Gomarara repazamu

Gomarara repazamu igomarara rinotangira munyama dzezamu. Kune maviri makuru marudzi ekenza yemazamu:

• Ductal carcinoma inotangira mumachubhu (ducts) anotakura mukaka kubva pazamu kuenda munyatso. Gomarara rakawanda remazamu nderudzi urwu.
• Lobular carcinoma inotanga muzvikamu zamu, zvinonzi makulules, zvinoburitsa mukaka.

Muzviitiko zvisingawanzoitika, mamwe marudzi ekenza yemazamu anogona kutanga mune dzimwe nzvimbo dzechipfuva.

Gomarara repazamu rine njodzi zvinhu zvinhu zvinowedzera mukana wekuti iwe ugone kukura kenza yemazamu:

• Zvimwe zvinhu zvine njodzi zvaunogona kudzora, senge kunwa doro. Zvimwe, senge nhoroondo yemhuri, haugone kuzvidzora.
• Izvo zvakanyanya njodzi zvinhu zvaunazvo, zvakanyanya njodzi yako inowedzera. Asi, hazvireve kuti uchaita gomarara. Vakadzi vazhinji vanoita gomarara repazamu havana chero njodzi dzinozivikanwa kana nhoroondo yemhuri.
• Kunzwisisa njodzi dzako kunogona kukubatsira kutora matanho ekuderedza njodzi yako.

Vamwe vakadzi vari panjodzi yakanyanya yekenza yemazamu nekuda kwehumwe mamaki emageneti kana akasiyana anogona kupfuudzwa pasi kubva kuvabereki vavo.

• Mageneti anozivikanwa se BRCA1 kana BRCA2 anokonzeresa zviitiko zvakawanda zvegomarara repamazamu rakagara nhaka.
• Chishandiso chekuongorora chine mibvunzo nezve nhoroondo yemhuri yako pamwe neyako inogona kubatsira mubatsiri wako wezvehutano kuti uve panjodzi yekutakura majini aya.
• Kana iwe uri panjodzi huru, kuongororwa ropa kuti uone kana uine majini.
• Mamwe mageneti anogona kutungamira kune imwe njodzi yekenza yemazamu.

Mazamu anodyara, kushandisa antiperspirants, uye kupfeka underwire bras hakuwedzeri njodzi yekenza yemazamu. Iko hakuna zvakare humbowo hwehukama chaihwo pakati pekenza yemazamu nemishonga yekuuraya zvipuka.

Kenza yemazamu yekutanga kazhinji haina kukonzera zviratidzo. Ichi ndicho chikonzero bvunzo yenguva dzose yemazamu uye mammograms akakosha, saka kanzura dzisina zviratidzo dzinogona kuwanikwa kare.

Sezvo kenza ichikura, zviratidzo zvinogona kusanganisira:

• Bundu remuzamu kana bundu muhapwa iro rakaomarara, rine mativi asina kuenzana, uye kazhinji harikuvadze.
• Chinja saizi, chimiro, kana kunzwa kwezamu kana zamu. Semuenzaniso, unogona kunge uine hutsvuku, dimpling, kana puckering inoratidzika seganda reorenji.
• Fluid kubva pazamu. Fluid inogona kunge iine ropa, yakajeka kune yero, girini, kana kutaridzika kunge pus.

Muvarume, zviratidzo zvekenza yemazamu zvinosanganisira bundu remuzamu uye kurwadziwa kwepamu uye unyoro.

Zviratidzo zvemberi kenza yemazamu inogona kusanganisira:

• Kurwadziwa kwepfupa
• Kurwadziwa kwepamuviri kana kusagadzikana
• Maronda eganda
• Kuzvimba kwema lymph node muhapwa (padhuze nezamu nekenza)
• Kuonda

Anopa hutano anozobvunza nezve ako zviratidzo uye njodzi zvinhu. Ipapo mupi achaita bvunzo dzepanyama. Iko kuongorora kunosanganisira zvese mazamu, hapwa, uye mutsipa uye chipfuva nzvimbo.

Vanhukadzi vanokurudzirwa kuti vazviongorore mazamu mwedzi wega wega. Nekudaro, kukosha kwekuzviongorora-wega kwekutsvaga gomarara repazamu kunopokana.

Miedzo inoshandiswa kuongorora uye kuongorora vanhu vane kenza yemazamu inogona kusanganisira:

• Mammography kuongorora kenza yemazamu kana kubatsira kuziva bundu repazamu
• Chipfuva ultrasound kuratidza kuti bundu racho rakasimba here kana kuti rakazara mvura
• Chipfuva biopsy, uchishandisa nzira dzakadai senge aspiration, ultrasound-inotungamirwa, stereotactic, kana yakavhurika
• Chipfuva MRI kubatsira zviri nani kuziva bundu remuzamu kana kuongorora shanduko isina kujairika pane mammogram
• Sentinel lymph node biopsy kutarisa kana gomarara rapararira kune ma lymph node
• CT scan kutarisa kana gomarara rapararira kunze kwezamu
• PET scan kuongorora kana gomarara rapararira

Kana chiremba wako akaziva kuti une kenza yemazamu, mimwe miedzo ichaitwa. Uku kunodaidzwa kunzi kutarisa kuti gomarara rapararira here. Kutepfenyura kunobatsira kutungamira kurapwa uye kutevera. Izvo zvakare zvinokupa iwe pfungwa yezvaunotarisira mune ramangwana.

Matanho ekenza yemazamu anotangira pa 0 kusvika IV. Iyo yakakwira nhanho, iyo yakawedzera kenza.

Kurapa kunoenderana nezvinhu zvakawanda, zvinosanganisira:

• Rudzi rwekenza yemazamu
• Chikamu checancer (staging chishandiso icho vanopa vako chavanoshandisa kuti vazive kuti kenza yakura zvakadii)
• Kunyangwe iyo cancer inonzwisisa kune mamwe mahormone
• Kunyangwe kenza ichiwedzera (overexpresses) iyo HER2 / neu protein

Cancer kurapwa kunogona kusanganisira:

• Hormone kurapa.
• Chemotherapy, iyo inoshandisa mishonga kuuraya cancer maseru.
• Radiation therapy, iyo inoshandiswa kuparadza cancer cancer.
• Kuvhiya kubvisa maronda ane cancer: Lumpectomy inobvisa bundu repazamu. Mastectomy inobvisa zvese kana chikamu chechipfuva uye pamwe nezvivakwa zviri padyo. Nhengo dzepedyo dzinogona kubviswa panguva yekuvhiyiwa.
• Kurapa kwakanangwa kunoshandisa mushonga kurwisa shanduko yemajini mumasero ekenza. Hormone kurapa muenzaniso wekurapa kwakanangwa. Iyo inovharira mamwe mahormone anowedzera kukura kwekenza.

Kenza kurapwa kunogona kuve kwenzvimbo kana systemic:

• Mishonga yemuno inosanganisira chete nzvimbo yechirwere. Radiation uye kuvhiya ndiwo mafomu ekurapa kwenzvimbo. Anonyanya kushanda kana gomarara risina kupararira kunze kwezamu.
• Kurapa kwakarongeka kunokanganisa muviri wese. Chemotherapy uye hormonal therapy ndiwo marudzi e systemic kurapwa.

Vazhinji vakadzi vanogamuchira musanganiswa wemishonga. Kune vakadzi vane gomarara repazamu, II, kana III, chinangwa chikuru ndechekurapa gomarara uye kuridzivirira kubva mukudzoka (kudzokorora). Kune vakadzi vane kenza yechikamu IV, chinangwa ndechekuvandudza zviratidzo uye nekuvabatsira kurarama kwenguva yakareba. Muzviitiko zvakawanda, danho IV kenza yemazamu haigone kurapwa.

• Stage 0 uye ductal carcinoma: Lumpectomy pamwe nemwaranzi kana mastectomy ndiyo yakajairwa kurapwa.
• Chikamu I uye II: Lumpectomy pamwe nemwaranzi kana mastectomy ine lymph node kubviswa ndiyo yakajairwa kurapwa. Chemotherapy, hormonal therapy, uye imwe yakanangwa kurapa inogona zvakare kushandiswa mushure mekuvhiyiwa.
• Stage III: Kurapa kunosanganisira kuvhiyiwa, pamwe kuchiteverwa nekemotherapy, kurapa kwehomoni, uye imwe nzira yekurapa.
• Stage IV: Kurapa kunogona kusanganisira kuvhiya, radiation, chemotherapy, hormone therapy, imwe yakanangwa kurapwa, kana musanganiswa weiyi marapirwo.

Mushure mekurapwa, vamwe vakadzi vanoramba vachitora mishonga kwechinguva. Vakadzi vese vanoramba vachiongororwa ropa, mammograms, uye kumwe kuongororwa mushure mekurapwa kuongorora kudzoka kwekenza kana kukura kweimwe gomarara repazamu.

Vakadzi vakaita mastectomy vanogona kunge vachigadzirisa ekuvhiya chipfuva. Izvi zvichaitwa chero panguva yemastectomy kana gare gare.

Unogona kudzikisira kushushikana kwehurwere nekujoinha boka rekutsigira gomarara. Kugovana nevamwe vane zvakajairika zviitiko uye matambudziko zvinogona kukubatsira kuti usazonzwa kusurukirwa.

Nyowani, kurapwa kwakavandudzwa kuri kubatsira vanhu vane kenza yemazamu kurarama kwenguva yakareba. Kunyangwe nekurapwa, gomarara repazamu rinogona kupararira kune dzimwe nhengo dzemuviri. Dzimwe nguva, gomarara rinodzoka, kunyangwe mushure mekunge bundu rese rabviswa uye ma lymph node ari padyo akawanikwa asina gomarara.

Vamwe vakadzi vane kenza yemazamu vanogadzira gomarara nyowani remazamu iro risinei nechuma chepakutanga.

Kunyatsoita kwaunoita mushure mekurapwa kenza yemazamu kunoenderana nezvinhu zvakawanda. Kunyanya kuwedzera kenza yako, murombo mhedzisiro. Zvimwe zvinhu zvinogadzirisa njodzi yekudzokazve uye mukana wekubudirira kurapwa unosanganisira:

• Nzvimbo yebundu uye kuti yakapararira zvakadii
• Kunyangwe bundu iri hormone receptor-yakanaka kana -negative
• Mamota mamaki
• Gene kutaura
• Saizi yemamota uye chimiro
• Chiyero chesero kupatsanurwa kana kuti nekukurumidza sei bundu riri kukura

Mushure mekutarisa zvese zvataurwa pamusoro, mupi wako anogona kutaura nezve njodzi yako yekudzokazve nekenza yemazamu.

Unogona kusangana nemhedzisiro kana kunetseka kubva pakurapwa nekenza. Izvi zvinogona kusanganisira kurwadziwa kwenguva pfupi kana kuzvimba kwezamu nenzvimbo dzakatenderedza. Kumbira mupiki wako nezve zvingangoitika mhedzisiro kubva pakurapwa.

Bata mupi wako kana:

• Une zamu kana hapwa
• Une zamu kubuda

Mushure mekurapwa kenza yemazamu, danai mupi wako kana iwe ukava nezviratidzo zvakaita se:

• Kubuda kwemboro
• Pundu pazamu
• Mapundu matsva muzamu
• Kuzvimba munzvimbo
• Marwadzo, kunyanya kurwadziwa kwepfupa, kurwadziwa mudumbu, kana kurwadziwa kwepfupa

Taura nemupi wako nezve kangani iwe unofanirwa kunge uine mammogram kana imwe bvunzo yekuyera kenza yemazamu. Gomarara repazamu rekutanga rinowanikwa nemammogram rine mukana wakanaka wekuporeswa.

Tamoxifen inogamuchirwa kudzivirira kenza yemazamu muvakadzi vane makore makumi matatu nemashanu zvichikwira vari panjodzi huru. Kurukura izvi nemupi wako.

Vakadzi vari panjodzi yakanyanya yekenza yemazamu vanogona kufunga nezvekudzivirira (prophylactic) mastectomy. Uku kuvhiyiwa kubvisa mazamu kenza yemazamu isati yaonekwa. Vanogona kukwikwidza vanosanganisira:

• Vakadzi vakatobviswa zamu rimwe nekuda kwegomarara
• Vakadzi vane nhoroondo yakasimba yemhuri yekenza yemazamu
• Vakadzi vane magene kana magene ekuchinja anokwidza njodzi yavo yekenza yemazamu (senge BRCA1 kana BRCA2)

Zvinhu zvakawanda zvine njodzi, senge magene ako uye nhoroondo yemhuri, hazvigone kudzorwaAsi kuita shanduko yemararamiro ane hutano kunogona kudzora mukana wako wese wekutora cancer. Izvi zvinosanganisira:

• Kudya chikafu chine hutano
• Kuchengeta huremu hune hutano
• Kuremedza kunwa doro kune 1 chinwiwa pazuva

Kenza - zamu; Carcinoma - ductal; Carcinoma - lobular; DCIS; LCIS; HER2-yakanaka kenza yemazamu; Kenza yemazamu ine ER-yakanaka; Ductal carcinoma mu situ; Lobular carcinoma mu situ

• Chipfuva chekunze danda radiation - kubuda
• Chemotherapy - chii chekubvunza chiremba wako
• Lymphedema - kuzvitarisira
• Mastectomy uye kuvaka zamu - chii chekubvunza chiremba wako
• Mastectomy - kubuda
• Radiation Therapy - mibvunzo yekubvunza chiremba wako

• Chipfuva chevakadzi
• Tsono biopsy yezamu
• Vhura biopsy yezamu
• Chipfuva kuzviongorora
• Chipfuva kuzviongorora
• Chipfuva kuzviongorora
• Lumpectomy
• Chipfuva kubvisa bundu - nhevedzano
• Mastectomy - akateedzana
• Sentinel node biopsy

Makhoul I. Maitiro ekurapa ekenza yemazamu. Mune: Bland KI, Copeland EM, Klimberg VS, Gradishar WJ, eds. Chipfuva: Yakakwana Management yeBenign uye Malignant Zvirwere. 5 ed. Philadelphia, PA: Elsevier; 2018: chitsiko 24.

National Cancer Institute webhusaiti. Kurapa kenza yemazamu (mukuru) (PDQ) - hutano nyanzvi vhezheni. www.cancer.gov/types/breast/hp/breast-treatment-pdq. Yakagadziridzwa Kukadzi 12, 2020. Yakasvika muna Kukadzi 25, 2020.

National Yakakwana Cancer Network webhusaiti. NCCN kiriniki yekudzidzira maitiro mune oncology (NCCN nhungamiro): Gomarara repazamu. Shanduro 2.2020. www.nccn.org/professionals/physician_gls/pdf/breast.pdf. Yakagadziridzwa Kukadzi 5, 2020. Yakasvika muna Kukadzi 25, 2020.

Siu AL; US Yekudzivirira Services Task Force. Kuongorora kenza yemazamu: US Preventive Services Task Force kukurudzira chirevo. Ann Mukati Med. 2016; 164 (4): 279-296. PMID: 26757170 pubmed.ncbi.nlm.nih.gov/26757170/.

US Preventive Services Task Force, Owens DK, Davidson KW, et al. Kuongororwa kwenjodzi, kurairwa kwemajini, uye kuongororwa kwegen'a nekenza inoenderana ne BRCA: US Preventive Services Task Force Kurudziro Chirevo [kururamisa kwakaburitswa kunoonekwa muJAMA. 2019; 322 (18): 1830]. JAMA. 2019; 322 (7): 652-665. PMID: 31429903 pubmed.ncbi.nlm.nih.gov/31429903/.