Types/breast/patient/pregnancy-breast-treatment-pdq

Kurapa Kenza Yezamu Panguva Yepamuviri Shanduro

Ruzivo Ruzhinji Nezve Cancer Breast Kurapa Panguva Yepamuviri

PFUNGWA DZINOKOSHA

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

• Dzimwe nguva gomarara repazamu rinowanikwa mumadzimai ane nhumbu kana vachangobva mukubereka.

• Zviratidzo zvegomarara repazamu zvinosanganisira bundu kana shanduko muzamu.

• Zvinogona kuve zvakaoma kuona (kuwana) kenza yemazamu pakutanga kwevakadzi vane nhumbu kana vanoyamwisa.

• Bvunzo dzechipfuva dzinofanirwa kuve chikamu chekutarisirwa kwepamberi pekuzvara.

• 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 dzezamu.

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.

Dzimwe nguva gomarara repazamu rinowanikwa mumadzimai ane nhumbu kana vachangobva mukubereka.

Gomarara repazamu rinoitika kanenge kamwe chete pakubata nhumbu zviuru zvitatu. Zvinoitika kazhinji muvakadzi vane makore makumi matatu kusvika makumi matatu nemasere ekuberekwa. Nekuti vakadzi vazhinji vari kusarudza kunonoka kuva nevana, zvingangoita kuti huwandu hwezviitiko zvitsva zvekenza yemazamu panguva yekuzvitakura ichawedzera.

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.

Zvinogona kuve zvakaoma kuona (kuwana) kenza yemazamu pakutanga kwevakadzi vane nhumbu kana vanoyamwisa.

Iwo mazamu anowanzo kuve makuru, akapfava, kana ane bundu mune vakadzi vane nhumbu, vanoyamwisa, kana vachangobva kuzvara. Izvi zvinoitika nekuda kwekuchinja kwehomoni kunoitika panguva yepamuviri. Shanduko idzi dzinogona kuita kuti mapundu madiki anetse kuona. Iwo mazamu anogona zvakare kuva akaomarara. Izvo zvinonyanya kuoma kuona gomarara repazamu mune vakadzi vane mazamu akaomarara vachishandisa mammography. Nekuti shanduko dzemazamu idzi dzinogona kunonoka kuongororwa, kenza yemazamu inowanzo kuwanikwa mune inotevera nhanho mune vakadzi ava.

Bvunzo dzechipfuva dzinofanirwa kuve chikamu chekutarisirwa kwepamberi pekuzvara.

Kuti vaone gomarara repazamu, vakadzi vane pamuviri uye vanoyamwisa vanofanirwa kuzviongorora. Vakadzi vanofanirwawo kupihwa bvunzo dzemazamu dzekurapwa panguva yekuvhenekwa kwavo kwepamuviri uye kusununguka. Taura nachiremba wako kana iwe ukaona chero shanduko mumazamu ako yausingatarisiri kana inokunetsa.

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

Iyi inotevera bvunzo uye maitiro anogona kushandiswa:

• Kuongorora kwepanyama uye nhoroondo: 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.

• 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 utarise gare gare.

• Mammogram: X-ray yezamu. Mammogram inogona kuitwa nenjodzi shoma kumwana asati aberekwa. Mamammograms mune vakadzi vane nhumbu anogona kuoneka asina kunaka kunyangwe gomarara riripo.

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

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

Kune matatu marudzi emazamu biopsies:

• Excisional biopsy: Kubviswa kwebundu rese rezvinyama.

• 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 pekurapwa kwakanyanya dzinoenderana nezvakabuda mukuyedzwa uku uye nezera remwana asati azvarwa. Iyo bvunzo inopa ruzivo nezve:

• Iyo kenza inogona kukura nekukurumidza sei.

• Ingangoita sei kuti gomarara ripararire kune dzimwe nhengo dzemuviri.

• Mamwe marapirwo anogona kushanda zvakadii.

• Ingangoita sei kenza kuti idzokere (kudzoka).

Miedzo inogona kusanganisira zvinotevera:

• Estrogen uye progesterone receptor bvunzo: Chiyero chekuyera huwandu hweestrogen uye progesterone (mahormone) ma receptors mune kenza tishu. Kana paine akawanda esrogen kana progesterone receptors kupfuura zvakajairwa, kenza inonzi estrogen receptor yakanaka kana progesterone receptor yakanaka. Rudzi urwu rwekenza yemazamu inogona kukura nekukurumidza. Mhedzisiro yekubvunzwa inoratidza kana kurapwa kwekuvhara estrogen uye progesterone yakapihwa mushure mekuzvarwa kwemwana 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. Kenza inogona kurapwa nemishonga inotarisa iyo HER2 / neu protein, senge trastuzumab uye pertuzumab, mushure mekunge mwana azvarwa.

• 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).

• Oncotype DX: Uyu muedzo unobatsira kufanotaura kana nhanho ini kana nhanho II kenza yemazamu iyo inonzi estrogen receptor yakanaka uye node-negative ichapararira kune dzimwe nhengo dzomuviri. Kana njodzi yekupararira kwekenza yakakwira, 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.

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

Kufungidzira (mukana wekupora) uye sarudzo dzekurapa dzinoenderana nezvinotevera:

• Chikamu chegomarara (saizi yebundu uye kana riri muzamu chete kana rapararira kune dzimwe nhengo dzemuviri).

• Rudzi rwekenza yemazamu.

• Zera remwana asati azvarwa.

• Kunyangwe paine zviratidzo kana zviratidzo.

• Hutano hwese hwemurwere.

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.

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

Maitiro anoshandiswa kutsvaga kana gomarara rapararira mukati mechipfuva kana kune dzimwe nhengo dzemuviri inonzi staging. Ruzivo rwakaunganidzwa kubva munzira yekugadzwa rinotara danho rechirwere. Izvo zvakakosha kuti uzive nhanho kuitira kuronga kurapwa.

Dzimwe nzira dzinogona kuisa mwana asati aberekwa kumwaranzi inokuvadza kana dhayi. Maitiro aya anoitwa chete kana zvichinyatso kudikanwa. Zvimwe zviito zvinogona kutorwa kuratidza mwana asati azvarwa kumwaranzi shoma sezvinobvira, sekushandisa nhoo-yakaturikwa nhovo kuvhara dumbu.

Iyi inotevera bvunzo uye maitirwo anogona kushandiswa kuratidza kenza yemazamu panguva yepamuviri:

• 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.

• 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 ane cancer uye inoonekwa ne scanner.

• Ultrasound bvunzo: Maitiro ayo ane simba-ruzha mafungu (ultrasound) anodonhedzwa kubva mukati memukati matema kana nhengo, senge chiropa, 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 akateedzana emifananidzo yakajeka yenzvimbo dziri mukati memuviri, senge huropi. Iyi nzira inonziwo nyukireya magnetic resonance imaging (NMRI).

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 Sarudzo Kuongorora

PFUNGWA DZINOKOSHA

• Kurapa sarudzo kune vakadzi vane nhumbu kunoenderana padanho rechirwere uye zera remwana asati azvarwa.

• Mhando mitatu yekurapa kwakajairika inoshandiswa:

• Kuvhiya

• Radiation kurapa

• Chemotherapy

• Kupedza nhumbu hakuite kunge kuri kuwedzera mukana waamai kupona.

• Kurapa kenza yemazamu kunogona kukonzera mhedzisiro.

Kurapa sarudzo kune vakadzi vane nhumbu kunoenderana padanho rechirwere uye zera remwana asati azvarwa.

Mhando mitatu yekurapa kwakajairika inoshandiswa:

Kuvhiya

Vanhukadzi vazhinji vane gomarara repazamu vanovhiyiwa kubvisa zamu. Mamwe emakirini ari munyasi meruoko anogona kubviswa kuitira kuti agotariswa pasi pe microscope nachiremba wezviratidzo zvecancer.

Mhando dzekuvhiya kubvisa kenza dzinosanganisira:

• 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. Rudzi urwu rwekuvhiya runowanzoitika mumadzimai akazvitakura.

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

• Kuvhiya-kuchengetedza zamu: 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.

Mushure mekunge chiremba abvisa kenza yese inogona kuonekwa panguva yekuvhiyiwa, vamwe varwere vanogona kupihwa chemotherapy kana radiation radiation mushure mekuvhiyiwa kuuraya chero gomarara maseru akasara. Kune vakadzi vane pamuviri vane gomarara repazamu rekutanga, kurapwa kwe radiation uye kurapa kwehomoni kunopihwa mushure mekuzvarwa kwemwana. Mushonga wakapihwa mushure mekuvhiyiwa, kudzikisa njodzi yekuti gomarara richadzoka, inonzi adjuvant therapy.

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 inogona kupihwa kune vakadzi vane nhumbu vane nhanho yekutanga (danho I kana II) gomarara repazamu mushure mekunge mwana azvarwa. Vakadzi vane nguva yekunonoka (danho III kana IV) kenza yemazamu vanogona kupihwa kurapwa kwekunze kwemwaranzi mushure memwedzi mitatu yekutanga yekubata kana, kana zvichibvira, radiation radiation inononoka kusvika mushure mekunge mwana azvarwa.

Chemotherapy

Chemotherapy mushonga wekenza unoshandisa mishonga kumisa kukura kwemasero ekenza, kungave nekuuraya maseru kana nekumisa maseru 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 kurapa kenza yemazamu panguva yekuzvitakura.

Chemotherapy kazhinji haina kupihwa mukati memwedzi mitatu yekutanga yepamuviri. Chemotherapy yakapihwa mushure menguva ino haiwanzo kukuvadza mwana asati azvarwa asi inogona kukonzera kusununguka kwekutanga kana huremu hwekuzvarwa.

Ona Zvinodhaka Zvinotenderwa Gomarara Rezamu kuti uwane rumwe ruzivo.

Kupedza nhumbu hakuite kunge kuri kuwedzera mukana waamai kupona.

Nekuti kupedza nhumbu hakugone kuvandudza mukana waamai wekupona, haiwanzo kuita sarudzo yekurapa.

Kurapa kenza yemazamu kunogona kukonzera mhedzisiro.

Kuti uwane ruzivo nezve mhedzisiro inokonzerwa nekurapwa kwegomarara, ona yedu Side Mhedzisiro peji.

Kurapa Sarudzo dzeKenza Yemazamu Panguva Yepamuviri

Muchikamu chino

• Pakutanga Stage Breast Cancer

• Kunonoka-Chikamu Chikamu Chemazamu

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

Pakutanga Stage Breast Cancer

Vakadzi vane pamuviri vane gomarara repazamu rekutanga (nhanho I uye nhanho yechipiri) vanowanzo kurapwa nenzira imwechete sevarwere vasina nhumbu, pamwe neshanduko kuchengetedza mwana asati azvarwa. Kurapa kunogona kusanganisira zvinotevera:

• Yakagadziriswa radical mastectomy, kana kenza yemazamu yakaonekwa ichitanga kuve nepamuviri.

• Kuvhiya-kuchengetedza zamu, kana gomarara repazamu rikaonekwa mushure mekuzvitakura. Radiation kurapwa kunogona kupihwa mushure mekunge mwana azvarwa.

• Yakagadziriswa radical mastectomy kana kuvhiya-kuchengetedza zamu panguva yekuzvitakura. Mushure memwedzi mitatu yekutanga yekuzvitakura, mamwe marudzi ekemotherapy anogona kupihwa pamberi kana mushure mekuvhiyiwa.

Hormone therapy uye trastuzumab haifanirwe kupihwa panguva yekuzvitakura.

Kunonoka-Chikamu Chikamu Chemazamu

Iko hakuna kurapwa kwakaringana kwevarwere vane yekupedzisira-nhanho yemazamu kenza (nhanho III kana nhanho IV) panguva yekuzvitakura. Kurapa kunogona kusanganisira zvinotevera:

• Radiation kurapa.

• Chemotherapy.

Radiation Therapy uye chemotherapy haifanire kupihwa mukati memwedzi mitatu yekutanga yekubata.

Nyaya Dzakakosha Nezve Kenza Yezamu Panguva Yepamuviri

PFUNGWA DZINOKOSHA

• Lactation (kugadzirwa kwemukaka wemukaka) uye kuyamwisa kunofanira kumiswa kana kuvhiya kana chemotherapy kuchirongwa.

• Gomarara repazamu hariratidzike sekukuvadza mwana asati azvarwa.

• Kubata pamuviri hakuite sekukanganisa kupona kwevakadzi vane kenza yemazamu munguva yakapfuura.

Lactation (kugadzirwa kwemukaka wemukaka) uye kuyamwisa kunofanira kumiswa kana kuvhiya kana chemotherapy kuchirongwa.

Kana kuvhiya kuchirongwa, kuyamwisa kunofanira kumiswa kudzikamisa kuyerera kweropa mumazamu nekuaita madiki. Mazhinji chemotherapy mishonga, kunyanya cyclophosphamide uye methotrexate, inogona kuitika mumatanho akakwirira mumukaka wemukaka uye inogona kukuvadza mwana anoyamwa. Vakadzi vanogamuchira chemotherapy havafanirwe kuyamwisa.

Kumisa lactation hakuvandudzi kufungidzira kwaamai.

Gomarara repazamu hariratidzike sekukuvadza mwana asati azvarwa.

Maseru egomarara repazamu anoita kunge haapfuuri kubva kuna amai kuenda kumwana asati aberekwa.

Kubata pamuviri hakuite sekukanganisa kupona kwevakadzi vane kenza yemazamu munguva yakapfuura.

Kune vakadzi vane kenza yemazamu, kubata pamuviri hakuite sekukanganisa kurarama kwavo. Zvisinei, vamwe vanachiremba vanokurudzira kuti mukadzi amirire makore maviri mushure mekurapwa kenza yemazamu asati aedza kuita mwana, kuitira kuti chero kukurumidza kudzoka kwegomarara kuonekwe. Izvi zvinogona kukanganisa sarudzo yemukadzi yekuva nepamuviri. Mwana asati azvarwa anoita kunge haabatwe kana amai vakaita gomarara repazamu.

Kuti Udzidze Zvakawanda Nezve Kenza Yezamu Panguva Yepamuviri

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

• Gomarara repazamu Home Peji

• Kenza Yemazamu Kudzivirira

• Kenza Yezamu Kuongorora

• Kuvhiya Sarudzo dzeVakadzi vane DCIS kana Breast Cancer

• Dense Mazamu: Mhinduro kumibvunzo inowanzo bvunzwa

• Mishonga Inotenderwa yeCancer yeCancer

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