Khansa ya m'mawere Yang'anani Alikes pa Kupenda ndi Mamemogram
Ambiri a ife tadziwa wina yemwe anali ndi khansara ya m'mawere ngakhale kuti anali ndi chibadwa chachibadwa. Pambaliyi, pamakhala maonekedwe abwino (osati khansa) omwe amatha kufanana ndi khansa ya m'mawere. Kuwongolera kwa khansa ya m'mawere kumayambitsa nkhawa ndi nkhawa. Kodi ndi zifukwa ziti zomwe zingakhale zolakwika chifukwa cha khansa ya m'mawere koma sizinasinthe?
Tiyeni tiyambe kuyang'ana mwachidule zizindikiro ndi zizindikiro za khansara ya m'mawere pa kafukufuku ndi maphunziro ojambula zithunzi.
Zizindikiro za Khansa ya M'bwere
Zomwe zimakhala zowawa ndi zotupa nthawi zina zimakhala zofanana, koma pali zina zomwe zimakhala ndi khansa. Izi zikuphatikizapo:
- Chifuwa cha m'mawere chomwe chimamverera cholimba
- Mbuzi ya m'mawere yomwe imayikidwa ndipo sitingasunthike pansi pa khungu
- Kufiira ndi kutupa (zizindikiro za khansa yapakhungu yotupa)
- Zilonda zamakono zowonjezera pansi pa mkono
Maphunziro a Mammogram ndi Khansa ya M'bwere
Mofanana ndi kafukufuku wanu wa kuchipatala, nthawi zina zimakhala zovuta kusiyanitsa pakati pa njira yowonongeka ya khansa ndi khansa ya m'mawere. Ndipotu nthawi zina izi zimatha kukhalapo (cholinga cha nkhaniyi). Mammograms amalingalira kuti ndi 60 mpaka 90% okhudzidwa, zomwe zikutanthauza kuti 60 mpaka 90 peresenti ya nthawi ngati khansayo ilipo, mammografia adzaipeza iyo. Mammograms ali ndi chidziwitso cha 93 peresenti. Izi zikutanthauza kuti 93 peresenti ya nthawi, chinachake chomwe chikuwoneka ngati khansara pamtundu wa mammimba chidzakhala khansa.
Izi zikutanthauza kuti 7 peresenti ya nthawi yomwe mammogram imasonyeza kwambiri khansara, ndi chinthu chinanso.
Zofufuza za m'magazi zomwe zimasonyeza kuti khansa imakhala ndi mawerengedwe a m'mawere , masisimo okhala ndi mawonekedwe osasintha, ndi minofu yowonongeka (minofu imaoneka ngati miyendo yopita kunja kuchokera ku misa yaikulu).
Akatswiri a zamankhwala amapereka mamemografia nambala yomwe imadziwika kuti Breast Imaging Reporting ndi Data System kapena BI-RADS . M'dongosolo lino, lipoti la mammogram limapatsidwa nambala pakati pa 1 ndi 6 akufotokoza mwayi wa khansa. Zambiri mwa izo zikutanthauza kuti palibe zizindikiro za khansara ndipo ziwerengero zisanu zimatanthawuza kuti mammogram ndizosautsa kwambiri za khansara (zowerengeka 6 zimatanthawuza khansara ndipo zimangoperekedwa pambuyo pa chiwopsezo).
Kawirikawiri chiwerengero cha kukumbukira kuchokera ku zojambulazo ndi 9,8 peresenti, kutanthauza kuti 9,8 peresenti ya amayi omwe ali ndi chiwerengero cha mammogram (omwe alibe zizindikiro zirizonse) amaitanidwa kukachita maphunziro ena. Mwa amayiwa, 12 peresenti adzafuna chikhalidwe chochitidwa. Mwazigawozi, 60 peresenti idzakhala yoipa. Mwa kuyankhula kwina, ngakhale mutakhala ndi chizoloŵezi chosawonongeka, ngakhale ngati maphunziro akutsatira akukulimbikitsani kuti mukhale ndi chiopsezo, mumakhalabe odwala kwambiri kuposa khansa.
Zotsatira za Breast Ultrasound ndi Khansa ya m'mimba
Matenda a ma ultrasound ndi othandizira panthawi yomwe amagwiritsidwa ntchito pamodzi ndi mammograms. Nthawi zina amatha kusiyanitsa chiguduli cholimba kwambiri, ndipo pakakhala phokoso amatha kutsanulidwa pansi pa njira yothetsera vutoli. Mankhwalawa angagwiritsidwe ntchito limodzi ndi mammogram ngati chida chowonetsera akazi omwe ali ndi mabere wambiri, koma ali ndi chiwerengero cholakwika chachinyengo.
Izi zikutanthauza kuti ali ndi chiwerengero chokwanira cha kansa ngakhale kuti khansayo siilipo.
Pa ultrasound, zizindikiro zomwe zimasonyeza kuti khansara zimaphatikizapo misala yosasinthasintha, m'mphepete mwazitali, ndi "osalingana."
Matenda a MRI Achifuwa Ndi Khansa ya M'bwere
Mankhwala a MRIs amapezeka kwa amayi omwe ali ndi chiopsezo chachikulu chokhala ndi khansa ya m'mawere, atakhala kale ndi khansa ya m'mawere, kapena ngati phunziro lotsatira kuti apeze zotsatira zenizeni pa mammogram, ultrasound, ndi test. Pa MRI, zofukufuku zomwe zimasonyeza kuti khansa ya m'mawere imakhala ndi misala yamtengo wapatali, kupindika kwachisawawa, kapena chimene chimatchedwa "washout kinetics."
Chifuwa cha m'mawere ndi khansa
Chidziwitso cha m'mawere ndi chiyeso chomveka ngati khansa ikuwoneka. Izi zikhoza kuchitidwa ngati chida chabwino cha singano (kawirikawiri chimasungidwa kwa mawere a m'mawere), chida chachikulu cha singano , chifuwa cha m'mawere , kapena chiopsezo chotseguka. Ngati zotsatira za kafukufuku wamkati ndi zojambula zimakhala zosagwirizana, chifuwa chotsegula (chotseguka) chimawatsatira .
Chiwopsezo chingathenso kudziwa mtundu wa khansara ngati wina alipo ndi kukhala ndi estrogen, progesterone, ndi HER2 receptors. Monga tafotokozera pamwambapa, ngakhale kwa amayi omwe ali ndi zovuta za mammogram ndi ultrasound zosonyeza kuti ali ndi khansara, zimakhalabe zovuta kuti chikhalidwe chikhale choipa.
Nanga ndi zotani za m'mawere zomwe zimatsanzira khansa ya m'mawere pa kafukufuku kapena zojambula zomwe zimafuna kuti pakhale vuto? Pali angapo omwe tiwone apa. Zina mwa izi ndizofala kwambiri kuposa zina, ndipo zifukwa zomwe zili m'munsizi sizinalembedwe mwadongosolo.
Khansa ya m'mimba Taonani Alikes
Zingamveke kuti pali kusiyana kwakukulu pakati pa khansa ndi osakhala ndi khansa pachifuwa chanu, koma nthawi zina izi zingakhale zovuta. Ngakhale tikudandaula kwambiri za kusowa kwa matenda a kansa ya m'mawere, kudandaula kuti kusintha koopsa ndi khansa kumayambitsa nkhaŵa yaikulu ndi chisoni.
Mwa kuyankhula kwina, ngati muli ndi vuto lodziwika ngati likhoza kukhala ndi khansa pamayesero, kapena amawoneka ngati khansa pamtambo, kumbukirani kuti zikanakhalabe zosaopsa. Sizitha mpaka biopsy yatha ndipo maselo amayang'anitsitsa pansi pa microscope yomwe madokotala angakuuzeni motsimikiza. Zinthu zomwe zimafanana ndi khansara pa zoyezetsa kapena zojambula zili m'munsimu. Tiyeni tiyang'ane pa izi zonsezi pafupi.
Mafuta Necrosis
Mafuta a necrosis a m'mawere amatanthauza "mafuta wakufa." Mafuta a necrosis ndi omwe amachititsa kuti thupi likhale lopweteka kwambiri ndipo amatha kumva ndi kuyang'ana kwambiri ngati khansara pamimba. Kaŵirikaŵiri amatsogoleredwa ndi kuvulala kwa bere m'mavuto a galimoto kapena kuvulaza masewera. Malo amtundu wa mafuta a necrosis amachitanso opaleshoni monga kuchepetsa m'mawere, kumanga mawere, kapena biopsies kapena opaleshoni ya khansa ya m'mawere. Mazira a khansa ya m'mawere ingayambitsenso mafuta necrosis, akudandaula chifukwa chotha kubwereza .
Ziphuphuzi nthawi zambiri zimakhala zovuta ndipo nthawi zina zimakhala zabwino. Pakhoza kukhala kutuluka kuchokera ku nkhono. Mwina chowopsya cha zonse zomwe zimayambitsa khungu lochotsa khungu kapena kupotoza; chizindikiro chodziwika bwino cha khansa ya m'mawere. Pa mammografia, iwo akhoza kukhala ndi mawonekedwe osasintha omwe ali ndi malire ozungulira ndi zochepa. Mawere a necrosis amatha kuwoneka ngati khansara pamtundu wa PET. Chowopsya chiyenera kuchitidwa kuti zitsimikizidwe kuti zimapezeka bwanji.
Mvula Yopanda
Mipira yamoto ndi nyenyezi zooneka ngati nyenyezi zomwe nthawi zambiri zimawononga koma zimakhala zosavuta . Mabala aakulu samayambitsa mawere koma amachititsa ululu wa m'mawere . Pa mammogram, mabala akuluakulu a radial angawoneke ngati nyenyezi ngati malire otsekemera. Zili zachilendo ndipo zimachitika kawirikawiri pakati pa amayi a zaka zapakati pa 40 ndi 60. Zikhoza kuyambitsidwa ndi kutupa, kupsa mawere, kapena kusintha kwa mahomoni.
Chiwopsezo chimakhala chosowa nthawi zonse, koma ngakhale pansi pa microscope mabala a radial akhoza kutsanzira khansa ya m'mawere, makamaka tubular carcinoma ya m'mawere . Kuti asokoneze nkhani zowonjezereka, nthawi zina pamakhala maselo osokoneza bongo omwe amabisala mkati mwake.
Mastitis
Mastitis ndi chikhalidwe chomwe chimakhala kutupa ndi kutupa kwa bere kapena popanda kukhalapo kwa matenda. Ndichizoloŵezi chokhudza pafupifupi 20 peresenti ya amayi oyamwitsa koma amapezeka mwa amayi omwe sali kuyamwa. Nthawi zambiri bere limakhala lofiira komanso lopweteka ndipo limayanjanitsidwa ndi zizindikiro monga chimfine, kuzizira, ndi thupi. Chithandizo nthawi zambiri chimaphatikizapo maantibayotiki, mpumulo, ndi kuyang'anira kuyamwitsa.
Vuto ndiloti khansa ya m'mimba yotupa imatha kuyang'ana kwambiri ngati mastitis kumayambiriro, ndipo nthawi zambiri amapezeka kuti atangopatsidwa chithandizo cha mastitis (nthawi zambiri popanda kusintha). Kansalu yotentha ya m'mawere imakhala pafupifupi 1 peresenti ya khansa ya m'mawere ndi amayi nthawi zambiri sakhala ndi mtanda ndipo nthawi zambiri sichisonyeza pamimba. Poyerekezera khansa yapakhungu yotupa ndi mastitis pali zofanana zambiri, ngakhale khansa ya m'mimba yotupa ikhoza kukhala ndi kupunduka kwachitsulo ndi maonekedwe a lalanje pakhungu. Ndi mastitis, ndikumanga maselo oyera a magazi ndi kuwonjezeka kwa magazi komwe kumabweretsa zizindikiro, pamene khansa ya m'mawere yotupa, zizindikiro zimagwirizana ndi kukhalapo kwa maselo a khansa omwe amaletsa njira zamakono zam'thupi m'mimba.
Magranulomatous mastitis ndi mitundu yosiyanasiyana ya mastitis yomwe nthawi zambiri imayambitsa matenda a chifuwa chachikulu, sarcoidosis, kapena chifuwa chachikulu. Ikhozanso kukhala yodopathika. Matenda a mastitis amachititsa nthawi yaitali kutupa m'mimba ndipo poyamba zimakhala zovuta kusiyanitsa ndi khansa ya m'mimba yotupa pamtambo, ultrasound, kapena MRI.
Cooper ya Ligament Fibrosis ndi Mabala
Mitsempha ya Cooper ndi zothandizira za m'mawere, ndipo anthu ambiri amadziwa izi monga mitsempha yomwe mukufuna kuti mukhale yoyenera pamene mukulamba. Kutambasula kwa mitsempha imeneyi kumbuyo kwaseri kumatulutsa "Dothi la Coop" ponena za "chiyambi" cha mawere ndi msinkhu.
Matenda a Fibrosis a Cooper akhoza kuchitika chifukwa cha zifuwa zoopsa komanso zowawa. Izi ndi njira imodzi yomwe zimayambira kubwerera m'mimba ndi kusintha kwa khungu. Koma mawere a berein, monga kutupa, mafuta a necrosis, ndi zipsera za biopsy zingawononge mitsempha yowoneka ngati khansa ya m'mawere.
Sarcoidosis
Sarcoidosis ndi chikhalidwe choipa chomwe chimapangidwa ndi mapangidwe a granulomas mthupi lonse. Ukapezeka m'mapapu, amachititsa chifuwa komanso mpweya wochepa, ngakhale kuti 50 peresenti ya anthu amakhala ochepa panthawi yomwe amadziwa.
Vuto la sarcoidosis ndilofunika kwambiri kwa amayi omwe apezeka kale ndi khansa ya m'mawere. Sarcoidosis granulomas ikhoza kuoneka ngati khansara ya metastatic pa PET, ndipo ngakhale zitsanzo za biopsy zingakhale zovuta kuzifufuza. Mwachitsanzo, granulomas ndi khansa ya m'mawere yamatenda amaoneka ngati ofanana ndi nthenda yamatenda kapena ma lymph node biopsy. Izi zingachititse kuti munthu adziwe kuti ali ndi khansa ya m'mawere kapena kuti khansa ya m'mawere.
Mshuga Wopusa
Matenda a shuga ndi chotupa chothetsa matenda omwe amapezeka mwa amayi (ndi amuna) omwe ali ndi mtundu wa 1 ndi mtundu wa 2 wa shuga wodalirika wa shuga. Kuyezetsa, matenda a shuga amaoneka ngati mfuti yaikulu, yopanda kupweteka yomwe imatha kutsanzira khansa ya m'mawere. Zimayambitsidwa chifukwa cha kutupa komanso kutentha kwambiri.
Zomwe zimagwirizanitsa zikhoza kusokonezeka ndi khansa ya m'mawere pa mammogram, ultrasound (komwe ingayang'ane makamaka yoopsa) ndi MRI. Pa maphunziro awa, chikhalidwecho chikuwoneka ngati anthu osalongosola. Nthenda yaikulu ya singano imakhala yofunika kwambiri kuti ipangidwe.
Fibromatosis
Matenda a ubongo, omwe amatchedwanso tumimba ya desmoid, amawerengera pafupifupi 0,2 peresenti ya mawere a m'mawere. Sidziŵa chomwe chimayambitsa vutoli koma zikuwoneka kuti chimayendetsa mabanja. Pa mammogram ndi ultrasound fibromatosis akhoza kuyerekezera zotsatira za khansa ya m'mawere. Matendawa amakhala opangidwa ndi chingwe chachikulu cha singano.
Maselo Ophwanya Maginito
Zilonda zam'kati zowonongeka, zomwe zimatchedwanso kuti mawere a granular cell myoblastomas, zingawoneke ngati khansa ya m'mawere. Ngakhale kuti nthawi zambiri zimakhala zonyozeka, zimachokera ku maselo a Schwann, maselo omwe amapezeka mu dongosolo lamanjenje.
Ziphuphuzi nthawi zambiri zimatulutsa khungu la khungu ndi kukonzekera kumapangidwe a m'mawere. Izi zimabweretsa mtanda womwe umawoneka wokhazikika, wofanana ndi khansa ya m'mawere. Zimakhalanso zovuta kwambiri, zofanana ndi khansa. Pa zojambula zojambula monga mammogram iwo amafanana ndi khansa. Amakonda kukhala ndi malire okonzedwa bwino koma ndi zokometsera za khansa.
Avereji ya zaka za anthu omwe ali ndi chifuwa chachikulu cha bere ndi 40, ndipo zimapezeka mwazimayi ndi amuna.
Mitsempha ya mitsempha yachitsulo
Zilonda za m'mimba zokhala ndi maselo osungunuka ndizovuta pa magulu ambiri. Zilonda zamagulu zong'onoting'ono zingamveke ndikuwoneka ngati zosazindikiritsidwa ndi khansa ya m'mawere, koma zilonda izi zingawoneke ngati khansara pansi pa microscope pambuyo pa chiwopsezo. Kuonjezera apo, zonsezi zimakhala ndi maselo osakaniza. Mwamwayi, maselo osungunula amaliseche siwodziwika, komabe akuyenera kuganiziridwa mosiyana ndi matenda omwe amapezeka m'mawere.
Myofibroblastoma ndi chotupa chachilendo chakumphasa chomwe chimakhala pansi pa gulu la maselo osungunula. Zitha kuchitika mwa amayi ndi abambo ndipo zingakhale zovuta kudziwa.
Pseudoangiomatous Stromal Hyperplasia (PASH)
Pseudoangiomatous stromal hyperplasia kapena PASH ndi mkhalidwe umene umapezeka makamaka mwa amayi nthawi yomwe amayamba kusamba ndi okalamba. Zikuwoneka kuti ndizofala kwambiri kwa iwo omwe atenga mahomoni (monga mapiritsi oletsa kubereka kapena mankhwala othandizira odwala), omwe amamwa mowa, komanso omwe ali olemera kwambiri. Ziphuphu zoterezi zimakula kukula kwambiri, ndipo chidziwitso chotseguka (osati kungokhala chiyambi cha biopsy) kawirikawiri amafunika kuti apange matenda.
Mawu Ochokera
Monga tanenera kale, pali zinthu zambiri zolimbitsa thupi zomwe zimatha kufanana ndi khansa ya m'mawere pa kafukufuku, masomphenya, komanso nthawi zina ngakhale pansi pa microscope. Pamene akusowa khansa ya m'mawere ndi zomwe anthu ambiri amaopa, molakwika kuganiza kuti mtanda kapena kusintha ndi khansara pamene sizingatheke kukhumudwitsidwa mumtima. Zinthu zomwe zimawoneka ngati khansa ya m'mawere zingayambitse maphunziro ena ojambula zithunzi, zochitika zapadera, komanso zochitika zowonekera, zomwe zimakhala zovuta.
Chinthu chofunika kwambiri chomwe mungachite ngati mupeza mtundu uliwonse wa zosavomerezeka, kapena kumva za m'mimba yanu, ndikufunsa mafunso ambiri. Khalani mu mpando wa dalaivala ndikuyembekezera mayankho. Kukhala wothandizira kwanu kungathandize kwambiri kupeza chisamaliro chomwe mukuyenera komanso kuchepetsa kuchuluka kwa kukhumudwa kwapadera kumeneku kumakhala kosavuta kumabweretsa miyoyo yathu.
> Zotsatira:
> Fazzio, R., Shah, S., Sandhu, N., ndi K. Glazebrook. Idiopathic Granulomatous Mastitis: Kujambula Kutsitsimula ndi Kuwonanso. Malingaliro Opita Ku Imaging . 2016. 7 (4): 531-9.
> Kochoyan, T., Akhmedov, M., Shabanov, A., ndi I. Terekhov. Sarcoidosis Kutsanzira Khansa ya Breast Metastasis: Nkhani Yokambirana ndi Kulemba Zolemba. Cancer Biology ndi Mankhwala . 2016. 13 (3): 396-398.
> Mario, J., Venkataraman, S., Dialani, V., ndi P. Slanetz. Zilonda za Breast Breast That Cancer Mimic: Kudziwa Radiologic-Pathologic Concordance. Zolemba zamakono . 2015. 44 (9): 28-32.