Types/breast/paget-breast-fact-sheet

Isifo sePaget sesifuba

Sisiphi isifo sePaget sesifuba?

Isifo sePaget sesifuba (esikwabizwa ngokuba sisifo sePaget sengono kunye nesifo esincancisayo sePaget) luhlobo olunqabileyo lomhlaza olubandakanya ulusu lwengono kwaye, ngesiqhelo, isangqa esimnyama sesikhumba esijikelezileyo, esibizwa ngokuba yi-areola. Uninzi lwabantu abanesifo sePaget sesifuba sinesinye okanye nangaphezulu amathumba ngaphakathi kwebele elinye. Ezi zivumba zebele zi-ductal carcinoma in situ okanye umdlavuza webele (1-3).

Isifo sikaPaget sesifuba sathiywa ngegama likagqirha wase-Bhritane wenkulungwane ye-19 uSir James Paget, owathi, ngo-1874, waphawula ubudlelwane phakathi kotshintsho kwingono nakumhlaza wamabele. (Ezinye izifo zithiywe ngo-Sir James Paget, kubandakanya isifo se-Paget sesifo samathambo kunye ne-extramammary Paget isifo, esiquka isifo se-Paget sesifo sangasese kunye nesifo se-Paget sobudoda. Iphepha lixoxa kuphela ngesifo sePaget sesifuba.)

Iiseli ezinobungozi ezaziwa ngokuba ziiseli zePaget luphawu oluxeliweyo lwesifo sePaget sesifuba. Ezi seli zifumaneka kwi-epidermis (umaleko womphezulu) wolusu lwengono kunye ne-areola. Iiseli zePaget zihlala zinembonakalo enkulu, engqukuva phantsi kwemicroscope; Banokufunyanwa njengeeseli ezizodwa okanye njengamaqela amancinci eeseli ngaphakathi kwesikhumba.

Ngubani ofumana isifo sePaget sesifuba?

Isifo sePaget sesifuba sivela kwabasetyhini nakumadoda, kodwa uninzi lweziganeko zenzeka kubafazi. Phantse i-1 ukuya kwi-4 yepesenti yazo zonke iimeko zomhlaza webele zibandakanya isifo sePaget sesifuba. Umndilili weminyaka yokufumanisa isifo yiminyaka engama-57, kodwa esi sifo sifunyenwe kulutsha nakubantu abakwiminyaka yama-80s (2, 3).

Yintoni ebangela isifo sePaget sesifuba?

Oogqirha abaqondi ngokupheleleyo ukuba yintoni ebangela isifo sePaget sesifuba. Eyona nkolelo yamkelwe ngokubanzi yeyokuba iiseli zomhlaza ezivela kwithumba ngaphakathi kwebele zihamba ngemijelo yobisi iye kwingono kunye ne-areola. Oku kungachaza ukuba kutheni isifo sePaget sesifuba kunye nethumba ngaphakathi kwebele elinye zihlala zifumaneka kunye (1, 3).

Ithiyori yesibini kukuba iiseli kwingono okanye i-areola ziba nomhlaza ngokwazo (1, 3). Oku kungachaza ukuba kutheni abantu abambalwa bephuhlisa isifo sePaget sesifuba ngaphandle kokufumana ithumba ngaphakathi kwebele elinye. Ngaphaya koko, kunokwenzeka ukuba isifo sePaget sesifuba kunye nezihlunu ngaphakathi kwebele elifanayo ukukhula ngokuzimela (1).

Zithini iimpawu zesifo sebele sePaget?

Iimpawu zesifo sePaget sesifuba zihlala ziphosakele ngenxa yeemeko ezithile zesikhumba ezinobungozi, ezinje nge-dermatitis okanye i-eczema (1-3). Ezi mpawu zinokubandakanya oku kulandelayo:

• Ukurhawuzelela, ukurhawuzelela, okanye ububomvu kwingono kunye / okanye kwi-areola

• Isikhumba esijiyayo, esijijekileyo, okanye esijiyileyo okanye ecaleni kwengono

• Ingono ethambileyo

• Ukukhutshwa kwingono enokuba tyheli okanye inegazi

Ngenxa yokuba iimpawu zokuqala zesifo sePaget zesifuba sinokubonisa imeko yesikhumba enobungozi, kwaye ngenxa yokuba esi sifo sinqabile, sinokungaqondwa gwenxa ekuqaleni. Abantu abanesifo sePaget sesifuba bahlala benempawu kwiinyanga ezininzi ngaphambi kokuba bafunyaniswe ngokuchanekileyo.

Sichongwa njani isifo sePaget?

Ingono ye-biopsy ivumela oogqirha ukuba bafumane ngokuchanekileyo isifo sePaget sesifuba. Kukho iintlobo ezininzi ze-biopsy yengono, kubandakanya iinkqubo ezichazwe ngezantsi.

• Umphezulu webhiopsy: Isilayidi seglasi okanye esinye isixhobo sisetyenziselwa ukukrwela ngobunono iiseli kumphezulu wolusu.

• Shaves biopsy: Isixhobo esifana nesitshixo sisetyenziselwa ukususa umaleko ophezulu wolusu.

• I-Punch biopsy: Isixhobo sokusika setyhula, esibizwa ngokuba yi-punch, sisetyenziselwa ukususa isiqwenga setisisi esimile sediski.

• I-wedge biopsy: I-scalpel isetyenziselwa ukususa i-wedge encinci yeethishu.

Ngamanye amaxesha, oogqirha bangayisusa yonke ingono (1). Ugqirha wezifo uvavanya iiseli okanye izicwili phantsi kwemicroscope ukukhangela iiseli zePaget.

Uninzi lwabantu abanesifo sePaget sesifuba banesinye okanye nangaphezulu amathumba ngaphakathi kwebele elinye. Ukongeza koku-odola i-biopsy yengono, ugqirha kufuneka enze uvavanyo lwebele lweklinikhi ukujonga amaqhuma okanye olunye utshintsho lwebele. Baninzi kangangeepesenti ezingama-50 zabantu abanezifo zePaget zamabele ezinamaqhuma amabele anokuvakala kuvavanyo lwebele lweklinikhi. Ugqirha unokuyalela iimvavanyo ezongezelelweyo zokuqonda isifo, ezinje nge-diagnostic mammogram, uvavanyo lwe-ultrasound, okanye iskena sokucinga ngemagneti yokujonga ukujonga amathumba (1, 2).

Sinyangwa njani isifo sePaget sesifuba?

Kwiminyaka emininzi, i-mastectomy, kunye okanye ngaphandle kokususwa kwee-lymph node phantsi kwengalo kwicala elifanayo lesifuba (esaziwa ngokuba yi-axillary lymph node dissection), yathathwa njengotyando oluqhelekileyo lwesifo sePaget sesifuba (3, 4). Olu hlobo lotyando lwenziwa kuba abaguli abanesifo sePaget sesifuba bebehlala befunyanwa benesifo esinye okanye nangaphezulu ngaphakathi kwebele elinye. Nokuba bekukho ithumba elinye kuphela, elo thumba linokufumaneka kwisentimitha ezininzi kude nengono kunye ne-areola kwaye ngekhe lisuswe ngotyando kwingono kunye ne-areola yodwa (1, 3, 4).

Izifundo zibonisile, nangona kunjalo, ukuba utyando olugcina ibele olubandakanya ukususwa kwengono kunye ne-areola, lulandelwa lunyango olupheleleyo lwebele, lukhetho olukhuselekileyo kubantu abanesifo sePaget sesifuba abangenaso isigaxa esifubeni kwaye ii-mammograms zakhe zingavezi ithumba (3-5).

Abantu abanesifo sePaget sesifuba abanesifo sebele kwaye bane-mastectomy kufuneka banikwe i-sentinel lymph node biopsy ukubona ukuba umhlaza usasazekile kwii-axillary lymph node. Ukuba iiseli zomhlaza zifunyenwe kwi-sentinel lymph node (s), kunokufuneka kwenziwe utyando lwe-lymph node (1, 6, 7). Kuxhomekeka kwinqanaba kunye nezinye izinto zesisu sethumba (umzekelo, ubukho okanye ukungabikho kokubandakanyeka kwe-lymph node, i-estrogen kunye ne-progesterone receptors kwiiseli zethumba, kunye ne-HER2 protein overexpression kwiiseli zethumba), unyango oluncedisayo, oluquka ichemotherapy kunye / okanye unyango lwehomoni, kunokucetyiswa.

Sisiphi isibhengezo kubantu abanePaget isifo sesifuba?

Ukuxela kwangaphambili, okanye imbonakalo yabantu abanePaget isifo sesifuba kuxhomekeke kwizinto ezahlukeneyo, kubandakanya oku kulandelayo:

• Nokuba likhona okanye alikho ithumba ebeleni elichaphazelekayo

• Ukuba inye okanye nangaphezulu izicwili ezikhoyo kwisifuba esichaphazelekayo, nokuba ezo tumors ziyi-ductal carcinoma in situ okanye umhlaza webele ongenayo

• Ukuba umhlaza webele ongenayo ukho kwisifuba esichaphazelekayo, inqanaba lalo mhlaza

Ubukho besifo somhlaza kwisifuba esichaphazelekayo kunye nokusasazeka komhlaza kwii-lymph node ezikufutshane kunxulunyaniswa nokuncitshiswa kokusinda.

Ngokwenkqubo ye-NCI's Surveillance, Epidemiology, kunye neZiphumo zokuQhubeka, iminyaka emi-5 yokuphila kwabo bonke abasetyhini e-United States abafunyaniswa benesifo sePaget sesifuba phakathi kuka-1988 no-2001 yayingama-82.6 epesenti. Oku kuthelekiswa nokusinda kwesihlobo seminyaka emi-5 yeepesenti ezingama-87.1 kwabasetyhini abafunyaniswa benalo naluphi na uhlobo lomhlaza wamabele. Kubafazi abanesifo sePaget sesifuba kunye nomhlaza ongenayo kwisifuba esinye, ukusinda kwesihlobo seminyaka emi-5 kuye kwehla ngenqanaba elonyukayo lomhlaza (inqanaba I, iipesenti ezingama-95.8; inqanaba II, iipesenti ezingama-77.7; inqanaba III, ipesenti ezingama-46.3; isigaba IV, iipesenti eziyi-14.3) (1, 3, 8, 9).

Zeziphi izifundo zophando eziqhubekayo kwisifo sePaget sesifuba?

Uvavanyo lweklinikhi olulawulwa ngokungahleliwe, oluthathwa njenge "mgangatho wegolide" kuphando lomhlaza, kunzima ukwenza isifo sePaget sesifuba kuba bambalwa kakhulu abantu abanesi sifo (4, 10). Nangona kunjalo, abantu abanePaget isifo sesifuba banelungelo lokungena kwizilingo zeklinikhi ukuvavanya unyango olutsha lomhlaza wamabele ngokubanzi, iindlela ezintsha zokusebenzisa unyango lomhlaza wamabele, okanye iindlela zokuthintela umhlaza webele ukuphindeka kwakhona.

Ulwazi malunga nonyango lomhlaza wamabele kunyango lwezonyango luyafumaneka ngokukhangela uluhlu lweNCI lovavanyo lomhlaza kwiklinikhi. Ngenye indlela, tsalela umnxeba iZiko loNxibelelwano leNCI kwi-1-800-4-CANCER (1-800-422-6237) ngolwazi malunga novavanyo lwezonyango kubantu abanesifo sePaget sesifuba.

Izalathiso ezikhethiweyo

1. UHarris JR, uLippman ME, uMorrow M, u-Osborne CK, abahleli. Izifo zesifuba. Ngomhla we-4. IPhiladelphia: Lippincott Williams kunye noWilkins; U-2009.
2. ICaliskan M, Gatti G, Sosnovskikh I, et al. Ukuchaneka Isifo sebele sikaPaget: amava e-European Institute of Oncology kunye nokuphononongwa koncwadi. Uphando lomhlaza wamabele kunye nonyango 2008; 112 (3): 513-521. [PubMed Abstract]
3. I-Kanitakis J. Mammary kunye nesifo se-Paget esingekapheli. Ijenali ye-European Academy yeDermatology kunye neVenereology 2007; 21 (5): 581-590. [PubMed Abstract]
4. UKawase K, uDimaio DJ, uTucker SL, et al. Isifo sesifuba sikaPaget: kukho indima kunyango lokugcina amabele. Izibhengezo zeOncology yoPhando ngo-2005; 12 (5): 391--397. [PubMed Abstract]
5. UMarshall JK, uGriffith KA, uHaffty BG, et al. Ukulawulwa okugcinayo kwesifo sePaget sesifuba nge-radiotherapy: iziphumo ze-10- kunye ne-15-yeminyaka. Umhlaza 2003; 97 (9): 2142-2149. [PubMed Abstract]
6. USukumvanich P, uBentrem DJ, uCody HS, et al. Indima ye-sentinel lymph node biopsy kwisifo sikaPaget sesifuba. Izibhengezo zeOncology yoPhando ngo-2007; 14 (3): 1020–1023. [PubMed Abstract]
7. ULaronga C, uHasson D, uHoover S, et al. Isifo sikaPaget ngexesha le-sentinel lymph node biopsy. Ijenali yaseMelika yoPhando ngo-2006; 192 (4): 481--483. [PubMed Abstract]
8. Ries LAG, Eisner MP. Umhlaza webele lowasetyhini. Ku: Ries LAG, Young JL, Keel GE, et al., Abahleli. I-SEER Survival Monograph: Ukuphila komhlaza phakathi kwabantu abadala: Inkqubo ye-US SEER, ngo-1988-2001, izigulana kunye neempawu zesisu. I-Bethesda, MD: IZiko leSizwe loMhlaza, iNkqubo ye-SEER, 2007. Ibuyiswe ngo-Epreli 10, 2012.
9. I-Chen CY, iLanga LM, kunye noAnderson BO. Isifo sePaget sesifuba: ukutshintsha iipateni zeziganeko, ukubonakaliswa kweklinikhi, kunye nonyango kwi-US Cancer 2006; 107 (7): 1448-1458. [PubMed Abstract]
10. UJoseph KA, Ditkoff BA, Estabrook A, et al. Ukhetho kunyango lwesifo sikaPaget: iziko elinye lokufunda emva kwexesha elide. Ijenali yebele 2007; 13 (1): 110-111. [PubMed Abstract]