Ngati mwakhala ndi chifuwa cha m'mawere, lumpectomy , kapena mastectomy yachitidwa ndikubwezeretsanso zotsatira kuchokera ku labotolo, mudzafuna kumvetsetsa zomwe gawoli likutanthauza. Kuphatikizana kumagwirizana ndi njira zomwe mungasankhire komanso momwe mungapulumutsire.
Funso limodzi loyamba limene mungafunse ndi lakuti, "Khansa imafalikira kupitirira chifuwa, kapena kodi ili yonse?" Pakalipano, palibe mayesero amodzi omwe amakupatsani yankho la funsoli, koma pali dongosolo lokhazikitsa khansa mu magawo, pogwiritsa ntchito zinthu zitatu.
Dongosolo la TNM la Kusinthanitsa Khansa ya M'bwere
Njira yogwiritsa ntchito kwambiri ndiyo njira ya TNM.
- T amagwiritsidwa ntchito kwa Matenda. Mu fano (mammogram kapena ultrasound) la chotupacho, radiologist ikhoza kupanga muyeso wa kukula kwa chotupacho. Nthawi zina izi zimakhala zovuta kuchita, malingana ndi mbali ya chifuwa chogwirizana ndi filimuyo, kapena ngati chotupacho chiri mkatikati mwa bere. Chotupa chimakhala chosasunthika, kapena cham'mbali kunja kwake, nthawizina chimatchedwa mawonekedwe osongoka. Sizimakhala zozungulira nthawi zonse, ndipo zimatha kukhala motalika kuposa momwe zimakhalira. Njira yolondola kwambiri yopezera kukula kwa chotupa ndiyo opaleshoni yakuchotsa zonsezi, ndikuyesa. Kukula kwa mimba kumagawidwa m'magulu anayi: T-1 amachokera ku 0 - 2 masentimita, T-2 ndi 2 - 5 masentimita, T-3 ndi wamkulu kuposa 5cm, ndipo T-4 ndi chotupa cha kukula kwake kulikonse (ulcerated) khungu kapena kumangirizidwa ku khoma la chifuwa.
- N amagwiritsidwa ntchito pa maonekedwe a Lymph Node. Popeza khansara ikhoza kuyendayenda mu thupi lanu, ndizofunika kuti mukhale ndi maselo omwe ali pafupi kwambiri ndi chifuwa chachikulu cha khansa ndi micro-metastasis. Pali njira ziwiri zowunika ma lymph node: pogwira, ndi opaleshoni. Ngati minofu yanu imayang'aniridwa ndi kukhudza, dokotala wanu amatha kumva (khungu) khungu pamwamba pa mitsempha yambiri, ndi kuwayesa. Ngati dokotalayo sangathe kumva nthata yotupa, chiwerengerocho ndi N-0, ngati dokotalayo amatha kumva kutupa ndikuganiza kuti nthendayi ndi yabwino (khansa) chiwerengero ndi N-1. Ngati minofu imamva ngati imakhala yotupa ndipo imagwirizana pamodzi (m'malo mwake ndi lumpy), imayikidwa N-2, kapena ngati ili pafupi ndi collarbone, imayikidwa N-3. Njira yachiwiri yoyendera ma lymph nodes ndi ndondomeko ya nthendayi.
- M amagwiritsidwa ntchito pa Metastasis. Metastasis imakhudza siteji ya khansa. Ngati zitsanzo za nodezi zakhala zikuchotsedwa ndikuyesedwa, ndipo zikuwoneka kuti zili ndi khansara, zimayesedwa M-0, koma ngati ali ndi maselo a kansa kapena micrometastasis mwa iwo, amawerengedwa M-1. Izi zikukuwuzani kuti chotupacho chataya maselo kuposa malo ake oyambirira, ndipo khansa ikhoza kukhala mbali zina za thupi.
Zonse za TNM zidzaphatikizidwa kawiri, kamodzi ndi dokotala wa opaleshoni, ndipo kachiwiri ndi wodwalayo mu labata. Katswiri aliyense adzapereka maganizo pa khansara pamtundu wake wa TNM. Palibe malingaliro awa omwe angakhale yankho lenileni kwa "khansa iyi?" Mwina mungafunike kudziwa zambiri za izo, monga
- malo ovomerezeka a mahomoni (otengedwa ndi homoni)
- chiwerengero cha chotupa (kasi ya kukula)
- ndipo ngati yafalitsidwa (yowonongeka)
- kumene wapita ku thupi lanu
Zonsezi zimakhudza matenda anu ndipo zidzakambidwa poyang'ana njira zomwe mungasankhe.
Maphunziro anayi a khansa ya m'mawere
Pali magawo anai a khansa ya m'mawere, ndipo matenda anu amatengera chiwerengero cha TNM chotupa. Majini carcinomas otchedwa Precancerous amatchedwa Stage Zero . Apa pali momwe masitepe ndi nambala za TNM zikukhudzana.
- Gawo 1 limatanthauza kuti muli ndi chotupa cha T-1 ndipo mumamveka ma lymph node popanda umboni wa metastasis, kapena T1N0M0.
- Gawo 2 liri ndi magawo atatu, omwe akuphatikizapo chotupa cha T1, T2, kapena T3, zithompho zabwino kapena zoipa, ndipo palibe metastasis; Mwachitsanzo T1N0M0.
- Gawo lachitatu lilinso ndi magawo atatu, omwe amachokera ku kusakaniza kwa chifuwa chilichonse, ma lymph nodes kapena nodes omwe ali m'dera la collarbone, ndipo palibe metastasis; Mwachitsanzo T3N1M0.
- Gawo lachinayi limatchedwanso khansa ya m'mawere ndipo imayesedwa pokhala ndi chiwerengero cha chotupa, chithokomiro choipa kapena choipa, mwachitsanzo, T1N1M1.
Momwe Kumayendera Kukula Kumayesedwa
Kukula kwa matumbo kumayesedwa ndi katswiri wa zamagetsi pogwiritsa ntchito mammogram kapena chithunzi cha ultrasound chomwe chinachokera pa bere lanu. Koma sizitundu zonse zophweka, zozungulira zosavuta kuziyeza. Mwachitsanzo, chotupacho chikhoza kupangidwa monga mbatata yophika ndipo chithunzichi chikhoza kukhala pambali yomwe radiologist sungakhoze kuwona miyeso yonse. Ndipo zotupa zina zimakhala zopanda malire kotero n'zovuta kulingalira chiwerengero chonse cha chotupacho.
Kupeza Zithunzi Zabwino za Kutupa
Poyambirira kuti mudziwe zambiri zokhudza khansara yanu, mumakhala ndi chithunzi chowoneka bwino cha chotupacho. Pofika poyeza kukula kwa chotupa chanu musanachite opaleshoni, madokotala amadalira zotsatira za maphunziro a kujambula. Tiyeni tifanizire njira zofananamo za chifuwa cha m'mawere:
- Mamemogram: Zojambula zamakono zamakono zingagwiritsidwe ntchito pojambula minofu ya m'mawere, koma sizowona molondola pa minofu yambiri yammimba. Ngati muli ndi mimba yam'mawa kapena simunatenge mimba, mabere anu akhoza kukhala ochuluka kwambiri kuti abisala masewera, kuwapangitsa kuti aziwunikira. Koma ngati muli ndi mimba, mumakhala ndi minofu, kapena muli ndi pakati, filimu yam'mimba imatha kudziwa molondola chifuwa chanu. Digital mammography imagwira ntchito bwino pamatumbo ammimba ndipo imatha kugwiritsidwa ntchito kuti muyese bwino.
- Breast Ultrasound: Popanda kugwiritsa ntchito mankhwalawa, ultrasound ndi yabwino kusiyanitsa pakati pa chimbudzi chodzaza ndi madzi ochuluka monga chotupa. Ultrasound ingagwiritsidwe ntchito kupanga mimba ya chifuwa cha m'mawere. Koma zikhoza kukhala zochepa kwambiri kuposa mamemogram, monga momwe zapezedwera kuchepetsa kukula kwa chotupa.
- Matenda a Miri: MRI ndi yopanda phokoso komanso yopanda ululu, ndipo imagwiritsira ntchito mazira ena osapanga maonekedwe a minofu. Ngakhale mammogram angapeze mtanda wanu, MRI ingafunikire kuyeza ngati minofu yanu ndi yowuma kapena ngati chiwonetsero chanu chikuwonetsa kuti misa ndi yayikulu kuposa momwe ikuyembekezeredwa. MRI ingagwiritsidwenso ntchito pa nthawi ya neoadjuvant chemotherapy kuti ayang'ane momwe chithandizo chikuyendera. Ngakhale kuti MRI ingapange chithunzi chodziwika bwino cha chotupa chanu, zimangowonjezeratu kukula kwake m'mizere itatu.
Zotsatira za Matenda Okhudza Opaleshoni
Maphunziro ndi zojambula zojambula zimapangitsa kuti thupi lanu liziyenda bwino. Koma mukufunikira kukula kwenikweni kwa chotupa kuti mupange chisankho chabwino kwambiri cha mankhwala. Dokotala wanu adzagwiritsa ntchito chidziwitso kuchokera ku mayesero apitalo monga chitsogozo pamene mukuchotsa chotupa chanu. Pambuyo pa lumpectomy kapena mastectomy, minofu yanu yamtengo wapatali idzaphatikizidwa ndi minofu yanu yambiri, ndipo wodwalayo adzafufuza mliri weniweniwo. Chiwerengero cha chifuwa chanu cha chotupa chanu ndichoyimira golidi kukula kwake. Lipoti lanu loperekera opaleshoni lidzafotokozera mwachidule matenda anu a kansa ya m'mawere.
Zifukwa Zopangira Opaleshoni Yodziletsa
Tsopano podziwa kuti ndondomeko yanu yochitira opaleshoni ya opaleshoni ndiyo njira yabwino kwambiri yodziwira kukula kwa chifuwa chanu, mwina mukufunsapo kuti, "Bwanji osangopanga opaleshoni yoyamba ndikuponyera mayeso ena onsewa?" Maphunziro anu a zojambula ndi zojambula amachitidwa kuti akutsogolereni inu ndi dokotala wanu kuti musankhe chisankho chosamalidwa pa opaleshoni ya m'mawere.
Ngati lumpectomy imachotsa khansara yanu, mutha kupewa mastectomy. Koma ngati neoadjuvant chemo ikhoza kugwetsa chifuwa chanu chisanachitike opaleshoni, ndiye mungafunike minofu yochepa kuchotsedwa. Nthawi zina, monga khansara ya m'mawere yosabalalitsa, amatha kugwiritsira ntchito matenda opatsirana. Kudziwa zambiri komanso kumvetsetsa zotsatira za mayesero anu kumakuthandizani kuti mudziwe zambiri, komanso mwanzeru.
Kupanga Kusankhidwa ndi Dokotala Wanu
Pamene mukukonzekera dokotala, ndipo mukudziwa kuti mukakambirana za zotsatira za matenda anu, zotsatira za labu, kapena mapulani a mankhwala, mungafunse wina kuti abwere nanu, kuti alembe. Ngati izi sizingatheke, kutenga kachidutswa kakang'ono ka matepi ndi lingaliro labwino. Nthawi zina tikamamva nkhani zosangalatsa, zimatidabwitsa m'maganizo mwathu kapena m'maganizo mwathu, ndipo tingaleke kukambirana nawo. Kukhala ndi mnzanu wachibale kapena wothandizira angakuthandizeni, polemba mbiri ya mafunso ndi mayankho ndikukupatseni mthunzi wamaganizo. Onetsetsani kuti bwenzi lanu kapena achibale anu akhoza kusunga chinsinsi chanu chaumoyo ngati mukufuna.
Zotsatira
Kanema Staging, National Cancer Institute.