Umdlavuza Engingabhekana Nawo. Ukulahlekelwa Isifuba Sami Angikwazanga

-Delile

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• UFiona MacNeill mdala kunami ngeminyaka embalwa, usevile eminyakeni engama-50.
• Ukwelashwa komdlavuza webele kuya ngokuya kwenziwa ngezifiso.
• Kodwa ukukhipha okwenzekayo kubantu besifazane ngemuva kokubeletha kunzima.
• Isonto ngemuva kokukhanselwa kwe-mastectomy yami, ngabuyela esibhedlela ukuyothola i-lumpectomy.

Itekisi lifike entathakusa kodwa belingafika nangaphambi kwalokho; Bengivukile ubusuku bonke. Ngangethukile ngosuku olulandelayo nokuthi luzosho ukuthini impilo yami yonke.

Esibhedlela ngashintsha ingubo yobuchwepheshe obuphezulu eyayizongigcina ngifudumele phakathi namahora amade lapho ngingaqulekile, futhi udokotela wami ohlinzayo wafika ukuzosheshe ahlole ngaphambi kokuhlinzwa. Kwaze kwaba lapho esemnyango, esezophuma egumbini, lapho ukwesaba kwami ​​ekugcineni kwathola izwi lakho. Ngathi, “Ngiyacela. "Ngidinga usizo lwakho. Ingabe uzongitshela futhi: kungani ngidinga lesi sifo? ”

Wabuyela kimi, futhi ngambona ebusweni ukuthi wayazi vele, ekujuleni kwenhliziyo, engangikuzwile sonke isikhathi. Lokhu kusebenza bekungeke kwenzeke. Bekuzofanele sithole enye indlela.

Umdlavuza webele wawugubuzele impilo yami emasontweni ambalwa edlule, lapho ngibona isibumbu esincane eduze kwengono yami yangakwesobunxele. I-GP icabange ukuthi ayilutho - kepha kungani uzifaka engozini, ubuze ngokuthokoza, eshaya ikhibhodi yakhe ukuhlela ukudluliselwa.

Emtholampilo ezinsukwini eziyishumi kamuva, izindaba zabonakala zinethemba futhi: i-mammogram yayicacile, umxhumanisi wacabanga ukuthi kwakuyi-cyst. Ezinsukwini ezinhlanu kamuva, emuva emtholampilo, ukuzingelwa komxhumanisi kutholakale kungalungile. I-biopsy iveze ukuthi nginesifo i-carcinoma ebangeni lesibili.

Ngashaqeka, kepha angikhungathekile. Umxhumanisi wanginikeza isiqiniseko sokuthi kufanele ngibe ngumuntu olungele ukungena kulokho akubiza ngokuhlinzwa okulondolozwa kwamabele, ukususa kuphela izicubu ezithintekile (lokhu kuvame ukubizwa nge-lumpectomy). Lokho kuzoba esinye isibikezelo esiyiphutha, yize ngijabula ngethemba enganginalo ekuqaleni. Umdlavuza, ngangicabanga ukuthi, ngingabhekana nawo. Ukulahlekelwa isifuba sami angikwazanga.

Igalelo eliguqula umdlalo lafika ngesonto elilandelayo. Isimila sami bekunzima ukusixilonga ngoba besisezinhlamvwini zesifuba, uma kuqhathaniswa namapayipi (lapho kuvela khona umdlavuza wamabele ongamaphesenti angama-80). Umdlavuza we-Lobular uvame ukukhohlisa i-mammography, kepha kungenzeka ukuthi ubonakale kuskena se-MRI. Futhi umphumela wokuhlolwa kwami ​​kwe-MRI wawubuhlungu kakhulu.

Isimila esasifakwa esifubeni sami sasisikhulu kakhulu kune-ultrasound esasikhombisile, sifinyelela ku-10 cm ubude (10 cm! Angikaze ngizwe ngomuntu onesimila esikhulu kangako). Udokotela odalule lezi zindaba akazange abuke ubuso bami; amehlo akhe ayexhunywe kusikrini sakhe sekhompyutha, izikhali zakhe ngokumelene nomzwelo wami. Sasihlukaniswe ngamasentimitha kodwa sasingaba semaplanethi ahlukile. Ngenkathi eqala ukudubula amagama anjengokuthi "ukufakelwa", "i-dorsi flap" kanye "nokwakhiwa kabusha kwezingono" kimi, bengingakaqali nokucubungula izindaba zokuthi, kukho konke ukuphila kwami, ngibe nesifuba esisodwa esilahlekile.

Lo dokotela wayebonakala enesifiso sokukhuluma ngezinsuku zokuhlinzwa kunokungisiza ngibe nengqondo nge-maelstrom. Into engiyibonile ukuthi bekumele ngisuke kuye. Ngakusasa umngane wangithumela uhlu lwabanye ababonisi, kepha ngizoqala ngaphi? Futhi-ke ngibonile ukuthi igama elilodwa kuphela ohlwini elilelo lowesifazane. Nginqume ukuzama ukuthola isikhathi sokubonana naye.

UFiona MacNeill mdala kunami ngeminyaka embalwa, usevile eminyakeni engama-50.

Angikhumbuli neze lutho ngengxoxo yethu yokuqala, ezinsukwini ezimbalwa nje ngifunde igama lakhe. Ngangisolwandle, ngifutha. Kepha esivunguvungwini sempi 10 impilo yami yayivele yaba ngokuzumayo, iMacNeill kwaba umbono wami wokuqala womhlaba owomile izinsuku. Ngangazi ukuthi wayengumuntu engingamethemba. Ngazizwa ngijabule kakhulu ezandleni zakhe kangangokuthi ngase ngiqale ukuqeda ububi obabubangelwa ukulahlekelwa isifuba sami.

Engangingakwazi ngaleso sikhathi ukuthi ububanzi bemizwa obubanzi ukuthi abesifazane banabo ngamabele abo. Ekugcineni yilabo abanendlela yokubathatha, noma yokubashiya, abanomuzwa wokuthi amabele abo awabalulekanga ngokukhethekile ekuzizweni kwabo. Kokunye abesifazane abanjengami, amabele abo abonakala ebaluleke kakhulu njengenhliziyo noma amaphaphu.

Engikutholile futhi ukuthi imvamisa kuba nokuncane okuncane noma ukungavunywa kwalokhu. Iningi labesifazane abazoba nokuhlinzwa okuzoshintsha impilo yomdlavuza webele abanalo ithuba lokubona isazi sokusebenza kwengqondo ngaphambi kokuhlinzwa.

Ukube benginikwe lelo thuba, bekuzobonakala phakathi nemizuzu eyishumi yokuqala ukuthi bengingajabule neze, ngaphakathi kimi, emcabangweni wokulahlekelwa isifuba sami. Futhi ngenkathi ochwepheshe bomdlavuza webele besazi ukuthi usizo lwengqondo luyoba yinzuzo enkulu kwabesifazane abaningi, amanani amakhulu alabo abatholakala betholakala enza kungasebenzi.

Ezibhedlela eziningi ze-NHS, izinsiza zokusebenza kwengqondo yomtholampilo yomdlavuza webele zikhawulelwe. UMark Sibbering, udokotela ohlinzayo webele eRoyal Derby Hospital kanye nomlandeli kaMacNeill njengomongameli we-Association of Breast Surgery, uthi iningi lisetshenziselwa amaqembu amabili: iziguli ezicabangela ukuhlinzwa okunciphisa ingozi ngoba zithwala izakhi zofuzo ezibabeka emdlavuza webele, futhi labo abanomdlavuza esifubeni esisodwa ababheka i-mastectomy yabo engathintekile.

Ingxenye yesizathu sokuthi ngigqibe ukungajabuli kwami ​​lapho ngilahlekelwa isifuba kungenxa yokuthi uMacNeill uthole enye indlela engcono kakhulu kunenqubo ye-dorsi flap omunye udokotela ohlinzayo ayenikeza ngayo: ukwakhiwa kabusha kwe-DIEP. Yethiwe ngemuva kwesitsha segazi esiswini, inqubo isebenzisa isikhumba namafutha ukusuka lapho ukwakha kabusha isifuba. Yathembisa into elandelayo engcono yokugcina ibele lami, futhi ngangimethemba kakhulu udokotela ohlinzayo owayezokwakha kabusha njengoba ngenza eMacNeill, owayezokwenza i-mastectomy.

Kepha ngiyintatheli, futhi lapha amakhono ami okuphenya angiphoxa.Lokho obekufanele ngabe ngikubuza ukuthi: ngabe kukhona yini okunye okungasetshenziswa esikhundleni se-mastectomy?

Ngangibhekene nokuhlinzwa okukhulu, ukuhlinzwa amahora ayi-10 kuye kwayi-12. Kungangishiya nesifuba esisha engingasizwa nesibazi esinzima esifubeni sami nasesiswini sami, futhi bengingeke ngisaba nayo ingono yangakwesobunxele (yize ukwakhiwa kwezingono kungenzeka kwabanye abantu). Kodwa ngigqoke izingubo zami, kwakungangabazeki ukuthi ngangizobukeka ngimangalisa, ngama-perter boobs nesisu esincane.

Ngokwemvelo nginethemba. Kepha ngenkathi ngibonakala kulabo abangizungezile ukuthi ngihamba ngokuzethemba ngakulungiswa, ukwazi kwami ​​okungaphansi kwakusekela emuva kakhulu. Vele ngangazi ukuthi ukuhlinzwa kwakuzosusa umdlavuza, kodwa engangingakwazi ukukubala ukuthi ngizozizwa kanjani ngomzimba wami omusha.

Ngihlale ngiwathanda amabele ami, futhi abalulekile emqondweni wami. Bayingxenye ebalulekile yobulili bami, futhi bengincelisa ingane ngayinye yezingane zami iminyaka emithathu. Ukwesaba kwami ​​okukhulu ukuthi ngangizoncishiswa i-mastectomy, ukuthi angisoze ngiphinde ngizizwe ngiphelele, noma ngizethemba ngokweqiniso noma ngikhululekile ngami.

Ngiyenqabile le mizwa isikhathi eside ngangokunokwenzeka, kepha ekuseni kokuhlinzwa kwakungekho ndawo yokucasha. Angazi ukuthi ngangilindeleni lapho ekugcineni ngizwakalisa ukwesaba kwami. Ngicabanga ukuthi bengicabanga ukuthi uMacNeill uzobuyela ekamelweni, ahlale phansi embhedeni anginikeze inkulumo ekhulunywayo. Mhlawumbe ngivele ngadinga ukubanjwa ngesandla nokuqinisekiswa ukuthi konke kuzolunga ekugcineni.

Kepha uMacNeill akazange anginikeze inkulumo ekhulunywayo. Futhi akazange azame ukungitshela ukuthi ngenza into efanele. Lokho akusho kwakuwukuthi: “Kufanele ube ne-mastectomy kuphela uma uqinisekile ukuthi yinto elungile. Uma ungenaso isiqiniseko, akufanele senze lo msebenzi - ngoba uzoshintsha impilo, futhi uma ungakulungele lokho kuzobangaba nomthelela omkhulu kwezengqondo ekusaseni lakho. "

Kuthathe elinye ihora noma ngaphezulu ngaphambi kokuthi senze isinqumo esiqondile sokukhansela. Umyeni wami wayedinga ukukholiseka ukuthi kwakuyinto efanele ukwenziwa, futhi ngangidinga ukukhuluma noMacNeill ngalokho ayengakwenza esikhundleni sakhe ukukhipha umdlavuza (ngokuyisisekelo, wayezozama i-lumpectomy; wayengeke athembise ukuthi uzokwazi ukuyisusa bese ingishiya nesifuba esihle, kepha ibizokwenza konke okusemandleni ayo). Kepha kusukela lapho ephendula njengoba enza, bengazi ukuthi i-mastectomy ibingeke yenzeke, nokuthi bekuyisixazululo esingalungile kimi.

Obekucacele thina sonke ukuthi impilo yami yengqondo ibisengcupheni. Vele ngangifuna ukuthi umdlavuza uhambe, kepha ngasikhathi sinye ngangifuna ukuthi umqondo wami ungaphelele.

Eminyakeni emithathu nengxenye kusukela ngalolo suku ngisesibhedlela, ngiphinde ngaba nokuqokwa okuningi neMacNeill.

Into eyodwa engiyifundile kuye ukuthi abesifazane abaningi bakholelwa ngephutha ukuthi imastectomy ukuphela kwendlela noma ephephe kunazo zonke yokubhekana nomdlavuza wabo.

Ungitshele ukuthi abesifazane abaningi abathola isimila sebele - noma umdlavuza webele wangaphambi kokuhlasela njenge-ductal carcinoma in situ (DCIS) - bakholelwa ukuthi ukunikela ngebele elilodwa noma womabili amabele abo kuzobanikeza lokho abakufunayo kakhulu: ithuba lokuqhubeka nokuphila nekusasa elingenomdlavuza.

Lowo kubukeke kungumyalezo abantu abathathe esinqumweni sika-Angelina Jolie esamenyezelwa kakhulu ngo-2013 sokuba ne-mastectomy ephindwe kabili. Kodwa lokho kwakungekhona ukwelapha umdlavuza wangempela; bekuyisenzo sokuvikela ngokuphelele, esikhethwe ngemuva kokuthola ukuthi ubephethe okuhlukile okuyingozi kofuzo lwe-BRCA. Lokho-ke, bekuyinto ehlukile kwabaningi.

Amaqiniso nge-mastectomy ayinkimbinkimbi, kepha abesifazane abaningi bathola i-mastectomy eyodwa noma kabili ngaphandle kokuqala ukuweqa. Kungani? Ngoba into yokuqala eyenzeka kuwe uma utshelwa ukuthi unomdlavuza webele ukuthi wethuka kakhulu. Okusabisa kakhulu kusobala: ukuthi uzokufa. Futhi uyazi ukuthi ungaqhubeka uphile ngaphandle kwesifuba (amabele) sakho, ngakho-ke ucabanga ukuthi ukususwa kwabo kuyisihluthulelo sokuqhubeka uphila, ukulungele ukuvalelisa.

Eqinisweni, uma uke waba nomdlavuza esifubeni esisodwa, ingozi yokuwuthola kwesinye isifuba sakho ngokuvamile iba ngaphansi kwengozi yokuthi umdlavuza wokuqala ubuyele engxenyeni ehlukile yomzimba wakho.

Icala le-mastectomy mhlawumbe liyakholisa ngokwengeziwe lapho utshelwa ukuthi ungaba nokwakhiwa kabusha okuzocishe kufane nento yangempela, mhlawumbe ngesisu sokuqalisa. Kepha nangu umqubuko: ngenkathi iningi lalabo abenza lokhu kukhetha bakholelwa ukuthi benza into ephephe kakhulu futhi engcono ukuzivikela ekufeni nasezifweni ezizayo, iqiniso alicaci kangako.

"Abesifazane abaningi bacela imastectomy ephindwe kabili ngoba bacabanga ukuthi kuzosho ukuthi ngeke baphinde bathole umdlavuza webele, noma ukuthi ngeke bafe ngawo," kusho uMacNeill. “Futhi abanye odokotela abahlinzayo bavele bathathe idayari yabo. Kepha okufanele bakwenze ukubuza: kungani ufuna i-mastectomy ephindwe kabili? Yini onethemba lokuyizuza? ”

Ngaleso sikhathi, uthi, abesifazane bavame ukuthi, "Ngoba angiphinde ngifune ukuyithola futhi," noma "Angifuni ukufa ngayo," noma "Angisafuni ukwelashwa ngamakhemikhali futhi." "Futhi-ke ungaba nengxoxo," kusho uMacNeill, “ngoba azikho kulezi zifiso ezingatholakala nge-mastectomy ephindwe kabili.”

Odokotela abahlinzayo bangabantu kuphela. Bafuna ukugxila kokuhle, kusho uMacNeill. Iqiniso elingaqondakali kahle le-mastectomy, uthi, yilokhu: ukunquma ukuthi isiguli kufanele noma akufanele yini sibe naso akuvamile ukuxhunyaniswa nengozi ebangelwa umdlavuza. “Kuyisinqumo sobuchwepheshe, hhayi isinqumo somdlavuza.

“Kungenzeka ukuthi umdlavuza mkhulu kangangokuba awukwazi ukuwususa bese ushiya noma isiphi isifuba singenawo; noma kungenzeka ukuthi isifuba sincane kakhulu, futhi ukususa isimila kuyosho ukususa ingxenye enkulu [yesifuba]. Konke kumayelana nomthamo womdlavuza uma kuqhathaniswa nomthamo webele. "

UMark Sibbering uyavuma. Izingxoxo udokotela ohlinzayo webele adinga ukuba nazo nowesifazane okutholwe ukuthi unomdlavuza, uthi, ezinye zezinzima kakhulu ukucabanga.

"Abesifazane abatholakala benomdlavuza webele bazofika namazinga ahlukene olwazi ngomdlavuza webele, kanye nemibono ebonwe ngaphambili maqondana nezindlela zokwelashwa ezingaba khona," esho. "Kaningi udinga ukwahlulela imininingwane okuxoxwe ngayo ngokufanele."

Isibonelo, uthi, owesifazane onomdlavuza webele osanda kutholakala angacela imastectomy yamazwe amabili nokwakhiwa kabusha. Kepha uma enomdlavuza webele onolaka, nosongela impilo, ukwelashwa kwalokho kudinga kube yinto ephambili. Ukususa elinye ibele ngeke kushintshe imiphumela yalokhu kwelashwa kepha, uSibbering uthi, "kuzokwengeza ubunzima bokuhlinzwa futhi kungakhuphula amathuba ezinkinga ezingabambezela ukwelashwa okubalulekile njenge-chemotherapy".

Ngaphandle kokuthi isiguli sesivele sazi ukuthi sisengozini enkulu yokuba nomdlavuza wesifuba wesibili ngoba siphethe ukuguquka kwezakhi ze-BRCA, uSibbering uthi uyenqena ukuhlinzeka ngokuhlinzwa kwamazwe amabili. Isifiso sakhe ukuthi abesifazane abasanda kutholakala benze izinqumo ezinolwazi, ezicatshangelwe kunokuba babone isidingo sokujaha ukuhlinzwa.

Ngicabanga ukuthi ngize ngiseduze ngangokunokwenzeka ukuthi ngize esinqumweni engikholwa ukuthi bengizozisola ngaso. Futhi ngicabanga ukuthi kunabesifazane ngaphandle lapho okungenzeka ukuthi bathathe isinqumo esihlukile ukube bebazi konke lokho abakwaziyo manje.

Ngenkathi ngicwaninga le ndatshana, ngabuza omunye wabahlinzeka ngomdlavuza ngabasindile bomdlavuza ababanikeza njengabakhulumeli bezindaba ukuthi bakhulume ngamacala abo. Inhlangano esiza ngothando yangitshela ukuthi ayinazifundo zamacala zabantu abangazizwa benokuzethemba ngokukhetha kwe-mastectomy abakwenzile. "Ucwaningo lwezifundo luvame ukuba ngabakhulumeli ngoba bazizwa beziqhenya ngolwazi lwabo kanye nomzimba wabo omusha," kusho isikhulu sezindaba. "Abantu abazizwa bengazethembi bavame ukuziqhelelanisa nabantu."

Futhi-ke kunabesifazane abaningi laphaya abanelisekile ngesinqumo abasithathile. Ngonyaka odlule ngangixoxisana nomsakazi waseBrithani nentatheli uVictoria Derbyshire. Wayenomdlavuza ofana kakhulu nami, isimila sobuso esasingu-66 mm ngesikhathi sitholakala, futhi wakhetha ukwenza imastectomy ngokwakhiwa kabusha kwamabele.

Wabuye wakhetha ukufakelwa esikhundleni sokwakhiwa kabusha kwe-DIEP ngoba ukufakelwa kuyindlela esheshayo futhi elula yokwakha kabusha, yize kungenjalo ngokwemvelo njengokuhlinzwa engikukhethile. UVictoria akazizwa ukuthi amabele akhe amchaza: ungakolunye uhlangothi lwe-spectrum kimi. Ujabule kakhulu ngesinqumo asithathile. Ngiyasiqonda isinqumo sakhe, naye angasiqonda esami.

Ukwelashwa komdlavuza webele kuya ngokuya kwenziwa ngezifiso.

Isethi yokuguquguquka okuyinkimbinkimbi ngokweqile kufanele kulinganiswe okuphathelene nesifo, izindlela zokwelashwa, imizwa yowesifazane ngomzimba wakhe, kanye nombono wakhe wobungozi. Konke lokhu kuyinto enhle - kepha kuzoba ngcono kakhulu, ngokubona kwami, lapho kunengxoxo ethembekile ngokwengeziwe mayelana nokuthi yini i-mastectomy engayenza nengakwazi ukuyenza.

Uma sibheka idatha yakamuva etholakalayo, umkhuba bekungukuthi abesifazane abaningi ngokwengeziwe abanomdlavuza esifubeni esisodwa bakhetha i-mastectomy ephindwe kabili. Phakathi kuka-1998 no-2011 e-US, amazinga we-mastectomy ephindwe kabili kwabesifazane abanomdlavuza esifubeni esisodwa kuphela.

Ukwanda futhi kwabonwa eNgilandi phakathi kuka-2002 no-2009: phakathi kwabesifazane abahlinzwa okokuqala ngomdlavuza webele, izinga eliphindwe kabili le-mastectomy.

Kodwa ingabe ubufakazi buyasisekela lesi senzo? Ukubuyekezwa kwezifundo zika-Cochrane ngo-2010 kuphetha ngokuthi: “Kwabesifazane abake baba nomdlavuza esifubeni esisodwa (futhi ngenxa yalokho basengozini enkulu yokuba nomdlavuza oyinhloko kwesinye) ukususa elinye ibele (contralateral prophylactic mastectomy or CPM) kunganciphisa izehlakalo umdlavuza kulesinye isifuba, kodwa abukho ubufakazi obanele bokuthi lokhu kuthuthukisa ukusinda. ”

Ukwanda kwe-US kungenzeka, ngokwengxenye, kube ngenxa yendlela indlela usizo lwezempilo oluxhaswe ngayo - abesifazane abanomshuwalense omuhle banokuzimela okuningi. Ama-mastectomies aphindwe kabili futhi angaba inketho eheha kakhulu kwabanye ngoba ukwakhiwa kabusha okuningi e-US kwenziwa kusetshenziswa okufakelwa kunezicubu zomzimba wesiguli uqobo - futhi ukufakelwa esifubeni esisodwa nje kuvame ukunikeza umphumela wokulinganisa.

"Kodwa," kusho uMacNeill, "ukuphinda kabili ukuhlinzwa kusho izingozi eziphindwe kabili - futhi akuzona izinzuzo eziphindwe kabili." Kukwakha kabusha, kune-mastectomy uqobo, okuthwala lezi zingozi.

Kungahle kube nokubi ngokomqondo njengenqubo. Kunocwaningo oluphakamisa ukuthi abantu besifazane asebeke bahlinzwa, benokwakhiwa kabusha noma ngaphandle, bazizwa benomthelela omubi emqondweni wabo wobuntu babo, ubufazi nobulili babo.

Ngokwe-National Mastectomy and Breast Reconstruction Audit yaseNgilandi ngo-2011, ngokwesibonelo, abesifazane abane kuphela kwabayishumi eNgilandi babenelisekile ngokuthi babukeka kanjani bengagqokile ngemuva kokukhishwa kwesisu ngaphandle kokwakhiwa kabusha, bakhuphukela kwabayisithupha kwabayishumi kulabo ababenokwakhiwa kabusha kwamabele ngokushesha

Kodwa ukukhipha okwenzekayo kubantu besifazane ngemuva kokubeletha kunzima.

UDiana Harcourt, uprofesa wokubukeka nezengqondo kwezempilo e-University of the West of England, wenze umsebenzi omningi nabesifazane abake baba nomdlavuza webele. Uthi kuyaqondakala ngokuphelele ukuthi owesifazane oye waba ne-mastectomy akafuni ukuzwa ukuthi wenze iphutha.

"Noma ngabe yini abesifazane abahlangabezana nayo ngemuva kokukhulelwa komzimba, bathambekele ekuzikholiseni ukuthi ukwelashwa obekuzoba kubi kakhulu," esho. “Kodwa akungabazeki ukuthi kunomthelela omkhulu ekutheni owesifazane uzizwa kanjani ngomzimba wakhe nokubukeka kwakhe.

“I-Mastectomy nokwakha kabusha akuyona nje into eyodwa - awuvele uyinqobe bese kuba yilokho. Kungumcimbi obalulekile futhi uhlala nemiphumela kuze kube phakade. Ngisho nokwakhiwa kabusha okungcono kakhulu ngeke kufane nokubuyiselwa kwesifuba sakho futhi. ”

Okwe-mastectomy ephelele kwakuyindlela ejwayelekile yegolide yokwelashwa komdlavuza webele. I-forays yokuqala yokuhlinzwa okulondolozwa kwamabele yenzeka ngawo-1960.Le ndlela yathuthuka, kwathi ngo-1990, i-US National Institutes of Health yakhipha umhlahlandlela otusa i-lumpectomy kanye ne-radiotherapy kwabesifazane abanomdlavuza webele wokuqala. "Bekuncono ngoba ihlinzeka ngokusinda okulingana ne-mastectomy ephelele ne-axillary dissection ngenkathi kugcinwa isifuba".

Eminyakeni edlule, ucwaningo oluthile lukhombisile ukuthi i-lumpectomy plus radiotherapy ingaholela emiphumeleni engcono kune-mastectomy. Isibonelo, ezinze eCalifornia kubhekwe abesifazane abacishe babe yi-190,000 abanomdlavuza webele ongahlangani (isigaba 0 kuya ku-III). Ucwaningo, olushicilelwe ngo-2014, lukhombise ukuthi i-bilate mastectomy yayingahlobene nokufa okuphansi kune-lumpectomy ne radiation. Futhi zombili lezi zinqubo zazinokufa okuphansi kune-unilateral mastectomy.

Kubhekwe iziguli eziyi-129,000. Kuphethe ngokuthi i- lumpectomy plus radiotherapy “kungancanyelwa kakhulu ezigulini ezinomdlavuza webele” okungenzeka ukuthi leyo nhlanganisela noma i-mastectomy izolungela bona.

Kepha ihlala iyisithombe esixubekile. Kunemibuzo ephakanyiswe yilolu cwaningo neminye, kufaka phakathi ukuthi ungabhekana kanjani nezimo ezididayo, nokuthi izici zeziguli ezifundwe zingayithinta kanjani imiphumela yazo.

Isonto ngemuva kokukhanselwa kwe-mastectomy yami, ngabuyela esibhedlela ukuyothola i-lumpectomy.

Ngangiyisiguli somshwalense wangasese. Yize kungenzeka ukuthi ngithole ukunakekelwa okufanayo ku-NHS, umehluko owodwa okungenzeka bekungafanele ulinde isikhathi eside ngaphambi kokusebenza okuhleliwe kabusha.

Ngangisehholo lokuhlinzwa ngaphansi kwamahora amabili, ngaya ekhaya ngebhasi ngemuva kwalokho, futhi angizange ngidinge ukuthatha ipilisi elilodwa lezinhlungu. Ngenkathi umbiko kadokotela wezifo zezicubu ezazisusiwe wembula amangqamuzana omdlavuza ayingozi eduze kwamaphethelo, ngabuyela emuva ngathola i-lumpectomy yesibili. Ngemuva kwalokhu, amamajini acacile.

Ama-Lumpectomies ngokuvamile ahambisana ne-radiotherapy. Lokhu kwesinye isikhathi kubhekwa njengokubuyela emuva, njengoba kudinga ukuvakashelwa esibhedlela kuze kube yizinsuku ezinhlanu ngesonto amasonto amathathu kuye kwayisithupha. Kuxhunyaniswe nokukhathala nezinguquko zesikhumba, kepha konke lokho bekubonakala kuyintengo encane ukukhokha ngokugcina isifuba sami.

Enye into exakayo mayelana nenani elikhulayo lama-mastectomies ukuthi umuthi wenza inqubekela phambili enciphisa isidingo sokuhlinzwa okunjalo okunamandla, ngisho nangezicubu ezinkulu zesifuba. Kunezinhlangothi ezimbili ezibalulekile: eyokuqala ukuhlinzekwa nge-plastiki, lapho kwenziwa khona i-lumpectomy ngasikhathi sinye nokwakhiwa kabusha. Udokotela ohlinzayo uyawususa umdlavuza bese ehlela kabusha izicubu zamabele ukuze agweme ukushiya isifaca noma ukucwilisa, njengoba bekuvame ukwenzeka ngama-lumpectomies esikhathini esedlule.

Owesibili usebenzisa i-chemotherapy noma i-endocrine drug ukwehlisa isimila, okusho ukuthi ukuhlinzwa kungancipha kakhulu. Eqinisweni, iMacNeill ineziguli eziyishumi eMarsden ezikhethe ukuthi zingaphinde zihlinzwe ngoba izimila zazo bekubonakala sengathi zanyamalala ngemuva kokwelashwa kwezidakamizwa. "Sikhathazekile kancane ngoba asazi ukuthi ikusasa lizoba yini, kodwa laba ngabesifazane abanolwazi kakhulu, futhi sibe nezingxoxo ezivulekile nezithembekile," usho kanje. "Angikwazi ukuncoma leso senzo, kodwa ngiyakwazi ukusisekela."

Angizicabangi njengomuntu osinde kumdlavuza webele, futhi angikaze ngikhathazeke ngokuthi umdlavuza uzobuya. Kungenzeka, noma kungahle kungenjalo - ukukhathazeka ngeke kwenze mehluko. Lapho ngikhumula izingubo zami ebusuku noma ejimini, umzimba enginawo ngumzimba ebengihlala nginawo. UMacNeill usike isimila - esibe ngu-5.5 cm, hhayi u-10 cm - nge-incision ku-areola yami, ngakho-ke anginaso isibazi esibonakalayo. Wabe esehlela kabusha izicubu zesifuba, futhi isifaca cishe asibonakali.

Ngiyazi ukuthi ngibe nenhlanhla. Iqiniso wukuthi angazi ukuthi bekuzokwenzekani ukube siqhubekile nemastectomy. Ithumbu lami, lokuthi lizongishiya nobunzima bengqondo, kungenzeka ukuthi lalibekwe endaweni engafanele. Ngingahle ngilunge phela ngomzimba wami omusha. Kepha lokhu ngiyakwazi: bengingeke ngibe sendaweni engcono kunaleyo engiyiyo manje. Futhi ngiyazi futhi ukuthi abesifazane abaningi abake baba nama-mastectomies bakuthola kunzima ukuzivumelanisa nomzimba abahlala kuwo ngemuva kokuhlinzwa.

Engikutholile ukuthi i-mastectomy akuyona ukuphela kwendlela, engcono noma enesibindi yokubhekana nomdlavuza webele. Into ebalulekile ukuqonda ngangokunokwenzeka ukuthi yikuphi ukwelashwa okungahle futhi okungakwazi ukukufeza, ngakho-ke isinqumo osithathayo asisekelwanga emaqinisweni angaphenyeki kodwa kubhekwe ngokufanelekile okungenzeka.

Okubaluleke kakhulu ukubona ukuthi ukuba yisiguli somdlavuza, noma ngabe kuyesabeka kangakanani, akukukhululi emthwalweni wakho wokukhetha. Abantu abaningi kakhulu bacabanga ukuthi udokotela wabo angabatshela okufanele bakwenze. Iqiniso ngukuthi ukukhetha ngakunye kuza nezindleko, futhi ukuphela komuntu ongagcina ngokulinganisa ubuhle nobubi, futhi enze lokho kukhetha, akuyena udokotela wakho. Uwena.

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