Umdlavuza webele

Umdlavuza webele umdlavuza oqala ezicutshini zesifuba. Kunezinhlobo ezimbili eziyinhloko zomdlavuza webele:

• I-Ductal carcinoma iqala kumashubhu (amapayipi) athwala ubisi ukusuka esifubeni kuya engonweni. Iningi lomdlavuza webele yilolu hlobo.
• I-Lobular carcinoma iqala ezingxenyeni zesifuba, ezibizwa ngama-lobules, ezikhiqiza ubisi.

Ezimweni ezingavamile, ezinye izinhlobo zomdlavuza webele zingaqala kwezinye izindawo zesifuba.

Izici zomdlavuza webele yizinto ezandisa amathuba okuthi ube nomdlavuza webele.

• Ezinye izinto ezinobungozi ongazilawula, njengokuphuza utshwala. Eminye, njengomlando womndeni, awukwazi ukuyilawula.
• Lapho unezinto eziyingozi kakhulu, ingozi yakho iyanda. Kepha, akusho ukuthi uzoba nomdlavuza. Abesifazane abaningi ababa nomdlavuza webele abanazo izinto eziyingozi noma umlando womndeni.
• Ukuqonda izici zakho zobungozi kungakusiza uthathe izinyathelo zokwehlisa ubungozi bakho.

Abanye besifazane basengozini enkulu yomdlavuza webele ngenxa yezimpawu ezithile zofuzo noma okuhlukile okungadluliselwa kubazali babo.

• Izakhi zofuzo ezaziwa nge-BRCA1 noma i-BRCA2 zibhekene nezimo eziningi zomdlavuza webele ozuzwe njengefa.
• Ithuluzi lokuhlola elinemibuzo ngomlando womndeni wakho kanye nowakho lingasiza umhlinzeki wakho wokunakekelwa kwezempilo ukuthi ngabe usengozini yokuphatha lezi zofuzo.
• Uma usengozini enkulu, ukuhlolwa kwegazi ukubona ukuthi uziphethe yini izakhi zofuzo.
• Ezinye izakhi zofuzo zingaholela engozini eyengeziwe yomdlavuza webele.

Ukufakwa kwesifuba, ukusebenzisa izidambisi zomoya, nokugqoka o-brasi abangaphansi kwe-underwire akwenyusi ingozi yomdlavuza webele. Abukho futhi ubufakazi bokuxhumana okuqondile phakathi komdlavuza webele nemithi yokubulala izinambuzane.

Umdlavuza webele wasekuqaleni kaningi awubangeli zimpawu. Yingakho izivivinyo zamabele ezijwayelekile kanye nama-mammograms kubalulekile, ngakho-ke umdlavuza ongenazo izimpawu ungatholwa ngaphambi kwesikhathi.

Njengoba umdlavuza ukhula, izimpawu zingafaka:

• Isigaxa sesifuba noma isigaxa ekhwapheni esinzima, sinemiphetho engalingani, futhi imvamisa asilimazi.
• Shintsha usayizi, ukuma, noma imizwa yebele noma yengono. Isibonelo, ungahle ube nokubomvu, ukufinyela, noma ukupakisha okubukeka njengesikhumba se-orange.
• Uketshezi oluvela engonweni. Uketshezi kungaba negazi, kucace kuphuzi, luhlaza, noma kubukeke njengobomvu.

Emadodeni, izimpawu zomdlavuza webele zifaka phakathi isigaxa sesifuba nobuhlungu besifuba nobumnene.

Izimpawu zomdlavuza webele osezingeni eliphakeme zingabandakanya:

• Ubuhlungu bamathambo
• Ubuhlungu besifuba noma ukungaphatheki kahle
• Izilonda zesikhumba
• Ukuvuvukala kwama-lymph node ekhwapheni (eduze kwesifuba esinomdlavuza)
• Ukwehla kwesisindo

Umhlinzeki wezokunakekelwa kwempilo uzobuza ngezimpawu zakho nezici zobungozi bakho. Ngemuva kwalokho umhlinzeki uzokwenza ukuhlolwa ngokomzimba. Ukuhlolwa kufaka zombili amabele, amakhwapha, nendawo yentamo nesifuba.

Abesifazane bayakhuthazwa ukuthi bazihlole amabele inyanga ngayinye. Kodwa-ke, ukubaluleka kokuzivivinya ngokwakho ukuthola umdlavuza webele kuyaphikiswa.

Ukuhlolwa okusetshenziselwa ukuxilonga nokuqapha abantu abanomdlavuza webele kungabandakanya:

• Mammography ukuhlola umdlavuza webele noma ukusiza ukukhomba isigaxa sesifuba
• I-ultrasound yebele ukukhombisa ukuthi isigaxa siqinile noma sigcwele uketshezi
• I-biopsy yebele, kusetshenziswa izindlela ezifana nenaliti aspiration, ultrasound-led, stereotactic, noma open
• I-Breast MRI ukusiza kangcono ukukhomba isigaxa sesifuba noma ukuhlola ushintsho olungavamile ku-mammogram
• I-Sentinel lymph node biopsy ukubheka ukuthi umdlavuza ususabalele yini kuma-lymph node
• I-CT scan ukuhlola ukuthi umdlavuza ususabalele ngaphandle kwebele
• Iskena se-PET ukuhlola ukuthi umdlavuza ususakazekile yini

Uma udokotela wakho ezwa ukuthi unomdlavuza webele, ukuhlolwa okuningi kuzokwenziwa. Lokhu kubizwa ngokuthi yisiteji, esihlola ukuthi umdlavuza ususakazekile yini. Isiteji sisiza ukuqondisa ukwelashwa nokulandelela. Ibuye ikunikeze umbono wokuthi yini ongayilindela esikhathini esizayo.

Izigaba zomdlavuza webele zisuka ku-0 ziye ku-IV. Ukuphakama kwesiteji, umdlavuza uqhubekela phambili.

Ukwelashwa kusekelwe ezintweni eziningi, kufaka phakathi:

• Uhlobo lomdlavuza webele
• Isigaba somdlavuza (isiteji ithuluzi abahlinzeki bakho abalisebenzisayo ukuthola ukuthi umdlavuza uthuthuke kangakanani)
• Ukuthi umdlavuza ubucayi yini kuma-hormone athile
• Ukuthi umdlavuza ukhiqiza ngokweqile (overexpresses) iphrotheni ye-HER2 / neu

Ukwelashwa komdlavuza kungabandakanya:

• Ukwelashwa kweHormone.
• I-Chemotherapy, esebenzisa imithi ukubulala amangqamuzana omdlavuza.
• Ukwelashwa ngemisebe, okusetshenziselwa ukubhubhisa izicubu ezinomdlavuza.
• Ukuhlinzwa ukususa izicubu ezinomdlavuza: I-lumpectomy isusa isigaxa sesifuba. I-Mastectomy isusa lonke noma ingxenye yebele futhi mhlawumbe nezakhiwo eziseduze. Ama-lymph node aseduze nawo angasuswa ngesikhathi sokuhlinzwa.
• Ukwelashwa okuhlosiwe kusebenzisa umuthi ukuhlasela izinguquko zofuzo kumaseli womdlavuza. Ukwelashwa kweHormone kuyisibonelo sokwelashwa okuhlosiwe. Ivimbela ama-hormone athile abangela ukukhula komdlavuza.

Ukwelashwa komdlavuza kungaba kwendawo noma okuhleliwe:

• Ukwelashwa kwasendaweni kubandakanya kuphela indawo yesifo. Imisebe nokuhlinzwa yizinhlobo zokwelashwa kwasendaweni. Zisebenza kahle kakhulu uma umdlavuza ungasakazekanga ngaphandle kwebele.
• Ukwelashwa okuhlelekile kuthinta umzimba wonke. I-Chemotherapy kanye nokwelashwa kwe-hormonal yizinhlobo zokwelashwa okuhleliwe.

Abesifazane abaningi bathola inhlanganisela yokwelashwa. Kwabesifazane abanomdlavuza webele wesigaba I, II, noma III, inhloso enkulu wukwelapha umdlavuza nokuwuvikela ukuthi ungabuyi (uphindaphinde). Kwabesifazane abanomdlavuza wesigaba IV, inhloso ukuthuthukisa izimpawu nokubasiza baphile isikhathi eside. Ezimweni eziningi, umdlavuza webele wesigaba IV awulapheki.

• Isigaba 0 ne-ductal carcinoma: I-Lumpectomy kanye ne-radiation noma i-mastectomy yindlela yokwelashwa ejwayelekile.
• Isigaba I no-II: I-Lumpectomy plus radiation noma i-mastectomy ngokususwa kwe-lymph node yindlela ejwayelekile yokwelashwa. I-Chemotherapy, ukwelashwa kwe-hormonal, kanye nokunye ukwelashwa okuhlosiwe nakho kungasetshenziswa ngemuva kokuhlinzwa.
• Isigaba III: Ukwelashwa kufaka phakathi ukuhlinzwa, okungenzeka kulandelwe ukwelashwa ngamakhemikhali, ukwelashwa kwama-hormone nokunye ukwelashwa okuhlosiwe.
• Isigaba IV: Ukwelashwa kungafaka ukuhlinzwa, imisebe, i-chemotherapy, i-hormone therapy, okunye ukwelashwa okuqondisiwe, noma inhlanganisela yalezi zindlela zokwelapha.

Ngemuva kokwelashwa, abanye besifazane bayaqhubeka nokuphuza imithi okwesikhashana. Bonke abesifazane bayaqhubeka nokuhlolwa igazi, ama-mammograms, nokunye ukuhlolwa ngemuva kokwelashwa ukuqapha ukubuya komdlavuza noma ukukhula komunye umdlavuza webele.

Abesifazane abaye baba ne-mastectomy bangase babe nokuhlinzwa kabusha kwebele. Lokhu kuzokwenziwa noma ngesikhathi se-mastectomy noma kamuva.

Unganciphisa ukucindezela kokugula ngokujoyina iqembu lokusekela umdlavuza. Ukwabelana nabanye abanokuhlangenwe nakho okuvamile nezinkinga kungakusiza ungazizwa uwedwa.

Izindlela zokwelashwa ezintsha nezithuthukisiwe zisiza abantu abanomdlavuza webele ukuthi baphile isikhathi eside. Ngisho nangokwelashwa, umdlavuza webele ungasakazekela nakwezinye izingxenye zomzimba. Kwesinye isikhathi, umdlavuza uyabuya, noma ngabe sekususwe sonke isimila futhi kutholakala ukuthi ama-lymph node aseduzane awunawo umdlavuza.

Abanye besifazane abake baba nomdlavuza webele baba nomdlavuza omusha webele ongahlobene nesimila sokuqala.

Ukwenza kahle kwakho ngemuva kokwelashwa umdlavuza webele kuncike ezintweni eziningi. Lapho umdlavuza wakho usuthuthuke kakhulu, umphumela uba mpofu. Ezinye izinto ezinquma ubungozi bokuphindeka kanye namathuba okwelashwa okuphumelelayo afaka:

• Indawo yesimila nokuthi sesisabalale kangakanani
• Ukuthi isimila siyi-receptor receptor-positive noma -gative yini
• Izimpawu zesimila
• Isisho se-Gene
• Usayizi wesimila nomumo
• Izinga lokwehlukaniswa kwamaseli noma ukuthi isimila sikhula ngokushesha kangakanani

Ngemuva kokucubungula konke okungenhla, umhlinzeki wakho angaxoxa ngobungozi bakho bokuphindaphinda umdlavuza webele.

Ungahle ube nemiphumela engemihle noma izinkinga ezivela ekwelashweni komdlavuza. Lokhu kungabandakanya ubuhlungu besikhashana noma ukuvuvukala kwesifuba nendawo ezungezile. Buza umhlinzeki wakho ngemiphumela engemihle evela ekwelashweni.

Xhumana nomhlinzeki wakho uma:

• Unesigaxa sebele noma somakhwapheni
• Ukhipha ingono

Ngemuva kokuphathwa ngomdlavuza webele, shayela umhlinzeki wakho uma uba nezimpawu ezinjengalezi:

• Ukukhishwa kwengono
• Ukuqhuma ebeleni
• Izigaxa ezintsha esifubeni
• Ukuvuvukala endaweni
• Ubuhlungu, ikakhulukazi ubuhlungu besifuba, ubuhlungu besisu, noma ubuhlungu bethambo

Khuluma nomhlinzeki wakho mayelana nokuthi kufanele ube nemammogram noma ezinye izivivinyo kangaki ukuze uhlolwe umdlavuza webele. Umdlavuza webele wokuqala otholwe yi-mammogram unethuba elihle lokuthi welapheke.

I-Tamoxifen ivunyelwe ukuvimbela umdlavuza webele kwabesifazane abaneminyaka engama-35 nangaphezulu abasengozini enkulu. Xoxa ngalokhu nomhlinzeki wakho.

Abesifazane abasengozini enkulu kakhulu yomdlavuza webele bangabheka imastectomy yokuvimbela (prophylactic). Lokhu ukuhlinzwa ukususa amabele ngaphambi kokuba kutholakale umdlavuza webele. Abaqokiwe okungenzeka bafaka:

• Abesifazane asebesuswe ibele elilodwa ngenxa yomdlavuza
• Abesifazane abanomlando womndeni oqinile womdlavuza webele
• Abesifazane abanezakhi zofuzo noma ukuguqulwa kwezakhi zofuzo eziphakamisa ingozi yomdlavuza webele (njenge-BRCA1 noma i-BRCA2)

Izici eziningi zobungozi, ezinjengezakhi zofuzo zakho nomlando womndeni, azikwazi ukulawulwa.Kodwa ukwenza izinguquko zokuphila ngendlela enempilo kunganciphisa amathuba akho okuba nomdlavuza. Lokhu kufaka:

• Ukudla ukudla okunempilo
• Ukugcina isisindo esinempilo
• Ukunciphisa ukusetshenziswa kotshwala ku-1 isiphuzo ngosuku

Umdlavuza - isifuba; I-Carcinoma - i-ductal; Carcinoma - lobular; I-DCIS; I-LCIS; Umdlavuza webele we-HER2; Umdlavuza webele we-ER-positive; I-Ductal carcinoma in situ; I-Lobular carcinoma in situ

• Imisebe yesifuba sangaphandle - ukukhishwa
• I-Chemotherapy - yini ongayibuza udokotela wakho
• ILymphedema - ukuzinakekela
• I-Mastectomy nokwakhiwa kabusha kwesifuba - okufanele ubuze udokotela wakho
• I-Mastectomy - ukukhipha
• Ukwelashwa ngemisebe - imibuzo ongayibuza udokotela wakho

• Ibele lesifazane
• I-Needle biopsy yesifuba
• Vula i-biopsy yesifuba
• Ukuzihlola kwamabele
• Ukuzihlola kwamabele
• Ukuzihlola kwamabele
• I-Lumpectomy
• Ukususwa kwesigaxa samabele - uchungechunge
• I-Mastectomy - uchungechunge
• I-Sentinel node biopsy

Makhoul I. Izindlela zokwelapha umdlavuza webele. Ku: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, ama-eds. Isifuba: Ukuphathwa Okuphelele Kwezifo zeBenign and Malignant. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2018: isahluko 24.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza webele (omdala) (PDQ) - inguqulo yezempilo. www.cancer.gov/types/breast/hp/ Ukwelashwa kwesibeletho-pdq. Kubuyekezwe uFebhuwari 12, 2020. Kufinyelelwe kuFebhuwari 25, 2020.

Iwebhusayithi ye-National Comprehensive Cancer Network. Imikhombandlela ye-NCCN yokwenza imitholampilo ku-oncology (imihlahlandlela ye-NCCN): Umdlavuza webele. Inguqulo 2.2020. www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Kubuyekezwe uFebhuwari 5, 2020. Kufinyelelwe ngoFebhuwari 25, 2020.

Siu AL; I-US Preventive Services Task Force. Ukuhlolwa umdlavuza webele: Isitatimende sezincomo se-US Preventive Services Task Force. U-Ann Intern Med. 2016; 164 (4): 279-296. I-PMID: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.

I-US Preventive Services Task Force, u-Owens DK, uDavidson KW, et al. Ukuhlolwa kobungozi, ukwelulekwa ngezakhi zofuzo, kanye nokuhlolelwa izakhi zofuzo zomdlavuza ohlobene ne-BRCA: Isitatimende Sencomo Sezincomo Zase-US Preventive Services Task Force [ukulungiswa okushicilelwe kuvela ku-JAMA. 2019; 322 (18): 1830]. JAMA. 2019; 322 (7): 652-665. I-PMID: 31429903 pubmed.ncbi.nlm.nih.gov/31429903/.