Ukuqonda Isiteji Somdlavuza Webele

-Delile

• Umdlavuza webele uhlelwa kanjani?
• Ziyini izigaba zomdlavuza webele?
• Isigaba 0
• Isigaba 1
• Isigaba 2
• Isigaba 3
• Isigaba 4
• Umdlavuza webele ophindaphindiwe
• Ingabe isigaba somdlavuza webele siyazithinta izimpawu?
• Isikhathi sokuphila ngesigaba
• Izinketho zokwelashwa ngesigaba
• Isigaba 0
• Izigaba 1, 2, no-3
• Isigaba 4
• Ukuthethelelwa nobungozi bokuphindeka
• Ukuthatha

Umdlavuza webele ngumdlavuza oqala kuma-lobules, amapayipi, noma izicubu ezihlanganayo zesifuba.

Umdlavuza webele uhlelwe kusuka ku-0 kuye ku-4. Isiteji sikhombisa ubukhulu besimila, ukubandakanyeka kwe-lymph node, nokuthi umdlavuza kungenzeka usabalale kangakanani. Ezinye izinto, njengesimo se-receptor receptor kanye nebanga le-tumor, nazo zifakwa esiteji.

Lolu lwazi lubalulekile ekwenzeni izinqumo zokwelashwa kanye nokuqonda umbono wakho jikelele.

Qhubeka ufunde ukuze ufunde ukuthi umdlavuza webele uhlelwa kanjani, ukuthi lokho kuthinta kanjani ukwelashwa, nokuthi yini ongayilindela.

Umdlavuza webele uhlelwa kanjani?

Udokotela angase asole umdlavuza webele ngemuva kokuhlolwa ngokomzimba, i-mammogram, noma okunye ukuhlolwa kwe-imaging. Bangase bancome i-biopsy, okuwukuphela kwendlela yokuqinisekisa ukutholakala komdlavuza webele.

Udokotela uzosebenzisa imiphumela evela ku-biopsy yakho ukwabela isigaba “somtholampilo”.

Ngemuva kokuhlinzwa ukuze ususe isimila, udokotela wakho uzokwazi ukwabelana nawe ngeminye imininingwane mayelana nokubandakanyeka kwe-lymph node, kanye neminye imibiko yokugula.

Ngaleso sikhathi, udokotela wakho uzokwabela isiteji esinembile "se-pathologic" esebenzisa isikali se-TNM. Nakhu ukwehlukaniswa kokuthi T, N, no M kusho ukuthini:

T iphathelene nosayizi wesimila.

• I-TX. Isimila asikwazi ukuhlolwa.
• T0. Akunabufakazi besimila sokuqala.
• Ithis. Isimila asikakhuli sibe izicubu zamabele ezinempilo (in situ).
• T1, T2, T3, T4. Lapho le nombolo iphakama, iba mkhulu isimila noma lapho ihlasela kakhulu izicubu zamabele.

N iphathelene nokubandakanyeka kwe-lymph node.

• NX. Ama-lymph node aseduze awakwazi ukuhlolwa.
• Cha. Akukho ukuzibandakanya kwe-lymph node eseduze.
• N1, N2, N3. Ukuphakama kwenombolo, ukubandakanyeka kakhulu kwe-lymph node.

UM iphathelene ne-metastasis ngaphandle kwebele.

• MX. Ayikwazi ukuhlolwa.
• M0. Akunabufakazi be-metastasis ekude.
• I-M1. Umdlavuza usabalalele ezingxenyeni ezikude zomzimba.

Izigaba zihlanganisiwe ukuthola isiteji, kepha lezi zinto zingathinta nesiteji:

• isimo se-estrogen receptor
• isimo se-progesterone receptor
• Isimo se-HER2 / neu

Futhi, izicubu zibekwa esikalini sika-1 kuye ku-3 ngokuya ngokuthi amaseli womdlavuza avele ngokungajwayelekile kanjani. Ukuphakama kwebanga, kukhula kakhulu futhi kusabalale.

Ziyini izigaba zomdlavuza webele?

Isigaba 0

Umdlavuza webele ongabonakali uhlanganisa i-ductal carcinoma in situ (DCIS). Amaseli angajwayelekile awazange ahlasele izicubu eziseduze.

Isigaba 1

Isigaba 1 sehlukaniswe izigaba 1A no-1B.

Esigabeni 1A umdlavuza webele, isimila sifinyelela kumasentimitha ama-2, kepha akukho kubandakanyeka kwe-lymph node.

Ngomdlavuza webele wesigaba 1B, isimila singaphansi kwamasentimitha ama-2, kepha kunamaqoqo amancane amaseli womdlavuza kuma-lymph node aseduze.

Umdlavuza webele weSigaba 1B nawo uyabelwa uma singekho isimila, kodwa kunamaqoqo amancane amaseli omdlavuza kuma-lymph node.

Qaphela: Uma isimila siyi-estrogen receptor- noma i-progesterone receptor-positive, ingahle ibekwe njenge-1A.

Isigaba 2

Isigaba 2 sehlukaniswe izigaba 2A no-2B.

Isigaba 2A sinikezwe noma ikuphi kokulandelayo:

• asikho isimila, kepha ama-lymph node eyodwa kuya kwamathathu ngaphansi kwengalo noma eduze kwethambo lesifuba aqukethe amangqamuzana omdlavuza
• isimila esifinyelela kumasentimitha ama-2, kanye nomdlavuza kuma-lymph node ngaphansi kwengalo
• isimila esiphakathi kwamasentimitha ama-2 kuye kwayi-5, kepha akukho ukubandakanyeka kwe-lymph node

Qaphela: Uma isimila sine-HER2-positive futhi ne-estrogen receptor- ne-progesterone receptor-positive, ingahle ibekwe njengesigaba 1A.

Isigaba 2B sabelwe okunye kwalokhu okulandelayo:

• isimila esiphakathi kwamasentimitha amabili kuya kwangu-5, kanye namaqoqo amancane omdlavuza ku-lymph node eyodwa kuya kwamathathu aseduze
• isimila esingaphezu kwamasentimitha ama-5, kepha akukho ukubandakanyeka kwe-lymph node

Qaphela: Uma isimila sine-HER2-positive ne-estrogen receptor- ne-progesterone receptor-positive, ingahle ibekwe njengesigaba 1.

Isigaba 3

Isigaba 3 sehlukaniswe ngezigaba 3A, 3B, no-3C.

Isigaba 3A sinikezwe okunye kwalokhu okulandelayo:

• umdlavuza ezindaweni ezine kuya kwezingu-9 eziseduze, ezine-tumor noma ezingenayo
• isimila esingaphezu kwamasentimitha ama-5, kanye namaqoqo amancane amaseli womdlavuza kuma-lymph node

Qaphela: Uma isimila esingaphezu kwamasentimitha ama-5 singu-grade 2, i-estrogen receptor-, i-progesterone receptor-, ne-HER2-positive, kanye nomdlavuza utholakala kuma-lymph node amane kuya kwayisishiyagalolunye angaphansi kwekhwapha, angahle abekwe njenge-1B.

Esigabeni 3B, isimila sesifinyelele odongeni lwesifuba, kanye nomdlavuza ongaba nawo:

• ukusabalala noma ukuphuka esikhunjeni
• isabalalele kuze kufike kuma-lymph node ayisishiyagalolunye ngaphansi kwengalo noma eduze kwethambo lesifuba

Qaphela: Uma isimila sine-estrogen receptor-positive ne-progesterone receptor-positive, khona-ke singabizwa ngeSigaba 1 noma 2 ngokuya ngebanga le-tumor. Umdlavuza webele wokuvuvukala uhlala okungenani isigaba 3B.

Esigabeni 3C, kungahle kungabi bikho isimila esifubeni. Kepha uma kukhona, kungenzeka ukuthi kufinyelele odongeni lwesifuba noma esikhumbeni sebele, futhi:

• Ama-lymph node angama-10 noma ngaphezulu ekhanda
• ama-lymph node eduze ne-collarbone
• ama-lymph node ngaphansi kwengalo naseduze kwesifuba sesifuba

Isigaba 4

Isigaba 4 sithathwa njengomdlavuza webele osezingeni eliphakeme, noma umdlavuza webele we-metastatic. Lokhu kusho ukuthi isabalalele ezingxenyeni ezikude zomzimba. Umdlavuza ungaba khona emaphashini, ebuchosheni, esibindini noma emathanjeni.

Umdlavuza webele ophindaphindiwe

Umdlavuza obuya ngemuva kokwelashwa okuphumelelayo ngumdlavuza ophindayo webele.

Ingabe isigaba somdlavuza webele siyazithinta izimpawu?

Ungahle ungabi nezimpawu kuze kube yilapho isimila sikhulu ngokwanele ukuba uzizwe. Ezinye izimpawu zokuqala zingafaka ushintsho kusayizi noma ekubunjweni kwesifuba noma ingono, ukuphuma engonweni, noma isigaxa esingaphansi kwengalo.

Izimpawu zakamuva zincike lapho umdlavuza usabalale khona futhi zingafaka:

• ukulahlekelwa isifiso sokudla
• ukuncipha komzimba
• ukuphelelwa umoya
• ukukhwehlela
• ikhanda
• ukubona kabili
• ubuhlungu bamathambo
• ubuthakathaka bemisipha
• i-jaundice

Isikhathi sokuphila ngesigaba

Noma sehlukaniswe yisiteji, kunzima ukunquma isikhathi sokuphila somuntu onomdlavuza webele ngenxa yalokhu okulandelayo:

• Kunezinhlobo eziningi zomdlavuza webele, futhi ziyahlukahluka ezingeni labo lobudlova. Abanye bahlose ukwelashwa, kanti abanye abakwenzi.
• Ukwelashwa okuphumelelayo kungaxhomeka eminyakeni yobudala, ezinye izinkinga zempilo, kanye nokwelashwa okukhethayo.
• Amanani okusinda ayizilinganiso ezisuselwa kubantu abatholwe eminyakeni edlule. Ukwelashwa kuthuthuka ngokushesha, ngakho-ke ungaba nesikhathi esilula sokuphila kunabantu abatholakala ngisho eminyakeni emihlanu edlule.

Yingakho kungafanele uthathe izibalo ezijwayelekile. Udokotela wakho angakunika umbono ongcono wokuthi yini ongayilindela ngokuya ngephrofayili yakho yezempilo.

I-Surveillance, Epidemiology, and End Results Programme (SEER) ayilandeleli amazinga okusinda komdlavuza webele ngohlobo noma ngezigaba 0 kuya ku-4. Izinga lokusinda elilinganisiwe liqhathanisa abantu abanomdlavuza webele nabantu emphakathini jikelele.

Okulandelayo amazinga we-SEER weminyaka emihlanu yokusinda okuhlobene nokususelwa kwabesifazane abatholakala phakathi kuka-2009 no-2015:

Izinketho zokwelashwa ngesigaba

Isiteji ukucatshangelwa okubalulekile ekunqumeni ukwelashwa, kepha kukhona okunye, okufana nalokhu:

• uhlobo lomdlavuza webele
• isimila grade
• isimo se-estrogen receptor ne-progesterone receptor
• Isimo se-HER2
• ubudala nokuthi usufinyelele yini ukunqamuka kokuya esikhathini
• impilo yonke

Udokotela wakho uzokubheka konke lokhu lapho encoma ukwelashwa. Iningi labantu lidinga inhlanganisela yokwelashwa.

Isigaba 0

• Ukuhlinzwa okulondoloza amabele (i-lumpectomy). Udokotela wakho uzokhipha izicubu ezingajwayelekile kanye nomugqa omncane wezicubu ezinempilo.
• Ukuzivocavoca umzimba. Udokotela wakho uzosusa lonke ibele futhi, kwezinye izimo, ahlole ama-lymph node aseduze ngomdlavuza.
• Ukwelashwa ngemisebe. Lokhu kwelashwa kunganconywa uma ngabe une-lumpectomy.
• Ukuhlinzwa okwakhiwa kabusha kwamabele. Ungahlela le nqubo ngokushesha noma ngosuku oluthile.
• Ukwelashwa kweHormone (tamoxifen noma i-aromatase inhibitor). Udokotela wakho angancoma lokhu kwelashwa lapho i-DCIS iyi-estrogen receptor- noma i-progesterone receptor-positive.

Izigaba 1, 2, no-3

• i-lumpectomy noma i-mastectomy nokususwa kwama-lymph node aseduze ukuhlola umdlavuza
• ukwakhiwa kabusha kwamabele ngokushesha noma kamuva
• ukwelashwa ngemisebe, ikakhulukazi uma ukhethe i-lumpectomy kune-mastectomy
• ukwelashwa ngamakhemikhali
• ukwelashwa kwama-hormone komdlavuza webele we-estrogen receptor-positive ne-progesterone receptor-positive
• izidakamizwa ezihlosiwe ezifana ne-trastuzumab (Herceptin) noma i-pertuzumab (i-Perjeta) yomdlavuza we-HER2

Isigaba 4

• i-chemotherapy yokunciphisa izicubu noma ukukhula kancane kwesimila
• ukuhlinzwa ukuze kususwe izimila noma ukwelapha izimpawu
• ukwelashwa ngemisebe ukudambisa izimpawu
• izidakamizwa ezihlosiwe ze-estrogen receptor-, progesterone receptor-, noma umdlavuza webele we-HER2-positive
• imithi yokudambisa izinhlungu

Kunoma yisiphi isigaba, ungakwazi ukubamba iqhaza ezivivinyweni zokwelashwa. Lezi zifundo zokucwaninga zingakunika ukufinyelela kuzindlela zokwelapha ezisakhula. Buza udokotela wakho mayelana nokuhlolwa kwemitholampilo okungakulungela kahle.

Ukuthethelelwa nobungozi bokuphindeka

Ukuxolelwa ngokuphelele kusho ukuthi zonke izimpawu zomdlavuza azisekho.

Kwesinye isikhathi, amangqamuzana omdlavuza asala ngemuva kokwelashwa ekugcineni enza izicubu ezintsha. Umdlavuza ungabuya endaweni, esifundeni, noma ezindaweni ezikude. Yize lokhu kungenzeka noma nini, kungaphakathi kweminyaka emihlanu yokuqala.

Ngemuva kokuqeda ukwelashwa, ukuqapha okujwayelekile kufanele kufake ukuvakashelwa odokotela, ukuhlolwa kwe-imaging, nokuhlolwa kwegazi ukubheka izimpawu zomdlavuza.

Ukuthatha

Umdlavuza webele uhlelwe kusuka ku-0 kuye ku-4. Uma usuwazi uhlobo nesigaba, ithimba lakho lezokunakekelwa kwempilo lizosebenzisana nawe ukukhetha uhlelo lokusebenza olungcono kakhulu.