Ukwelashwa kwemisebe yamabele okuyingxenye - ugongolo lwangaphandle

Ukwelashwa kwemisebe yebele okuyingxenye isebenzisa ama-x-ray anamandla amakhulu ukubulala amangqamuzana omdlavuza webele. Kubizwa nangokuthi imisebe yebele esheshayo esheshayo (APBI).

Inkambo ejwayelekile yokwelashwa kwesifuba sangaphandle ithatha amasonto amathathu kuye kwayisithupha. I-APBI ingafinyelelwa esikhathini esingangesonto elilodwa kuya kwamabili. I-APBI ihlose umthamo omkhulu wemisebe kuphela endaweni eseduze noma eseduze nendawo lapho isisu sesifuba sisuswe khona. Kugwema ukuveza izicubu eziseduze emisebeni.

Kunezindlela ezintathu ezivamile ze-APBI:

• Ugongolo lwangaphandle, isihloko salesi sihloko
• I-Brachytherapy (ifaka imithombo enemisebe ebeleni)
• Imisebe yokuhlinzwa (ukuletha imisebe ngesikhathi sokuhlinzwa egumbini lokuhlinza)

Ukwelashwa ngemisebe kuvame ukulethwa ngaphandle kweziguli, ngaphandle kwelashwa ngemisebe ye-intraoperative.

Amasu amabili ajwayelekile asetshenziselwa ukwelashwa kwemisebe yangaphandle yesifuba sangaphandle:

• Imisebe yemisebe yangaphandle ehambisanayo emithathu (3DCRT)
• Ukwelashwa kwemisebe ye-intension-modulated (IMRT)

Ngaphambi kokuba uthole ukwelashwa ngemisebe, uzohlangana ne-radiation oncologist. Lo muntu ungudokotela ogxile ekwelashweni ngemisebe.

• Udokotela uzobeka amamaki amancane esikhunjeni sakho. Lezi zimaki ziqinisekisa ukuthi umiswe kahle ngesikhathi sokwelashwa kwakho.
• Lawa mamaki kungaba o-inki noma i-tattoo ehlala njalo. Ungagezi omaki bo-inki kuze kuphele ukwelashwa kwakho. Zizobuna ngokuhamba kwesikhathi.

Ukwelashwa kuvame ukunikezwa izinsuku ezinhlanu ngesonto noma yikuphi kusuka emavikini amabili kuya kwayisithupha. Ngezinye izikhathi inganikezwa kabili ngosuku (imvamisa iba namahora amane kuya kwayisithupha phakathi kwezikhathi).

• Ngesikhathi ngasinye sokwelashwa uzolala etafuleni elikhethekile, kungaba emhlane noma esiswini sakho.
• Ochwepheshe bazokubeka ukuze imisebe ikhombe endaweni yokwelashwa.
• Ungacelwa ukuthi ubambe umoya wakho ngenkathi imisebe ihanjiswa. Lokhu kusiza ukukhawulela ukuthi inhliziyo yakho ithola imisebe engakanani.
• Imvamisa, uzothola ukwelashwa ngemisebe phakathi kwemizuzu eyi-1 nengu-5. Uzongena futhi uphume esikhungweni somdlavuza ngaphakathi kwemizuzu engu-15 kuye kwengu-20 ngokwesilinganiso.

Qiniseka ukuthi awusebenzisi imisebe ngemuva kwalezi zindlela zokwelapha ngemisebe. Kuphephile ukuba phakathi kwabanye, kufaka phakathi izingane nezingane.

Ochwepheshe bathola ukuthi umdlavuza othile kungenzeka ukuthi ubuye eduze nendawo yokuqala yokuhlinzwa. Ngakho-ke, kwezinye izimo, lonke ibele kungenzeka lingadingi ukuthola imisebe. Imisebe yebele engaphelele iphatha kuphela amanye kodwa hhayi lonke ibele, igxile endaweni lapho umdlavuza kungenzeka ubuyele khona.

Le radiation esheshayo yebele esheshayo isheshisa inqubo.

I-APBI isetshenziselwa ukuvimbela umdlavuza webele ukuthi ungabuyi. Lapho ukwelashwa ngemisebe kunikezwa ngemuva kokuhlinzwa okonga ibele, kubizwa ngokuthi ukwelashwa ngemisebe ye-adjuvant (eyengeziwe).

I-APBI inganikezwa ngemuva kwe-lumpectomy noma i-mastectomy eyingxenye (ebizwa ngokuthi ukuhlinzwa okulondoloza amabele) ye:

• I-Ductal carcinoma in situ (DCIS)
• Umdlavuza webele wesigaba sokuqala noma sesibili

Tshela umhlinzeki wakho wezempilo ukuthi yimiphi imithi oyiphuzayo.

Gqoka izingubo ezifanelekile lapho ulashwa.

Ukwelashwa ngemisebe nakho kungalimaza noma kubulale amaseli aphilile. Ukufa kwamaseli aphilile kungaholela emiphumeleni emibi. Le miphumela emibi incike kumthamo wemisebe nokuthi ulashwa kangaki. Imisebe ingaba nemiphumela emibi yesikhashana (acute) noma yesikhathi eside (kamuva).

Imiphumela emibi yesikhathi esifushane ingaqala zingakapheli izinsuku noma amasonto ngemuva kokuqala ukwelashwa. Imiphumela emibi eminingi yalolu hlobo iyaphela kungakapheli amasonto ama-4 kuye kwayisithupha ngemuva kokuphela kokwelashwa. Imiphumela ejwayelekile yesikhashana ifaka phakathi:

• Ubomvu besifuba, ubumnene, ukuzwela
• Ukuvuvukala amabele noma i-edema
• Ukutheleleka kwesifuba (okungajwayelekile)

Imiphumela emibi yesikhathi eside ingaqala izinyanga noma iminyaka ngemuva kokwelashwa futhi ingafaka:

• Ukwehla kobukhulu besifuba
• Ukuqina okwengeziwe kwesifuba
• Ukubomvu kwesikhumba nokushintsha kombala
• Ezimweni ezingavamile, ukuphuka kwezimbambo, izinkinga zenhliziyo (cishe imisebe yesokunxele), noma ukuvuvukala kwamaphaphu (okubizwa ngokuthi i-pneumonitis) noma izicubu ezibomvu ezithinta ukuphefumula
• Ukukhula komdlavuza wesibili eminyakeni yesifuba noma isifuba noma emashumini eminyaka kamuva
• Ukuvuvukala kwengalo (i-edema) - kuvame kakhulu uma ama-lymph node asuswe ngokuhlinzwa futhi uma indawo yasemakhwapheni yelashwa ngemisebe

Abahlinzeki bakho bazochaza ngokunakekelwa ekhaya ngesikhathi nangemva kokwelashwa ngemisebe.

Imisebe yebele engaphelele elandela ukwelashwa kokondla amabele inciphisa ingozi yokuba umdlavuza ubuye, futhi mhlawumbe nokufa okubangelwa umdlavuza webele.

I-carcinoma yebele - ukwelashwa ngemisebe ngokwengxenye; Imisebe yangaphandle yesigxobo sangaphandle - isifuba; Ukwelashwa kwemisebe ye-intensity-modulated - umdlavuza webele; I-IMRT - umdlavuza webele WBRT; I-Adjuvant breast breast - IMRT; I-APBI - IMRT; Imfucumfucu yebele esheshayo esheshayo - IMRT; Imisebe yohlobo lwe-conformal yangaphandle - ibele

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa komdlavuza webele (omdala) (PDQ) - inguqulo yezempilo. www.cancer.gov/types/breast/hp/ Ukwelashwa kwesibeletho-pdq. Kubuyekezwe ngoFebhuwari 11, 2021. Kufinyelelwe ngoMashi 11, 2021.

Iwebhusayithi yeNational Cancer Institute. Ukwelashwa ngemisebe kanye nawe: ukusekelwa kwabantu abanomdlavuza. www.cancer.gov/publications/patient-education/radiationttherapy.pdf. Kubuyekezwe u-Okthoba 2016. Kufinyelelwe ngo-Okthoba 5, 2020.

Shah C, Harris EE, Holmes D, Vicini FA. Ukukhanya kwesifuba okuyingxenye: kusheshisiwe futhi kungenziwa ngokuhlinzwa. Ku: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, ama-eds. Isifuba: Ukuphathwa Okuphelele Kwezifo ZeBenign Nezimbi. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2018: isahluko 51.