Kubwezeretsa mimba ndi chinthu china pamwamba pa maganizo a amayi ambiri pamene akudziwa kuti ayenera kukhala ndi vutoli . Pofuna kuthana ndi vuto la matenda a khansa, amayi omwe ali ndi vutoli amavutika ndi kudziwa kuti matupi awo sadzafanana. Iwo akhoza kudandaula za kukongola kwawo ndi kugonana pambuyo pa opaleshoni, ndikuyang'ananso kumanganso kake ngati njira yothetsera vutoli.
Lingaliro la kubwezeretsa mawere lingakhale lokongola kwambiri chifukwa likhoza kuwoneka ngati njira yowoneka ndi "yachibadwa" kachiwiri. N'zotheka kuyamba kuyamba opaleshoni yatsopano pamene adakali ndi matenda opatsirana pogonana. Koma bwanji ngati mukufunikira kuti mukhale ndi ma radiation ndi chemotherapy mukamanganso? Kodi mankhwalawa angawononge zotsatira zomwe mukuyembekeza kukwaniritsa?
Mpaka zaka zingapo zapitazo, akatswiri ambiri adachenjeza za kubwezeretsa mazira asanayambe kutentha. Koma kafukufuku waposachedwapa, kuphatikizapo imodzi mwa Fox Chase Cancer Center ku Philadelphia ndi ina yunivesite ya Cleveland, akuganiza kuti palibe chifukwa choyikanira. Komabe, akuluakulu azachipatala sakugwirizanabe ngati odwala ayenera kuyembekezera kapena kupitiliza.
Wodwala aliyense akamaganizira za kumanganso khungu ayenera kufunsa katswiri wothandizira kumanga (kuphatikizapo oncologist wake) atangoyamba kumene kuyezetsa khansa kuti athe kudziwa zomwe akuchita.
Mlandu wa Kupita Patsogolo ndi Kumangidwanso kwa Amabere
Pali madalitso ochuluka kwa kubwezeretsa nthawi yomweyo. Ambiri amapanga opaleshoni yambiri, ndipo kuyambira iyo akadali pansi pa mastectomy anesthesia kumatanthawuza kuti njirayi ikuyenda bwino kuti wodwala asadzutse.
Mastectomy, yomwe imachokera pachifuwa "sac," imangolangizidwa ngati kumangidwanso kudzakhala pafupi.
Kawirikawiri, amayi omwe ali ndi kansa ya m'mawere oyambirira (ziwalo zochepa zomwe sizinafalikire ku maselo am'mimba kapena omwe ali ndi kachilombo koyambira pambali imodzimodziyo) akhoza kupitirizabe kumanganso. Pokhapokha zitakhala zoonekeratu kuti wodwalayo adzafunika ma radiation atatha kudwala matendawa chifukwa cha khansara yaikulu kwambiri m'kamwa kapena khansayo yowoneka mu khwangwala, Dr. Christy Russell, yemwe ali ndi khansa ya m'mawere ku yunivesite ya Southern California, akufuna kuti kumangidwanso kwatha panthawi yachisokonezo.
Komabe, zingakhale zovuta kudziwa ngati ma radiation adzafunika kwa odwala ena asanakumane nawo. Malingana ndi Dr. Russell, ambiri opaleshoni ya m'mawere angakonde kuti wodwalayo ayambe kumangidwanso mwamsanga, m'malo mochedwa kuchepetsa opaleshoni yachiwiri yayikulu komanso kupweteka kwambiri.
Zomwe zingakhale zovuta zingakhale zachipatala, zodzoladzola kapena zonse. Zitha kuphatikizapo mapangidwe a zikopa zamkati, minofu yowonjezera, matenda kapena necrosis (imfa) ya minofu yambiri ya mafuta, yomwe ingayambitse zilonda. Ngati zambiri, mavuto angapangitse opaleshoni yowonjezereka kukonza kapena kukonzanso zomangamanga.
Kafukufuku watsopano wapanga kuti pamene ma radiation amatsatira kumanganso khungu, palibe kuwonjezeka kwa mavuto akuluakulu kapena akuluakulu. Kafukufuku wina anapeza kuti odwala 75 peresenti omwe anali ndi feteleza asanayambe kutentha amafotokoza zotsatira zodzikongoletsera ngati zabwino kwabwino, zomwe ziri zofanana kapena zabwino kusiyana ndi okhutira omwe alibe ma radiation.
Kuchita opaleshoni yowonongeka panthawi yovuta kwambiri imakhala yowonjezereka m'magulu osiyanasiyana azachipatala omwe ali ndi oncologists ndi opaleshoni opaleshoni amagwira ntchito limodzi pamalo omwewo.
Mlandu Wodikira Kubwezeretsedwa kwa Amayi
American Cancer Society inanena kuti madokotala ambiri amalimbikitsa kuchepetsa kubwezeretsedwa kwa omwe amadziwa kuti adzakhala ndi ma radiation, omwe ali pafupi theka la odwala onse.
M'kupita kwanthawi, maizoni amatha kukhudza khungu, mawonekedwe, ndi zotupa, zomwe zingakhudze maonekedwe a mabere osinthidwa.
Azimayi omwe amadziwa kuti ali ndi khansa yapakatikati kapena yapamtunda (omwe matumbo awo ndi aakulu kuposa masentimita asanu ndi amphaka omwe amakhudzidwa) amauzidwa kuti azidikirira miyezi isanu ndi umodzi kuti apite opaleshoni mpaka atatha. Anthu omwe ali ndi kansa yapakhungu kapena yotupa m'madera akumidzi akuchenjezedwa mwamphamvu kuti asapite patsogolo ndi kukonzanso mwamsanga.
Poganizira za kuyamitsidwa kwa mazira ndi kuyamwitsa, ndikofunikira kudziŵa mtundu wa opaleshoni yomwe ili yabwino kwa inu:
Matenda Opangidwa ndi Mavitamini Omwe Amadziwika Ambiri
Ntchito yomanga thupi ndi njira yowonjezereka yopaleshoni, ndipo pali njira zingapo zomwe zingagwiritsidwe ntchito, zomwe zimaphatikizapo kugwiritsa ntchito minofu yomwe imachokera kumbali ya thupi kupatula pa bere.
Imodzi imatchedwa TRAM flap , yomwe imatchulidwa pamtundu wa rectus abdominis minofu (TRAM) yomwe imagwiritsidwa ntchito potsatira. Izi zimayenda bwino kwambiri kwa amayi omwe ali ndi mafuta ochuluka m'mimba mwawo kapena khungu lomwe linatulutsidwa kuchokera mimba.
Mitundu yatsopano yatsopano yomangidwira minofu imaphatikizapo kutsika kwapadera kwazithunzi zapamwamba (SIEA) ndi chida chachikulu chotsika kwambiri pamsewu wotchedwa perforator (DIEP), yomwe imagwiritsanso ntchito khungu ndi mafuta.
Pamene mazira akugwiritsidwa ntchito posokoneza magazi pakhungu ndi minofu ya chifuwa, chodzola, ndi bwino kuwunikira poyamba ndiyeno kubweretsanso chotsatira kusiyana ndi kuyesa chifuwa pamimba kapena kumbuyo.
Zojambula Zapangidwe kapena Zachifuwa
Mavitamini opangira mawere amatha kuwonjezerapo kukula kwa zomwe zimatchedwa "chifuwa cha m'mawere." Ma implants a abambo nthawi zambiri amalimbikitsidwa kwa amayi omwe ali ndi mawere ang'onoang'ono kapena omwe alibe chifuwa chokwanira kuti TRAM ichitike. Ngati mukuganiziranso kutentha kwa dzuwa pambuyo pake, onetsetsani kuti mumalandira chithunzithunzi ndi doko la pulasitiki mmalo mwa chitsulo chimodzi.
Ngakhale TRAM ili ndi chiopsezo chachikulu cha mafuta a necrosis, ndi bwino kusankha kupewa opaleshoni yothandizira mtsogolo pambuyo poizoni. Zingakhale zofunikanso kwambiri kwa iwo omwe amadikirira kumanganso mpaka pambuyo poizuma chifukwa minofu yotengedwa kuchokera m'mimba, kumbuyo kapena kwinakwake pa thupi siinatulukidwe.
Chemotherapy ndi Zina Zowonjezera Kuberekera
Kaya odwala matenda a mastectomy ayenera kuchedwa kumanganso mpaka mapeto a chemotherapy ndi mfundo ina yotsutsana. Kafukufuku wina wa amayi omwe anapeza chemo pambuyo pomanga nyumba anawonetsera 25% kulumpha pa chiwerengero cha opaleshoni yotsatila chifukwa cha zodzikongoletsera. Ndipo palinso vuto lina: Ngati chemo ikuperekedwa msangamsanga kamangidwe kameneka, ikhoza kuyimitsa njira yakuchiritsira, kuika chiopsezo chachikulu cha matenda.
Odwala omwe akukonzekera kukhala ndi implants akhoza kukhala owonjezera omwe amawaika panthawi yochepa. Pambuyo pake, ngati kuli kotheka, amatha kutenga mankhwala a chemotherapy pa miyezi ingapo yomwe imatengera kuti zowonjezereka zikhale zotambasula khungu (zisanafikepo).
Pali mbali yotsatila ya nkhani ngati mankhwala amakhudza zotsatira za opaleshoni yokonzanso: Kodi opaleshoni imakhudza chithandizo chamtsogolo? Chemotherapy amayamba nthawi yomweyo chitatha. Ngati chemo ikuchedwa kuti ipewe kusokoneza ndondomeko ya machiritso, mphamvu yake ikhoza kuchepa. Kuchedwa kwa dzuwa, komwe kawirikawiri kumaperekedwa kokha pambuyo pa chemotherapy, kungaposa kaŵirikaŵiri kuchuluka kwa chiwerewere cha khansa ya m'mawere.
Mfundo Yofunika Kwambiri
Pakalipano, pali mafunso ambiri monga mayankho pa nthawi yothandizira kumanga komanso mankhwala opatsirana. Ngati ndi nthawi yowonjezeretsa kubereka ndi zosankha zosintha moyo kwa odwala omwe ali kale kupanga zofunikira zina zambiri. Ndili ndi mfundo zotsutsana zochokera kuzinthu zambiri, kufufuza nkhani ndi kuyankhula ndi madokotala ndizofunikira kwambiri musanayambe kuthetsa yankho lomwe liri lolondola kwa inu.
Zotsatira:
Anderson, PR, ndi al. "Thupi la post-mastectomy Wall Radiation ku Kachitidwe ka Tissue Temporary kapena Permanent Breast Implant - Kodi Pali Kusiyanasiyana kwa Mavutowo?" International Journal of Radiation OncologyBiologyPhysics . 692003 S75 - S76. (kulembetsa)
"Chombo cha Breast Expander." mdanderson.org . 2008. Yunivesite ya Texas MD Anderson Cancer Center.
"Kubwezeretsa Amayi Pambuyo pa Kugonana Kwambiri." Cancer.org . 10/20/2015. American Cancer Society.
Christy Russell. Katswiri wa khansa ya m'mimba. University of Southern California Los Angeles. Kuyankhulana kwa foni.
"Kuchedwa Kuchiza Mankhwala Kumathandiza Kuti Khansa Ibwererenso." cancer.org . 26 Feb. 2003. American Cancer Society.
"Zotsatira za mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pambuyo pake." oncolink.upenn.edu . 31 Oktoba 2007. Center ya Kansa ya Abramson ya Yunivesite ya Pennsylvania.
Keiler, L., et al. "Mphamvu ya mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pogwiritsa ntchito mankhwala opatsirana pambuyo pake." International Journal of Radiation OncologyBiologyPhysics 692007 S76.
"Zotsatira Zakale za Mvula." mdanderson.org . 2008. Yunivesite ya Texas MD Anderson Cancer Center.
"Phunziro Limasonyeza Mavuto Ochepa Phindu la Kumangidwanso Pambuyo pa Kutuluka kwa Mafilimu." Hopkinsbreastcenter.org . Mwezi wa 2003. Malo a Chifuwa cha Johns Hopkins.
"Buku Lophunzitsidwa Odwala Wopatsa Chidziwitso Chothandizira Kubwezeretsa Matenda." mdanderson.org . 2008. Yunivesite ya Texas MD Anderson Cancer Center.
"Kodi Ndingatani Ngati Ndili ndi Matenda Achikopa?" cancer.org . 2 Oct. 2007. American Cancer Society.