwa

Kune vakadzi vakavhiyiwa kuchengetedza zamu, kurapwa nemwaranzi kunopihwa chipfuva chose kudzikisira mukana kenza ichadzoka. Radiation therapy inogona zvakare kupihwa kune lymph node munzvimbo iyi.

Kune vakadzi vakagadziriswa radical mastectomy, radiation radiation inogona kupihwa kudzikisira mukana kenza ichadzoka kana paine anotevera ari echokwadi:

• Kenza yakawanikwa mune mana kana anopfuura ma lymph node.

• Gomarara rakanga rapararira kusvika munyama dzakakomberedza ma "lymph node".

• Bundu racho rakanga rakakura.

• Kune bundu padyo kana kusara munyama padhuze nemipendero yenzvimbo yakabviswa bundu.

Postoperative systemic kurapa

Systemic Therapise iko kushandisa kwemishonga inogona kupinda muropa uye inosvika maseru ekenza mumuviri wese. Postoperative systemic therapy inopihwa kudzikisira mukana kenza ichadzoka mushure mekuvhiyiwa kubvisa bundu.

Postoperative systemic therapy inopihwa zvichienderana nekuti:

• Bundu iri hormone receptor isina kana yakanaka.

• Bundu iri HER2 / neu isina kana yakanaka.

• Bundu iri hormone receptor isina uye HER2 / neu isina (katatu isina kunaka).

• Kukura kwebundu.

Mune vakadzi ve premenopausal vane mahormone receptor akanaka mamota, hapasisina kurapwa kunogona kudiwa kana kurapwa kwepashure kunogona kusanganisira:

• Tamoxifen kurapwa pamwe kana pasina chemotherapy.

• Tamoxifen kurapwa uye kurapwa kumira kana kudzikisira kuti yakawanda sei estrogen inogadzirwa nemazai. Kurapa kwezvinodhaka, kuvhiya kubvisa maovari, kana radiation radiation kune maovari inogona kushandiswa.

• Aromatase inhibitor therapy uye kurapwa kumisa kana kudzikisa kuti yakawanda sei estrogen inogadzirwa nemazai. Kurapa kwezvinodhaka, kuvhiya kubvisa maovari, kana radiation radiation kune maovari inogona kushandiswa.

Mumadzimai epostmenopausal ane mahormone receptor akanaka mamota, hapasisina kurapwa kunogona kudiwa kana kurapwa kwepashure kunogona kusanganisira:

• Aromatase inhibitor therapy ine kana isina chemotherapy.

• Tamoxifen inoteverwa nearomatase inhibitor therapy, iine kana isina chemotherapy.

Mune vakadzi vane mahormone receptor isina matumbo, hapasisina kurapwa kunogona kudiwa kana kurapwa kwepashure kunogona kusanganisira:

• Chemotherapy.

Mune vakadzi vane HER2 / neu matumbo asina kunaka, kurapwa kwekuvhiya kunogona kusanganisira:

• Chemotherapy.

Mune vakadzi vane zvidiki, HER2 / neu zvakanaka mamota, uye hapana kenza mune lymph node, hapasisina kurapwa kunogona kudikanwa. Kana paine kenza mune iyo lymph node, kana bundu racho rakakura, kurapwa kwekuvhiya kunogona kusanganisira:

• Chemotherapy uye yakanangwa kurapa (trastuzumab).

• Hormone kurapa, senge tamoxifen kana aromatase inhibitor kurapa, kune mamota ayo ari zvakare hormone receptor yakanaka.

• Antibody-drug conjugate therapy neado-trastuzumab emtansine.

Mune vakadzi vane zvidiki, hormone receptor isina uye HER2 / neu isina mamota (katatu asina kunaka) uye hapana kenza mune ma lymph node, hapasisina kurapwa kunogona kudikanwa. Kana paine kenza mune iyo lymph node kana iro bundu rakakura, postoperative kurapwa inogona kusanganisira:

• Chemotherapy.

• Radiation kurapa.

• Kuongororwa kwekiriniki kweiyo nyowani chemotherapy regimen.

• Kuongororwa kwekiriniki yePARP inhibitor kurapa.

Preoperative systemic kurapa

Systemic Therapise iko kushandisa kwemishonga inogona kupinda muropa uye inosvika maseru ekenza mumuviri wese. Preoperative systemic therapy inopihwa kudzikisa bundu usati wavhiyiwa.

Mune vakadzi vanonzi postmenopausal vane mahormone receptor zvakanaka mamota, preoperative kurapwa inogona kusanganisira:

• Chemotherapy.

• Hormone kurapa, senge tamoxifen kana aromatase inhibitor kurapa, kune vakadzi vasingakwanise kuve nekemotherapy.

Mune vakadzi ve premenopausal vane mahormone receptor akanaka mamota, preoperative kurapwa inogona kusanganisira:

• Kuongororwa kwekiriniki kwehomoni yekurapa, senge tamoxifen kana aromatase inhibitor kurapa.

Mune vakadzi vane HER2 / neu mapundu akanaka, preoperative kurapwa inogona kusanganisira:

• Chemotherapy uye yakanangwa kurapa (trastuzumab).

• Targeted Therapy (pertuzumab).

Mune vakadzi vane HER2 / neu matumbo asina kunaka kana katatu asina kunaka mamota, preoperative kurapwa inogona kusanganisira:

• Chemotherapy.

• Kuongororwa kwekiriniki kweiyo nyowani chemotherapy regimen.

• Kuongororwa kwekiriniki ye monoclonal antibody therapy.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Munzvimbo Yepamberi kana Inoputira Bonde Kenza

Kurapa kwekenza yemukati kana yekuzvimba kenza yemazamu musanganiswa wemishonga inogona kusanganisira zvinotevera:

• Kuvhiya (kuvhiya chipfuva-kuchengetedza kana yakazara mastectomy) ine lymph node dissection.

• Chemotherapy pamberi uye / kana mushure mekuvhiyiwa.

• Radiation kurapwa mushure mekuvhiyiwa.

• Hormone kurapwa mushure mekuvhiyiwa kwemamota ayo ari estrogen receptor yakanaka kana estrogen receptor isingazivikanwe.

• Zvemakiriniki miedzo kuyedza nyowani anticancer zvinodhaka, musanganiswa mutsva wemishonga, uye nzira nyowani dzekupa kurapwa.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Locoregional Yakajairika YeCancer Breast

Kurapa kwekenza yemazamu inowanzoitika (kenza yakadzoka mushure mekurapwa pazamu, murusvingo rwechifuva, kana mune ma lymph node ari padyo), inogona kusanganisira zvinotevera:

• Chemotherapy.

• Hormone kurapa kwemamota ayo ari hormone receptor yakanaka.

• Radiation kurapa.

• Kuvhiya.

• Targeted Therapy (trastuzumab).

• Kuongororwa kwekiriniki kwekurapwa kutsva.

Ona Metastatic Breast Cancer chikamu cheruzivo nezve nzira dzekurapa kenza yemazamu yakapararira kumativi emuviri kunze kwezamu, chipfuva madziro, kana ma lymph node ari padyo.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Metastatic Breast Kenza

Kurapa sarudzo yekenza yemazamu (cancer yakapararira kumativi ari kure emuviri) inogona kusanganisira zvinotevera:

Hormone kurapa

Mune vakadzi vanonzi postmenopausal avo vachangobva kuongororwa kuti vane kenza yemazamu yemastastatic iyo iri hormone receptor yakanaka kana kana iyo mamiriro ekugamuchira mahormoni asingazivikanwe, kurapwa kunogona kusanganisira:

• Tamoxifen kurapa.

• Aromatase inhibitor therapy (anastrozole, letrozole, kana exemestane). Dzimwe nguva cyclin-inoenderana kinase inhibitor therapy (palbociclib, ribociclib, abemaciclib, kana alpelisib) inopihwa zvakare.

Mune vakadzi ve premenopausal avo vachangobva kuongororwa kuti vane metastatic kenza yemazamu iyo iri hormone receptor yakanaka, kurapwa kunogona kusanganisira:

• Tamoxifen, an LHRH agonist, kana ese ari maviri.

• Cyclin-inoenderana kinase inhibitor therapy (ribociclib).

Mune vakadzi vane mamota ane hormone receptor yakanaka kana hormone receptor isingazivikanwe, nekupararira kune pfupa kana zvinyoro zvinyoro chete, uye avo vakamborapwa netamoxifen, kurapwa kunogona kusanganisira:

• Aromatase inhibitor kurapa.

• Mamwe mahormone ekurapa senge megestrol acetate, estrogen kana androgen kurapa, kana anti-estrogen kurapa senge fulvestrant.

Targeted kurapwa

Mune vakadzi vane metastatic kenza yemazamu iyo iri hormone receptor yakanaka uye isina kupindura kune mamwe marapirwo, sarudzo dzinogona kusanganisira yakanangwa kurapwa senge:

• Trastuzumab, lapatinib, pertuzumab, kana mTOR inhibitors.

• Antibody-drug conjugate therapy neado-trastuzumab emtansine.

• Cyclin-dependent kinase inhibitor therapy (palbociclib, ribociclib, kana abemaciclib) inogona kusanganiswa nehomoni yekurapa.

Mune vakadzi vane metastatic kenza yemazamu iyo HER2 / neu yakanaka, kurapwa kunogona kusanganisira:

• Targeted kurapwa senge trastuzumab, pertuzumab, ado-trastuzumab emtansine, kana lapatinib.

Mune vakadzi vane kenza yemazamu yemastastatic iyo iri HER2 isina, nekuchinja kwema BRCA1 kana BRCA2 magene, uye avo vakamborapwa nekemotherapy, kurapwa kunogona kusanganisira:

• Targeted Therapy ine PARP inhibitor (olaparib kana talazoparib).

Chemotherapy

Mune vakadzi vane metastatic kenza yemazamu iyo iri hormone receptor isina, haina kupindura kune hormone kurapwa, yakapararira kune dzimwe nhengo kana yakakonzera zviratidzo, kurapwa kunogona kusanganisira:

• Chemotherapy neimwe kana zvimwe zvinodhaka.

Chemotherapy uye immunotherapy

Mune vakadzi vane metastatic kenza yemazamu iyo iri hormone receptor isina uye HER2 yakaipa, kurapwa kunogona kusanganisira:

• Chemotherapy uye immunotherapy (atezolizumab).

Kuvhiya

• Yese mastectomy yevakadzi vane akavhurika kana anorwadza mazamu maronda. Radiation therapy inogona kupihwa mushure mekuvhiyiwa.

• Kuvhiya kubvisa cancer yakapararira kuuropi kana musana. Radiation therapy inogona kupihwa mushure mekuvhiyiwa.

• Kuvhiya kubvisa gomarara iro rapararira kumapapu.

• Kuvhiya kugadzirisa kana kubatsira kutsigira asina kusimba kana akavhunika mapfupa. Radiation therapy inogona kupihwa mushure mekuvhiyiwa.

• Kuvhiya kubvisa fluid yakaunganidzwa yakatenderedza mapapu kana moyo.

Radiation kurapa

• Radiation kurapa kumabhonzo, huropi, musana, musana, kana chifuva madziro kugadzirisa zviratidzo uye nekuvandudza hupenyu hwehupenyu.

• Strontium-89 (a radionuclide) kubvisa marwadzo kubva pagomarara rakapararira kusvika pamapfupa mumuviri wese.

Dzimwe nzira dzokurapa

Dzimwe nzira dzokurapa dzekenza yemazamu inosanganisira:

• Kurapa kwezvinodhaka ne bisphosphonates kana denosumab yekudzora chirwere chepfupa uye kurwadziwa kana kenza yapararira kufupa. (Ona pfupiso ye pamusoro peCancer Pain kuti uwane rumwe ruzivo nezve bisphosphonates.)

• Kuongororwa kwekiriniki yeakakwira-dose chemotherapy ne stem cell transplant.

• Kuongororwa kwekiriniki yeantibody-drug conjugate (sacituzumab).

• Zvemakiriniki miedzo kuyedza nyowani anticancer zvinodhaka, musanganiswa mutsva wemishonga, uye nzira nyowani dzekupa kurapwa.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Kurapa Sarudzo dzeDuctal Carcinoma In Situ (DCIS)

Kuti uwane ruzivo nezve marapirwo akanyorwa pazasi, ona iyo Chikamu Sarudzo Yekutarisa Chikamu.

Kurapa kwe ductal carcinoma in situ kunogona kusanganisira zvinotevera:

• Chipfuva-kuchengetedza kuvhiya uye radiation radiation, ine kana isina tamoxifen.

• Yese mastectomy ine kana isina tamoxifen. Radiation therapy inogona zvakare kupihwa.

Shandisa yedu kiriniki yekuyedza kutsvaga kutsvaga NCI-yakatsigirwa kenza kiriniki miedzo iri kugamuchira varwere. Unogona kutsvaga miedzo zvichibva parudzi rwecancer, zera remurwere, uye iko kunoitwa miyedzo. Ruzhinji ruzivo nezve zvekuedzwa zvekiriniki zvakare zviripo.

Kuti Udzidze Zvakawanda Nezve Kenza Yezamu

Kuti uwane rumwe ruzivo kubva kuNational Cancer Institute nezve kenza yemazamu, ona zvinotevera:

• Gomarara repazamu Home Peji

• Kuvhiya Sarudzo dzeVakadzi vane DCIS kana Breast Cancer

• Kuvhiya Kuderedza Njodzi yeCancer yeCancer

• Chipfuva Kuvakazve Mushure meMastectomy

• Sentinel Lymph Node Biopsy

• Dense Mazamu: Mhinduro kumibvunzo inowanzo bvunzwa

• Mishonga Inotenderwa yeCancer yeCancer

• Hormone Therapy yeCancer yeCancer

• Targeted Cancer Therapies

• Chirwere Chebonde Chekuita

• BRCA Kuchinja: Kenza Njodzi uye Kuongorora kweGenetic

• Kuongorora kweGenetic kweiyo Yakagara nhaka Kenza Kufungira Syndromes

Kuti uwane ruzivo rwekenza uye zvimwe zviwanikwa kubva kuNational Cancer Institute, ona zvinotevera:

• Nezve Kenza

• Stage

• Chemotherapy uye Iwe: Tsigiro Yevanhu Vane Kenza

• Radiation Therapy uye Iwe: Rutsigiro rweVanhu Vane Kenza

• Kurarama neCancer

• Mibvunzo Yekubvunza Wako Chiremba nezveCancer

• Kune Vakapona uye Vanotarisira