Kubata uye Kuberekwa Kunobatsira Sei Kungozi Yako Chepabonde?
Kunyange zvazvo amai vachiwanzoita kusanganiswa kwakaoma kwemufaro uye kushungurudzika, vamwe vakadzi vanotarisana nekutyisidzika kwakawedzerwa kwekenza yengororo yekuongorora. Vakadzi vemarudzi ose kana zvikamu zvehupenyu vanogona kuongororwa vane kenza-haisati iri pamusoro wepfungwa huru yekuzvitakura nekuyamwisa.
Mahomoni, kunyanya mahomonikadzi eesrogen uye progesterone, uye kenza yemazamu ine ukama hwakaoma kwazvo.
Kusiyana kwemahomoni emadzimai kunoitika mwedzi woga woga mumakore ekuberekwa kwemukadzi uye kuderedza mushure mokunge apera. Kuvhiringidzika kwehupenyu hwemadzimai kumahomoni, anowanzoyerwa muhuwandu hwekuenda kumwedzi, inonyanya kuisa njodzi yekenza yepabonde.
Zvisinei, pane zvinhu zvakawanda zvine chokuita nekuzvitakura uye lactation zvinogona kuderedza ngozi yekenza yemazamu. Asi kune 1 muvakadzi 3 000, kenza yemazamu munguva kana kuti mushure mokunge atanga kubata pamuviri inoitika.
Muhurukuro neBrain Cancer Research Foundation (BCRF), Elisa Port, MD, munyori we "New Generation Breast Cancer Book" akagovana mazano anokosha pamusoro pezvinoitika zvakanyanya zvekenza yepabonde kutsvaga panguva kana mushure mokunge aberekwa, kuti vakadzi vanogona sei Ivai vakangwarira nezvehutano, uye zvitsva zvinoshandiswa pakurapa. Dr. Port muongorori weBBCRF uye Chief Breast Surgery uye Mutungamiriri weDubin Breast Center paGomo Sinai Sinai muNew York.
Kuvandudzwa kweMabere Panguva yekudzivirirwa uye Kuberekwa
Iyo yakazara yekuita pamuviri pakuyamwisa uye pakupedzisira, kuchinjwa, kana kuti chifuva chinodzokera kune chaicho chisati chaita pamuviri, chinokonzera mazamu emvere kuti akure uye kuchinja marudzi emahomoni ari kushanda muzamu.
Izvi zvinoderedza kusvibiswa kune estrogen.
Inofungidzirwa kuti kuderera kwe-estrogen kufungidzirwa uye mazamu ezvokurera zvishoma anowedzera mikana yokuti kenza inogona kukura. Ichi ndicho chikonzero chekutanga-kutanga kwekuberekwa kwekutanga uye nhamba yevana vakaberekerwa (inozivikanwa sehurumende) inogona kuderedza zvishoma zvingangove nekenza yepamuviri muhupenyu apo mukadzi ari mumakore makumi mashanu, makumi matanhatu kana makumi manomwe.
Kunwisa Kunopedza Kwose Kenza Kenza Yenharo
Kuberekwa kunokonzera kuchinja kwemahomoni uye nekuti kunonoka kudzoka kumwedzi shure kwekuita pamuviri, kunoderedza kusangana kwevakadzi nguva dzose kune estrogen panguva yaanoita mwedzi mumwe nomumwe, kuderedzera ngozi yekenza yemazamu, kunyanya mumadzimai anonzi premenopausal.
Kuenzaniswa nedzimwe nyika, kunwisa muAmerica kunoramba kuri pasi, kunyanya kuvadzimai vemavara kana vachienzaniswa nevakadzi vachena: 62 muzana yevakadzi vemavara vakaenzaniswa ne79 muzana vakadzi vachena vakatanga kuyamwisa nguva pfupi mushure mokuberekwa mune data yakapfuura iripo kubva muna 2014. Zvisinei, pa6 mwedzi mushure mekuberekwa, 36 muzana chete yevakadzi vemadimiri vaenzaniswa na 52 muzana yemamera vatsvene vakanga vachiri kuyamwa. Izvi zvinonyanya kutaura pamusoro pezvo, sezvinoitika mushumo wekupedzisira wakawana kuti vakadzi vemadire vaigona kunge vachifa kubva nekenza yemazamu kupfuura ivo vatsvene vavo, kusarura kuri kuwedzera munyika yose.
Kuongororwa kwakaitwa zvidzidzo makumi maviri nemaviri, kuenzanisa vanaamai vanoyamwisa vanaamai vasina kumboyamwisa, vakawana kuti:
- Amai vakatevedza nguva yeupenyu hwose (pamwe chete kwenguva yakawanda yekuyamwisa vana vose) kwegore rimwe vakanga vashoma zvishoma kuti vawane kenza yemazamu.
- Upenyu hwose hwemakore maviri hwakatora kaviri nguva inobatsira / kuderedza ngozi kune avo vanoyamwisa kwegore rimwe chete.
Chimwe chidzidzo chakabudiswa muAnals of Oncology chakawana kuti kunyamwa kunogona kunge kwakanyatsonaka pakuderedza ngozi ye ER- / katatu isina kushaya kenza yemazamu, iyo inonyanya kurwisa chirwere chacho.
Hazvisi kungoita kuti kunyanya kunetseka kuderedza ngozi yekenza yemazamu mushure mehupenyu uye ine mikana yakawanda yezvokudya kune mwana, inobatsirawo amai nekudzikisa ngozi yekenza yevana , postpartum depression, uye kunyange chechipiri chirwere cheshuga .
Kuberekwa-Kunoita Bonde reBonde
Muzviitiko zvisingawanzoitiki, pamuviri unogona kukonzera kenza yemazamu. Kenza yepabonde iyo inowanikwa munguva kana kuti mushure mokunge pamuviri inowanzowanikwa pane imwe nzvimbo ine utsinye, chikamu nokuti vakadzi vakawanda havatarisiri uye vanowanikwa mushure mekunge, kana kuti vanogona kuongororwa zvisina kukodzera kune dzimwe nyaya dzine chokuita nekuyamwisa, zvakadai semastitis.
Heano maitiro mashomanana aungave wakangwarira nezvehutano hwako hwepamuviri:
- Nguva dzose uzive "wako". Iva nehanya nemuviri wako uye chero shanduko dzinoitika kare, panguva uye shure kwekuita pamuviri (uye kazhinji muupenyu hwose, kutanga semwana wechidiki).
- Kana pane chimwe chinhu chinoshungurudza, iva nechokwadi chekuuisa kune chiremba wako-kusanganisira zviratidzo kunze kwezvipembenene, zvakadai semukomana kudengenyeka, kudpling yeganda, kana kubudiswa kubva muchero kunze kwemukaka wemukaka.
- Ngozi yekenza yemazamu inowedzera kwemakore anenge 4 kusvika mashanu mushure mekuberekwa kwega kwega. Mutemo mukuru wegumbo ndeyekuti vakadzi vanofanira kunyanya kungwarira nezvekusachinja kusina kuitika muzamu yavo kusvika mwana wavo apinda mukiraji.
Mishonga yeKuberekwa-Yakaenderana Nekenza Yekenza
Kana kenza yemazamu inowanikwa panguva yekuzvitakura, kurapwa kunova kwakaoma. Kunyangwe kuve nekuvhiyiwa uye / kana chemotherapy kunogona kutarisana ne trimester.
Chechipiri uye chechitatu chekuongorora zvirwere zvinowanzova nemigumisiro yakanakisisa yekuve nemimba inobata uye yekurapa kenza yemvere. Kurapa munguva yekutanga kwema1 trimester ndiyo nguva yakaoma uye yakaoma zvikuru yekuita zvisarudzo pamararudzo ekurapa, saka zvakakosha kuenzanisa marapirwo kune amai vane ngozi dzingangoita kumucheche.
Mishonga yeHormone Drived Breast Cancer
Nemhaka yeBRRF-yakabhadharwa nekutsvakurudza naDkt. Charles Perou nemamwe masayendisiti akawanda pasi rose, isu zvino tinoziva kuti kenza yemazamu haisi chirwere chimwe, asi vazhinji. Vanachiremba vanogona kuziva kuti ndeupi rudzi rwekenza yemazamu iyo mukadzi aine kuongorora mapuroteni uye DNA mumakumbo masero akabviswa ne biopsy uye nekuzara-pathology mushure mekuvhiyiwa.
Mishonga inowanzoenderana nehurongwa hwekuvhiya, mazairo uye / kana chemotherapy, asi kuziva ruzivo rwakakonzera kukura kwezvirwere zvinotarisirwa zvingaita kuti munhu aite zvakanakisisa mishonga kune chirwere chemurwere mumwe nomumwe.
Targeted therapees for each subtype inosanganisira:
- Kenza yepabonde-katatu ( TNBC ), 10 kusvika ku15 muzana yekenza yemazamu: Hapana hutachiona hunotarirwa asi huchibvumirwa kune TNBC. Zvisinei, chiropotherapy cocktails inogona kubudirira mukurapa TNBC uye pane dzimwe nguva inoita mhinduro dzakasimba.
- HER2 + kenza yemazamu, 15 kusvika ku20 muzana yekenza yemazamu : HER2 + yakanga iine hutsinye hunoshungurudzwa kusvikira mushonga unonzi Herceptin ® wakagadzirwa.
- Yakagamuchirwa muna 1998. HER2 + kenza yemazamu yakabva pakuva nehupenyu hunotyisa kurapa, zvichida kunyange kuporesa kune vamwe varwere.
- HER2 + kenza yemazamu inogona kudzoka mune imwe nhengo, uye inogona kusagadzikana naHerceptin ® . Mishonga mitsva yekurapa HER2 + inosanganisira Tykerb, Perjeta ® uye Kadcyla ® (T-DM1) inogona kukunda kusagadzikana kweHerceptin.
- Semuenzaniso, mukuongorora kwechangobva kuitika mukenza yemasasa, varwere vane chirwere cheHER2 + chepabonde vakanga vari nani zvakanyanya kupona (mwedzi 56 zvichienderana nemwedzi 40) apo Herceptin akabatanidzwa nePerjeta ® , achienzaniswa nevarwere vanogamuchira Herceptin ® voga.
- Eriya + kenza yemazamu, 60 kusvika ku70 muzana yekenza yemazamu: ER + ndiyo inonyanyozivikanwa yekenza yebonde uye zvinokonzera 60 kusvika ku70 muzana yevanhu vatsva 250 000 gore negore. Inogona kurapwa nekuvhiyiwa, rayation, chemo PLUS anti-estrogen therapies. Takafambira mberi zvikuru mukurapa chirwere cheEER + chepamuviri: Mishonga mitsva inozivikanwa seMTOR inhibitors uye CDK4 / 6 inhibitors inoratidzira mapuroteni uye iri kuratidza kuvimbiswa mumakiriniki echechi, uye nevakawanda vanobvumirwa mumakore achangopfuura kusanganisira mTOR inhibitor [insita mTOR name], uye CDK4 / 6 inhibitors Ibrance® neKisaqli®.
Kubereka Mushure Mekurapa
Kunyange zvazvo kubereka mushure mekunge chirwere chepachifu chekuongorora chinonyanya kunetseka, vakadzi vazhinji vane hutano hwakabudirira mushure mekenza yemazamu. Zvizhinji zvirongwa zvekurapa zvinosanganisira regimen yemishonga yakadai se tamoxifen kwemakore mashanu kusvika mashanu mushure mekuvhiyiwa uye / kana chemotherapy kuti kuderedze njodzi yekudzoka uye sezvo chirwere ichi chinogona kukonzera kukanganisa kuberekwa pamuviri kunofanira kudziviswa. Mamwe maitiro ekurwisa-estrogen anopiwa nechirwere chinoderedza basa rekuvhara maitiro kuitira kuchengetedza kubereka. Kusunungura mazai kana embryo zvinowanzoshamisa uye inogona kunge yakakurudzirwa sarudzo.
Zvisarudzo zvinofanira kuongororwa zvisati zvaitwa kuitira kuti mukadzi agone kuita sarudzo yakanakisisa kwaari nemhuri yake.
Zvitora Zvitsva
- Kuberekwa nekuyamwisa zvinowanzopedza mukana wekenza yepamuviri muupenyu.
- Ngozi yekenza yemazamu inowedzera zvishoma kwemakore mashanu mushure mekuberekwa. Iva wakangwarira nezvehutano hwako hwepamuviri panguva iyi.
- Kana kenza yemazamu inowanikwa panguva kana mushure mokunge avete pamuviri, kurapwa ihwo huwandu hwakakosha hunogona kuisa njodzi kuna amai uye fetus.
- Zvitsva, zvinotarisirwa kurapwa kwekenza yemakemikari yakakonzerwa nehommone yakagadzirisa kubudirira kwehutano.