Kugadziriswa kwebasa chinhu chiri pamusoro pevakadzi vakawanda pfungwa pavanoziva kuti vanofanira kuve nekuita mastectomy . Pamusoro pekutarisana nekudzvinyirira kwekenza kuongororwa, vakadzi vanotarisana nemasikiromiya vanorwisana neruzivo kuti miviri yavo haizombovi yakadaro. Vanogona kunetseka pamusoro pekukwezva kwavo uye zvepabonde mushure mekuvhiyiwa, uye kutarisa kumadzimai ekuvakazve senzira yekugadzirisa izvo zvinetso.
Chirevo chekudzorerwa kwemazamu chinogona kufadza zvikuru nokuti chinogona kuonekwa senzira yekutarisa uye kunzwa "yekare" zvakare. Zvakatoita kuti utange kuvhiyanisa zvakare apo uchiri pasi peanesthesia inopiwa nokuda kwemastectomy. Asi zvakadini kana iwe uchida kuiswa mairasi uye chemotherapy mushure mekudzorerwa kwemazamu ako? Mishonga iyoyo ingakuvadza here zvaunotarisira kuzadzika?
Kusvikira makore mashomanana apfuura, nyanzvi dzakawanda dzakanyevera pamusoro pekudzorerwa kwemazamu musati majekesa. Asi zvidzidzo zvenguva pfupi, kusanganisira imwe ne Fox Chase Cancer Center muFiladelphia uye imwe neYunivhesiti yeCleveland, inogumisa kuti hapana chikonzero chekuisa. Kunyange zvakadaro, zviremera zvezvechiremba hazvisi kubvumirana nezvekuti varwere vanofanira kumirira kana kuramba.
Chero ani zvake anorwara achifunga nezvekudzorerwa kwemazamu anofanirwa kutarisa mucheche wekuvaka zvakare (pamwe chete naye oncologist) nguva pfupi mushure mekunge kurapwa kwekenza zvichienderana nekugona kuona zvaanoita.
Nyaya Yekuenderera Mberi neBhenda Kuvakazve
Iko kune zvakawanda zvinobatsira kugadziriswa patsva. Kunyanya kugadziriswa kwezamu kunoda kushanda kwepamusoro, uye kuitanga ichiri pasi peganda reesesthesia zvinoreva kuti izvi zviri kuitika musati wambomuka.
Mastectomy yeganda, iyo inobva pazamu "sac," inongorayirwa chete kana kugadziriswa kuchave kwaswedera.
Sezvo mutemo wehurumende, vakadzi vane kenza yepabonde yepakutanga (zviduku zviduku zvisina kupararira kune lymph nodes kana kuti kufambira mberi kwayo kunongogadziriswa nhesi kune rumwe rutivi sehutachiona rwakatambudzwa) rinogona kuenderera mberi nekugadziriswa. Kunze kwokuti zviri pachena kuti murwere achange adikanwa nehutachiona mushure mekushaya kwake kwepamusoro pamusana pekenza huru kwazvo muzamu kana kenza yakajeka muchirongwa, Dr. Christy Russell, ane mazamu echecologist paYunivhesiti yeSouth California, anofarira kuti kuvakazve kwaitwa panguva yekuita mastectomy.
Zvisinei, zvinogona kuva zvakaoma kuziva kana kubuda kwemazuva kuchadiwa kune vamwe varwere vasati vasangana nemasitomu. Maererano naDr. Russell, vakawanda vanoita mazamu ekuvhiya vanozoita kuti murwere arambe achigadziriswazve, pane kungomunonoka kuti arege kuita chirwere chechipiri chikuru uye anesthesia.
Zvinetso zvinogona kuitika zvinogona kuva zvechiremba, zvinonongedza kana zviviri. Zvinogona kusanganisira kuumbwa kwechifukidzo chechifu chemasvingo, mishonga yakasimba, hutachiona kana necrosis (rufu) yemamwe mafuta, izvo zvinogona kukonzera maruva. Kana yakawandisa, zvinetso zvingadikanwa kuti upiwezve upiwe kugadzirisa kana kugadzirisazve kuvaka.
Zvitsva zvitsvakurudzo zvakagumisa kuti kana magetsi anotevera kutevedza mazamu, hapana kuwedzerwa mumatambudziko maduku kana makuru. Chimwe chekutsvaga chakawana kuti 75% yevarwere vaiva nehutano hwekudzoka musati majekesheni vakatsanangura mugumisiro wezvigadzirwa zvakanaka zvakanaka kune zvakanakisisa, izvo zvakafanana kana zviri nani kupfuura kugutsikana kwevarwere vakanga vasina radiation.
Kuvhiyiwa kwezvekugadziriswa panguva yekuita mastectomy kunonyanya kuwanzana mumatunhu akawanda ezvokurapa ane oncologist uye vanachiremba vepurasitiki vanoshanda pamwe chete mune imwe nzvimbo.
Nyaya yekumirira Breast Reconstruction
IAmerica Cancer Society inotaura kuti vanachiremba vazhinji vanokurudzira kunonoka kuvakazve kune avo vanoziva kuti vachava nemhepo, iyo inenge hafu yevamwe varwere.
Mukufamba kwenguva, miviri inogona kukanganisa zvachose ganda rekugadzirwa kweganda, mavara, uye kukonzera, izvo zvingakanganisa kuonekwa kwemazamu akavakwazve.
Vakadzi vanoziva kuti vane kenza yemukatikati kana yepamusoro (avo vane matumire makuru kupfuura masentimita mashanu nemakirini ane nhengo dzakapindwa) vanorayirwa kumirira mwedzi mitanhatu kusvikira pagore vachivhiyiwa kusvikira zvirwere zvapera. Vaya vane kenza yepamusoro yepamusoro kana inoputika inorayirwa zvakanyanya pamusoro pekuenderera mberi nekugadzirisa zvakare.
Paunofunga nezvemazizi uye kuvakwa kwezamu, zvinokosha kuziva kuti rudzi rwekuvhiya rwakakunakira iwe ndeupi:
Autologous Tissue Breast Reconstruction
Kugadzirwa kweAustogous tishu ndiyo nzira yakajairika yokuvhiya, uye kune nzira dzakawanda dzinogona kushandiswa, izvo zvose zvinosanganisira kushandiswa kwezvisikwa zvinobva kune chikamu chemuviri kunze kwechifuva.
Imwe inonzi TRAM flap , yakatumidzwa zita re transver rectus abdominis muscle (TRAM) iyo inoshandiswa mukugadzirisa. Izvi zvinoshanda zvakanyanya kuvakadzi vane mafuta akawandisa mumimba yavo kana ganda rakabviswa kubva pakuberekwa.
Zvitsva zvekugadziriswa kwezvikwata zvekugadzirwa kwezvivako zvinosanganisira zvipfeko zvepagastric artery flap (SIEA) uye yakadzika pasi pechipasita artery perforator flap (DIEP), iyo inoshandisawo ganda remuviri nemafuta.
Sezvo post-mastectomy mihizha inokanganisa ropa rinoiswa paganda nemasukisi echipfuva, zvigadziriswa, zviri nani kupisa pakutanga uye zvinounza chipfuva gare gare kuedza kubvisa chidzitiro kubva mudumbu kana kumashure.
Zvipfeko kana Breast Implants
Zvimwe zvipembenene kana mazamu zvinowanzoiswa mushure mekunyengera kwezvisikwa zvishoma nezvishoma zvinowedzera hukuru hwezvinonzi "chifuva chezamu." Zvipembenene zvepabonde zvinowanzokurudzirwa chete kuvadzimai vane mazamu maduku-kusvika-akaenzana kana avo vasina mishonga yakakwana yemimba ye TRAM inofanira kuitwa. Kana uchitarisa mazai emvura mushure mekusimudza, iva nechokwadi chokuti unogamuchira expander nemapurisa epurasitiki panzvimbo yesimbi imwe.
Kunyange zvazvo TRAM inokonzera njodzi yakakura yemafuta necrosis, ndicho chisarudzo chakanaka chekudzivirira chirwere chekugadzirisa mune remangwana mushure memazuva. Inogonawo kuva yakakosha zvikuru kune avo vanomirira kuvakwa kusvikira mushure memazuva ano nokuti mhuka dzinotorwa kubva mudumbu, kumashure kana kune imwe nzvimbo pamuviri hauna kujekeswa.
Chemotherapy uye Zvimwe Kuberekwa Kwezvechifuva Kufungisisa
Kunyangwe mastectomy varwere vanofanira kunonoka kuvakazve kusvikira kuguma chemotherapy kune imwe nzvimbo yekukakavadzana. Chimwe chidzidzo chevakadzi vakadzidza chemo mushure mekuvakazve vakaratidza 25% vachikwira muhuwandu hwekutevera-up-up nekuda kwezvikonzero zvezvipfeko. Uye pane imwe nyaya: Kana chemo inotorwa nokukurumidza mushure mekugadzirisazve, inogona kumisa kuporesa kwepanyama, kuumba mukana mukuru wehutachiona.
Varwere vanoronga kuva nezvipembenene vanogona kuva nekuwedzera kunowanikwa munguva yekuita mastectomy. Mushure mokunge, kana zvichidiwa, vanogona kupinda chemotherapy munguva yemwedzi inoverengeka inotora kuti zviwedzere kuparadzanisa ganda (zvisati zvasvike zviripo).
Iko kune flip kune imwe nyaya yekuti kurapwa kunobata migumisiro yekuvhiyazvezve: Kuvhiya kunobata zvirwere zvinotevera here? Chemotherapy inowanzotanga pakarepo mushure mastectomy. Kana chemo yakanonoka kuti isapindira nehutano hwekuporesa, kubudirira kwayo kunogona kuderedzwa. Kuderedza mazairo emvura, ayo anowanzopiwa pashure pemakemikari, anogona kudarika kaviri kudzokorora kwepamunharaunda yekenza yengamu.
The Bottom Line
Parizvino, kune mibvunzo yakawanda semhinduro kana pane nguva yekugadziriswa kwepfuva uye shure-mastectomy mishonga. Kana kana uye pakuve nekudzoka kwezvakafuridzirwa ndechipi chisarudzo chekuchinja hupenyu hwevarwere avo vari kutotanga kuita zvimwe zvisarudzo zvakawanda zvinokosha. Uine ruzivo runopesana runobva kune dzimwe nzvimbo, kutsvakurudza nyaya uye kutaurirana navanachiremba vako kunokosha kwazvo usati wagadzirisa pane mhinduro yakakunakira iwe.
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Christy Russell. Chirwere Chepabonde Oncologist. University of Southern California Los Angeles. Telefonhare Hurukuro.
"Kuderedza Mishonga Yemazuva Okurapa Kunotungamirira Kurapa Kudzoka." cancer.org . 26 Feb. 2003. American Cancer Society.
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Keiler, L., et al. "Kushandiswa kwePooperative Radiation Therapy pa Postmastectomy Breast Reconstruction." International Journal of Radiation OncologyBiologyPhysics 692007 S76.
"Mhedziso Yenguva refu Yekumhanya Kwemvura." mdanderson.org . 2008. University of Texas MD Anderson Cancer Center.
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"Ndingaitei Nezvematambudziko Eganda?" cancer.org . 2 Gumiguru 2007. American Cancer Society.