Kuongororwa, Kurapa, Kuponeswa Kwemari
Chikamu chekenza yebhumbu yakanyanyisa kupfuura danho repiri , asi harifaniri kutaridzika sedhematic. Nokuda kweizvi kuongororwa, kenza haina kupararira kubva muchifuva kune nhengo kana dzimwe nzvimbo dziri kure mumuviri, asi masero emukenza achange aenda kune zvisikwa zvishoma pasi (axillary) lymph nodes, kana kuti akaiswa mumakirini pasi pasi pemazamu ako (sternum) kana kunyange pasi wako collarbone.
Overview
Chikamu chetatu chepfupa bundu rinogona kubuda muhukuru kubva pasi pe2 cm kusvika kune 5 masikati, asi dzimwe nguva hapana dumbu rinowanikwa mumatomu emvere. Iyi nhanho yekenza yemazamu inoputika inogona kusanganisira chifukidzo chemuti mutsvuku pasi pezamu, kana kuti inogona kuchinja kamupa remuti. Kana ganda rezamu rinenge ravhiringidzika kana richirwara nekenza, inogona kunge ichiita chirwere chepachifu chechifu (IBC).
Chikamu chechitatu chekenza yemazamu isingawaniki inogona kurondedzerwa nezviratidzo zvitatu: 3A, B, uye C. Izvi zvinowedzera kuputsika nehutu hwemaitiro uye node yemamiriro, sezvinotsanangurwa neTMM system . Kunyange zvazvo lymph nodes inogona kuve yakabatanidzwa, chikamu chechitatu hachina kufungidzirwa semastatic.
TNM Kutarisa Matanho 3 Kenza Yemazamu
Nhanho 3 kenza yebonde inoputsika muchero 3A, 3B, uye 3C. Sezvo mazano ekurapa pamwe nekufananidzira kunogona kunge akasiyana zvakanyanya pakati pezvikamu izvi, kunyatsoongorora kunoda kudiwa. Pakutanga, urongwa hweTMM hunogona kuvhiringidza. Asi sezvo mune tsanangudzo yeT, N, uye M, inobvumira vanachiremba kunyatsotsanangurira danga.
TNM inoreva kuna:
- T: bundu rekukura. T0 inotaura nezvekenza yemazamu isati yambowanikwa muzamu dzako asi yakawanikwa kune imwe nzvimbo. T1 inosanganisira matumbo ane 2 cm (inenge inenge 1 inch) kana zviduku muhukuru. T2 inosanganisira matumbo ari pakati pe2 cm uye 5 cm muhupamhi. T3 matamu makuru kudarika 5 cm. T4 tumakumbo inogona kuva yakakura asi yakapinda rusvingo rwechifuva kana ganda. T4 inosanganisira chirwere chepachifu chinoputika.
- N: nodes. N0 zvinoreva kuti tumarara haina kupararira kune lymph nodes. N1 inoreva zviremara zvakapararira kune lymph nodes dziri pedyo (kusvika kusvika 3). N1mi inoreva kuti pane micrometastases, kana masero emarara zvinogona kuonekwa pasi pe microscope. N2 zvinoreva kuti tumarara yakapararira kusvika kumapapiro 4 kusvika ku 9 pasi pemaoko kana kune kupararira kwakanyanya kune mukati memamine lymph nodes. N3 inogona kureva mamiriro ezvinhu akasiyana-siyana, akadai ane 10 kana kupfuura akawanda emakirini anonzi akanaka kana kana kenza yakapararira kune zvinyorwa zvinonzi subclavicular (pasi pegiramu).
- M: metastases. M0 zvinoreva kuti hakuna maitiro akare ari kure. M1 inotaura nezvemakumbo anenge asangana nematambudziko (ari nhanho 4) uye akapararira. Apo kenza yemazamu inopararira nzvimbo dzinowanikwa dzakawanda dzemasimisita mapfupa, chiropa, uropi, kana mapapu.
Nhanho 3A Kenza Yemazamu
- Nhanho 3A: T0, N2, M0: Hapana chirwere chakawanikwa mumuviri wemazamu, asi masero emukenza akagara mumakirini ane nhengo dzemuviri wako kana muchipfuva chako.
- Nhanho 3A: T1, N2, M0: Chirwere chacho chiri 2 cm kana chiduku, kana chakakonzera zvishoma kubva muchifuva. Mukuwedzera, kenza yakapararira kune lymph nodes mujasi rako kana nodes mubhokisi rako.
- Nhanho 3A: T2, N2, M0: Chirwere chacho chinopfuura 2 cm, asi pasi pe5 cm kumativi ose. Kanzira yaenda kune lymph nodes mujasi rako kana nodes mubhokisi rako.
- Nhanho 3A: T3, N1, M0: Chirwere ichi chakakura kudarika 5cm nechekare uye hachina kupinda muchifuva chemuti kana mushumba wemadziro emapfupa. Kanzira yakange iwanikwa mune zvisingatauri lymph nodes.
- Chikamu 3A: T3, N2, M0: Chirwere ichi chakakura kudarika 5cm nechepamusoro uye hachina kukanganisa ganda remuti kana mushumba wematanda. Kanzira yakabatwa mune zvisikwa zvemuviri zvidhori kana nodes muzamu rako.
Chikamu 3B Mucheche weKenza
- Chikamu 3B: T4, N0, M0: Chirwere chacho chinogona kunge chakave chikafu uye chakakonzera ganda remuti, kana chakura mumadziro ako echifuva, pasina kusanganisira pectoralis muscle. Dzimwe nguva kenza inosvika pazvese pachipfuva chako uyewo murusvingo rwechifuva. Izvi zvinogona kuvewo kuva nekuputika kwekenza yemazamu.
- Nhanho 3B: T4, N1, M0: Chiremara ichi chinogona kuva chesimba uye chinogona kusungirirwa neganda kana rusvingo rwechifuva, kana chinogona kunge chichirwere chepfupa chepachifu. Kanzira yakatowanikwawo muchirwere chechirwere chemakumbo esirivha pedyo nebhokisi rakabatwa.
- Nhanho 3B: T4, N2, M0: Chirwere ichi chinogona kuva chero hukuru, chinokanganisa ganda remuti kana rusvingo rwechifuva, kana kuti inogona kuva neChirmatory breast cancer. Kanzira yakanyatsowanikwawo mune zvimedu zvisingatauri mishonga yemazamu kana nodes mukati memvere.
Chikamu 3C Chirwere Chechikara
- Nhanho 3C: T (chero ipi zvayo), N3, M0: Chiremera ichi chero hukuru, asi chiri mukati mematehwe emvere chete. Dombo rako repfupa uye chifuva cheganda hazvifaniri kunge zvisingabatsiri. Lymph node mamiriro ezvinhu achasiyana sezvinotevera: kenza inogona kuwanika mu nodes pasi pechanza chako, mukati mehumbu rako, pamusoro pemirasi yako, kana pasi pemirasi yako. Saizvozvowo, kenza inogona kuratidza pane dzakawanda zvezvivako izvi.
Survival Rate
Zvose zvinokwana makore mashanu ekupona kwechikamu chechitatu kenza yemazamu ndeye 73 muzana, asi izvi zvinogona kusiyana zvichienderana nechinzvimbo uye zvimwe zvinhu zvizhinji.
Oncologist inotaura nezvekuchengetedzwa kwekenza yepabonde maererano nemakore mashanu ekupona. Izvozvo hazvirevi kuti mutevedzeri murwere achava nemakore masere okurarama mushure mokunge aongororwa! Zvinoreva kuti varwere ivavo vakapona makore masere mushure mekuongororwa, uye vazhinji vavo vakararama kwenguva refu. Havasi varwere vose vachagumburwa nekenza yemazamu, asi vanogona kufa kubva kune zvimwe zvinhu.
Chiremba wako achakutaura newe nezvemaonero ako akasiyana-siyana ekupona, zvichienderana nehutano hwako hwose, zera, mamwe mamiriro ezvinhu, uye hutachiona hwehutano hwekenza. Nhamba iyo vanachiremba vanoshanda nayo inobva pane zvinyorwa zvinobva kuboka guru revanhu, asi hazvigoni kukodzera nyaya yako chaizvo. Mukuwedzera, nhamba idzi dzinoratidza kushanda kwekare kwezvirapa izvi; maitiro ave achikwira mumakore akawanda apfuura.
Mishonga
Urongwa hwako hwekurapa huchasanganisira kuvhiyiwa, chemotherapy, uye mumatambudziko akawanda, mahara. Kana chironda chako chaiva cheHER2-positive , iwe uchapiwawo Herceptin, uye kana iri hormone-sensitive (estrogen uye / kana progesterone-positive), unogona kutarisira kutora mishonga yehomoni kweanenge makore mashanu mushure mekunge kurapwa kwekutanga kuchipera.
Zviduku zviduku zvisina kumboputika mucheka kana musumbu zvinogona kubviswa ne- lumpectomy , uye chirwere chinonzi biodsy chidimbu chichadikanwa kuti chione kana kenza yemasasa yakapfuurira mberi kwako. Zviremara zvakakura, kusanganisira izvo zvakapinda murusvingo rwechifuva, zvinoda mastectomy uye lymph node biopsy. Kugadziriswa kwebonde kunogona kupiwa kwauri, asi dzimwe nguva kunofanira kunonoka nemhaka yehutachiona hwemaawa .
Chemotherapy inopiwa kudzingirira pasi chero ipi zvayo inokonzera kenza masero mumuviri wako; izvi zvinobatsira kudzivisa kudzokorora. Asi chemo inogona kupiwa zvakare musati mavhiyiwa kuti urove tumarara. Apo chemotherapy inopiwa mushure mekuvhiyiwa mukutanga kwekutanga kenza yepamu inonzi "adjuvant chemotherapy." Apo inopiwa musati mavhiyiwa inonzi "neoadjuvant chemotherapy."
Dzimwe nguva apo ganda rezamu rinobatanidzwa nekenza, inonzi chirwere chepamuviri chepamuviri. Kurapa kwakagadziriswa semakemikrasi inowanzotanga kurapwa kwekenza yepamusoro yepamuviri; izvi zvose zvinokonzera chiremera chikuru, zvichiita kuti zvive nyore kuti chiremba chiremba aibvise, uye anourayawo tumoramu masero anotenderera mumuganhu uye nzvimbo isina kunyatsobatanidzwa nekenza masero. Pasina kuvhara mitsara iyi yemasero emukenza, mazamu acho anoramba achiratidza zvakanaka, kazhinji zvichiguma nekuvhiya zvakare uye yakaipa kwazvo mushure mekuonekwa. Kanzera inoputira yezamu inowanzoda mastectomy uye axillary lymph node dissection.
Kuchengetedza Kuchengeta
Kutevedzera-kurapwa kunotarirwa nehomoni yako neHER2. Kana zvirwere zvichishanda zvakakwana, iwe uchava nemakore mashanu ekutevera nguva yekuongorora neoncologist yako, panguva iyo iwe ungada kutora hormone therapy kana chironda chako chakanga chiri chema hormone. Iwe uchave uine mammogram ako egore negore uye iwe unofanira kugara uripo iye zvino nehadzi rako kuzvidzidzira , zvichipa kuti iwe uchiri nemapfupa emvere mushure mekuvhiyiwa. Zvichibva pakuve nekenza yepazamu, chiremba wako angakurudzira nguva nenguva maRMIs emamwe mazamu. Endai pane chirongwa chekudya chine utano, uye taura nachiremba wako pamusoro pemaitiro akanaka ekuita muviri unozovaka zvakare simba rako nekugara zvakanaka.
Shoko Rinobva Kumatanho 3 Kanama Yemazamu
Nhanho yechitatu ndiyo yakatonyanya kufambira mberi kwekenza yepema asi ichiri kuraswa. Uye kurapwa kuri kuwedzera. Semuenzaniso, muna 2017 kuwedzerwa kwe-bisphosphonates kwakawedzerwa kune estrogen positive mazamu emukondombera kuderedza ngozi yokuti kenza ingapararira kumafupa. Ramba uchifunga kuti nhamba dzaunonzwa paunenge uchiverenga nezvekupona hazvifungi nezvemishonga iyi mitsva. Kusvitsa kune vamwe kwakaratidzwawo kuvandudza mitero yekupona. Itai boka rekutsigira kana kuwana kenza yemukati munharaunda. Zvizhinji zvezvose, ivai vatsigiri venyu mune utano hwehutano, kwete chete maererano nekenza yemazamu, asi kuchengetedza utano hwako hwose mushure mekurapa.
> Sources:
> AJCC Cancer Staging Manual 6 th Edition. Springer Verlag, New York, NY. 2002, mapeji 223-240.
> America Cancer Society. Chirwere Chepabonde Kupona Nharaunda neSiteji.
> America Cancer Society. Kurapa kweKenza Inobatsira Inoshandiswa, NeGweta.
> National Cancer Institute. Nhanho dzeBeast Cancer. Chikamu IIIA-C.
> Rudo, Susan M. Ndechipi Chechirwere Chepabonde Ndine: Kurongedza. Pp. 303-321. Dr Susan Love's Breast Book. MD Chechipiri Yegore, 2010.