I-Cancer Breast Bheka-I-Alikes on Exam kanye Mammogram
Abaningi bethu bebazi umuntu obenomdlavuza webele naphezu kwesimiso semvelo. Ehlangothini le-flip, kunezinguquko ezincelisayo (hhayi zomdlavuza) ezingase zilingise umdlavuza webele. Lokhu kuhlobana komdlavuza wesifuba kungabangela ukukhathazeka okukhulu nokucindezeleka. Yiziphi ezinye izimo ezingase ziphuthelwe ngomdlavuza webele kodwa zingabe zinezinkinga?
Ake siqale ngokubheka kancane izibonakaliso nezibonakaliso zomdlavuza webele ekuhlolweni nasezifundweni ze-imaging.
Izimpawu zeCanscer Breast
Ngokuqinisekile izibilini zesifuba ezinobuthi nezilimaza ngezinye izikhathi zizwa zifana, kodwa kunezinye izici ezivame kakhulu nomdlavuza. Lokhu kufaka:
- Isilonda sebele esizizwa siqinile
- Isisindo sebele esilungisiwe futhi asikwazi ukuzungezwa ngaphansi kwesikhumba
- Ukubomvu nokuvuvukala (izimpawu zesifo somdlavuza webele)
- Ama-lymph nodes ekhulisiwe ngaphansi kwengalo
Ukuthola Amamogramram Nomdlavuza Webele
Njengokuhlolwa kwakho kwemitholampilo, ngezinye izikhathi kungase kube nzima ukuhlukanisa phakathi kwenqubo enobungozi emdlalweni webele nesifuba. Eqinisweni, ngezinye izikhathi lezi zingakwazi ukungena ngokuphelele (injongo yalesi sihloko). Ama-Mammograms acatshangwa ukuthi angama-60 kuya ku-90 wamaphesenti azwelayo, okusho ukuthi amaphesenti angama-60 kuya kwangu-90 esikhathi uma umdlavuza ukhona, i-mammogram iyothola. Amammograms anezici ezithile ezingamaphesenti angu-93. Lokhu kusho ukuthi amaphesenti angama-93 esikhathi, into ebukeka sengathi isifo somdlavuza emkhatsini wemvelo iyoba nomdlavuza.
Okusho ukuthi amaphesenti angu-7 yesikhathi lapho ubukhulu bemvelo buphakamisa umdlavuza, kungenye into.
Iziphumo ze-Mammogram ezisho ukuthi umdlavuza uhlanganisa ukubalwa kwamabele , izimboni ezinomumo ongavamile, kanye nobuningi obuningi (ubukhulu bubukeka bezintambo ezidlulela ngaphandle ngaphandle kwesisindo esikhulu).
Ama-Radiologists anika inqwaba ye-mammogram eyaziwa ngokuthi Ukubikwa Kwama-Breast Imaging kanye ne-Data System noma i- BI-RADS ngezigaba . Kulesi simiso, umbiko we-mammogram unikezwa inombolo ephakathi kuka-1 no-6 echaza amathuba okuba nomdlavuza. Iningi le-1 lisho ukuthi akukho zibonakaliso zomdlavuza futhi iningi lamashombisa lisho ukuthi i-mammogram iyaphakamisa kakhulu umdlavuza (iningi lezinyanga eziyisithupha lisho umdlavuza futhi linikezwa ngemuva kokuba i-biopsy yenziwe).
Izinga lokukhumbula elivamile ukusuka ekuhloleni kwamaphesenti angu-9,8, okusho ukuthi amaphesenti angu-9,8 abesifazane abanomzimba omncane (abangenayo izimpawu) abizwa emuva ukwenza ezinye izifundo. Kulaba besifazane, amaphesenti angu-12 azodinga ukwenziwa kwe-biopsy. Kulezi zakhiwo, amaphesenti angama-60 azoba yinhlonipho. Ngamanye amazwi, noma ngabe unomzimba ongavamile, futhi ngisho noma izifundo zokulandelela zincoma ukuthi unokwenziwa kwe-biopsy, usengase ube nenqubo yesifuba enesifo kunomdlavuza.
Izifo ze-Breast Ultrasound With Cancer Breast
Izivivinyo ze- Breast ultrasound ziyisongezo esibalulekile uma sisetshenziselwa kanye ne-mammograms. Ngezinye izikhathi bangakwazi ukuhlukanisa i-cyst emzimbeni oqinile, futhi uma i-cyst ekhona ingasuswa ngaphansi kweseluleko se-ultrasound ukuxazulula inkinga. Ama-ultrasound angasetshenziswa kanye ne-mammogram njengethuluzi lokuhlolisisa labesifazane abanezinyosi ezinomsoco futhi, kodwa banezinga eliphakeme kakhulu lamanga elihle.
Okusho ukuthi banesilinganiso esiphakeme sokuphakamisa umdlavuza noma ngabe umdlavuza awukho.
Ku-ultrasound, izimpawu ezibonisa umdlavuza zihlanganisa ubuningi obuqinile obungavamile, ama-margins angavamile, kanye "nokuma okungafani."
Izifo ze-Breast MRI Nge-Cancer Breast
I-MRIs yesisu ngokuvamile igcinwa ngabesifazane abanengozi ephakeme yokuthuthukisa umdlavuza webele, sebevele benomdlavuza wesifuba, noma njengesifundo sokulandelela ekutholeni okungenakulinganiswa kumammogram, ultrasound, nokuhlolwa. Ku-MRI, okutholakele okubonisa ukuthi umdlavuza webele usubandakanya ububanzi obunamacu amacici, ukuthuthukiswa kobuningi emhlabeni wonke, noma yini eyaziwa ngokuthi "i-washout kinetics."
Isisu se-Breast and Cancer
I- biopsy yebele iwuvivinyo oluqondile uma umdlavuza usolwa. Lokhu kungenziwa njengenaliti yokufisa inaliti (ngokuvamile igcinelwe ama-cysts asebele), isisekelo se-needle biopsy , i- stopotactic breast biopsy , noma i-biopsy yokuvula evulekile. Uma imiphumela yocwaningo lwe-biopsy kanye ne-imaging lingavumelani, i- biopsy evulekile (evulekile) ilandelwa ngokujwayelekile.
I-biopsy inganquma nokuthi uhlobo lomdlavuza uma umuntu ekhona nokuthi kukhona i-estrogen, i-progesterone, ne-HER2 receptors. Njengoba kuphawuliwe ngenhla, ngisho nakwabesifazane abanokutholwa kwe-mammogram kanye ne-ultrasound okuphakamisa umdlavuza, kusengenzeka ukuthi i-biopsy izoba yinhlonipho.
Ngakho yiziphi izimo zesifuba ezifanisa umdlavuza webele emhlolweni wokuhlola noma ukucabanga okudinga i-biopsy? Kuneziningana ezimbalwa esizozibuka lapha. Ezinye zazo zivame kakhulu kunabanye, futhi izimo ezingezansi azikho ohlwini ngokulandelana.
I-Cancer Isifo-Bheka
Kungase kubonakale sengathi kufanele kube khona umehluko ocacile phakathi kwezinguquko zomdlavuza ezingezona umdlavuza esifubeni sakho, kepha ngezinye izikhathi lokhu kungaba nzima kakhulu. Ngisho noma sikhathazeka kakhulu mayelana nokulahlekelwa ukuxilongwa komdlavuza webele, sikhathazeke ngokuthi ushintsho olubi ngumdlavuza lubangela ukukhathazeka okukhulu nokudabuka.
Ngamanye amazwi, uma unesimo esingajwayelekile sokuthi unomdlavuza ekuhlolweni, noma ubukeka njengomdlavuza emkhathini, khumbula ukuthi kungase kube yingozi. Kuze kube yilapho i-biopsy isenziwa futhi amaseli abukwa ngaphansi kwe-microscope odokotela abangakutshela ngokuqinisekile. Izimo ezifana nomdlavuza ekuhlolweni noma ekucabangeni zibalwe ngezansi. Ake sibheke ngayinye yalezi ziseduze.
I-Fat Necrosis
I-necrosis yamafutha yesifuba ngokwezwi nezwi isho ukuthi "amafutha afile." I-necrosis ye-Fat iyisisusa esivame kakhulu sezinyosi ezincelisayo futhi zingabonakala futhi zibukeke kakhulu njengomdlavuza emulmogram. Ngokuvamile kulandelwa ukulimala esifubeni engozini yemoto noma ukulimala kwezemidlalo. Izindawo ze-fat necrosis nazo zivame ukulandela izinqubo zokuhlinza ezifana nokunciphisa amabele, ukuvuselelwa kwebele, noma ukuhlinzeka ngemithi yomdlavuza wesifuba. Ukushiswa komdlavuza webele webele kungabangela necrosis fat, ukukhulisa ukukhathazeka ngokuphindaphindiwe .
Lezi zindebe ngokuvamile zizwa zikhuni futhi ngezinye izikhathi zithenda. Kungase kukhishwe ku-ingono. Mhlawumbe ukwesabisa okwedlula konke okuvame ukubangela ukukhanda kwesikhumba okuholela ekuqedeni kwe-nipple noma inversion; isibonakaliso esaziwayo somdlavuza webele. Ku-mammogram, bangaba nomumo ongavamile ngomngcele we-spikey kanye nezinkampani ezincane. I-fat fat necrosis nayo ingabonakala njengomdlavuza ku-PET scan. I-biopsy ingadingeka yenziwe ukuze iqinisekise ukuxilongwa.
I-Radial Scar
Amacembe omlilo ayingxube yezinyosi ezinkanyezi ezivame ukungena kodwa zingase zivikeleke . Amacembe omsindo awabangeli izibilini zesifuba kodwa angabangela ubuhlungu besisu . Ku-mammogram, izibazi ezinkulu zomsakazo zingabonakala njengezinkanyezi ngemingcele ye-spikey. Ayinto engavamile futhi ivele kaningi emadodeni asephakathi kweminyaka engama-40 no-60. Angabangelwa ukuvuvukala, ukuhlinzwa kwebele, noma izinguquko ze-hormonal.
I-biopsy cishe idinga njalo, kodwa ngisho nangaphansi kwe-microscope izibazi zomsakazo zingalingisa umdlavuza webele, ikakhulukazi i -carcinoma ye-tubular yebele . Ukudideka izinto ngisho nangaphezulu, ngezinye izikhathi amangqamuzana anomdlavuza afihle ngaphakathi kwesikhala somsindo.
Isisu
I-mastitis yisimo lapho kukhona ukuvuvukala nokuvuvukala kwesifuba noma ngaphandle kokutholakala kwesifo. Isimo esivamile esiphathelene namaphesenti angama-20 omama abahlengikazi kepha singase senzeke kwabesifazane abangekho ukuncelisa. Isifuba sivame ukubomvu futhi sibe nesineke futhi singathintwa nezimpawu ezifana ne-fever, chills, nama-body aches. Ukwelashwa kuvame ukuhlanganisa ama-antibiotics, ukuphumula nokuphathwa kokuncelisa.
Inkinga ukuthi umdlavuza wesifuba wokuvuvukala ungabheka kakhulu njenge-mastitis ekuqaleni, futhi uvame ukutholakala kuphela ngemuva kokuba owesifazane uphathwe okokuqala ngenxa yesifo sokushaya isisu (ngokuvamile esingazange sithuthukise izimpawu). Ama-akhawunti omdlavuza webele we-inflammatory for cishe amaphesenti angu-1 emdlavuza wamabele kanye nabesifazane ngokuvamile abanayo inhlama futhi ngokuvamile ayibonisi ku-mammogram. Ngokuqhathaniswa nomdlavuza wesifuba ovuvukalayo nge-mastitis kukhona ukufana okuningi, nakuba umdlavuza wesifuba wokuvuvukala ungase ube ne-inversion ye-ingono nokubukeka kwe-orange peel esikhumbeni kanye. Nge-mastitis, yilapho kwakhiwa amangqamuzana egazi amhlophe nokwanda kwegazi okuphumela emalinini, kanti ngomdlavuza wesifuba ovuvukalayo, izimpawu zihlobene nokuba khona kwamangqamuzana omdlavuza avimbela iziteshi zethempeli esifubeni.
I-mastitis ene-granulomatous iyinhlobonhlobo ye-mastitis evame ukubangelwa izimo ze-rhumum, i-sarcoidosis, noma isifo sofuba. Kungaba futhi idiopathic. I-mastitis ekhululekile iholela ezinkathini ezide zokuvuvukala esifubeni futhi ekuqaleni kungaba nzima ukuhlukanisa umdlavuza wesifuba ovuvukalayo ku-mammogram, ultrasound, noma i-MRI.
I-Cooper's Ligament Fibrosis ne-Scars
I-Cooper's ligaments yizinhlaka ezisekelayo zesifuba, futhi abantu abaningi bazijwayele lokhu njengemigqa ofuna ukuhlala ngayo uma ukhula. Ukwehliswa kwalezi zimpawu ngokuhamba kwesikhathi kusengaphambili ukuba uhlanganise "i-droop ye-Coop" ebhekisela "emanzini" amabele aneminyaka yobudala.
I-Fibrosis ye-Cooper's ligaments ingenzeka ngenxa yezinguquko zomzimba ezinamahloni ezinonya futhi ezilimazayo.Le yindlela eyodwa lapho izicubu ezingaphansi ziholela ekutheni uphinde uguquke kanye nezinguquko ebusweni bokubonakala kwesikhumba. Kodwa izimo zesifuba ezinobuthi, ezifana nokuvuvukala, ama-fat necrosis, nezibazi ze-biopsy nazo zingalimaza lezi zimpawu ezibangelwa ukubonakala komdlavuza wesifuba.
I-Sarcoidosis
I-Sarcoidosis yisimo esibucayi esibonakala ukwakheka kwe- granulomas kuwo wonke umzimba. Uma ukhona emaphashini, ngokuvamile kuvame ukukhwehlela nokuphefumula, nakuba amaphesenti angu-50 abantu azinakwenzeka ngesikhathi sokuxilongwa.
Inkinga ye-sarcoidosis iyakhathazeka kakhulu ngabesifazane abaye bathola ukuthi banesifo somdlavuza webele wesandulela ngculazi. I-Sarcoidosis granulomas ingavela kakhulu njengomdlavuza we-metastatic kwi-PET scan, futhi ngisho namasampuli we-biopsy kungaba nzima ukuhlaziya. Isibonelo, i-granulomas ne-metastases yomdlavuza wesifuba ingabheka ngokufanayo kufana ne-sentinel node noma i-lymph node biopsy. Lokhu kungaholela ekuxilongweni okungamanga komdlavuza we-lymph node noma umdlavuza webele we-metastatic kumuntu onesifo esinezinkinga zesifo se-lymph node-negative.
Ukukhathazeka ngokweSifo sikashukela
Ukukhathazeka ngesifo sikashukela kuyisifo esinesifo esiyisifo esibuhlungu esingatholakala kubantu besifazane (namadoda) ngohlobo lwe-1 futhi uthayiphe isifo sikashukela esincike ku-insulini. Ekuhlolweni, ukukhathazeka kwesifo sikashukela kubonakala njengenqwaba yezinyosi ezingenabuhlungu ezingalingisa umdlavuza webele. Kubangelwa ukuhlanganiswa kokuvuvukala kanye ne-fibrosis encane emabeleni.
Ukucabanga okutholakele kungahlukaniswa nomdlavuza wesifu ku-mammogram, i-ultrasound (lapho ingabheka ikakhulukazi i-ominous) ne-MRI. Kulezi zifundo, isimo sibonakala njengabantu abaningi abachazwe kabi. Iningi le-needle biopsy ngokuvamile liyadingeka ukuze kutholakale ukuxilongwa.
I-fibromatosis
I-Breast fibromatosis, ebizwa nangokuthi i-tumor demoid, ibhalwa cishe ngamaphesenti angu-0,2 emiswini yebele. Akuqinisekile ukuthi yini ebangela lesi simo kodwa kubonakala sengathi isebenza emindenini. I-mammogram ne-ultrasound fibromatosis ingafanisa ukutholakala komdlavuza webele. Ukuxilongwa ngokuvamile kwenziwa nge-biopsy eyinhloko.
I-Granular Cell Tumor
Izicubu ze-cell granular, ezibizwa nangokuthi i-breast granular cell myoblastomas, zingavela kakhulu njengomdlavuza webele. Ngenkathi ivame ukubola, zivela kumaseli e-Schwann, amaseli atholakele ohlelweni lwezinzwa.
Lezi zicubu zivame ukhiqiza isikhumba se-fibrotic futhi sikulungiselele ku-fascia ngaphansi kwebele. Lokhu kubangela inhlama ebonakala ihleliwe, efana nomdlavuza wesifuba. Ngokuvamile futhi kunzima kakhulu, okufana nomdlavuza. Ekucwaningweni kokucwaninga okunjenge-mammogram nabo bafana nomdlavuza. Bavame ukuba nemingcele echazwe kahle kodwa nge-spiculation ebonisa umdlavuza.
Isilinganiso seminyaka yabantu abane-granular cell tumor tumor kuyinto engu-40, futhi zenzeka kokubili abesifazane nabesilisa.
I-spindle cell lesions
Izilonda zesisu ezinama cell spindle zinselele kumazinga amaningi. Izilonda ze-spindle zingase zizwe futhi zibukeke zingabonakali kusuka emdlalweni webele, kodwa lezi zilonda zingabonakala kakhulu njengomdlavuza ngaphansi kwe-microscope ngemuva kwe-biopsy. Ukwengeza, zombili izibilini zesifuba ezinobungozi kanye nomdlavuza zingase zifake amangqamuzana. Ngenhlanhla, izilonda ze-spindle zivamile, kodwa kufanele zibhekwe ngokuhlukana kokuhlukana kwesampuli se-biopsy.
I-Myofibroblastoma iyinhlamba engavamile yesisu esiwela ngaphansi kwesigaba sezilonda ze-spindle. Kungenzeka ku bobabili besifazane nabesilisa futhi kungaba yinselele ukuxilonga.
I-Pseudoangiomatous Stromal Hyperplasia (PASH)
I-pseudoangiomatous stromal hyperplasia noma i-PASH yinkinga etholakala kakhulu kulabo besifazane phakathi nesikhathi sokuya esikhathini nokudala. Kubonakala sengathi kuvame kakhulu kulabo abathathe ama-hormone (njengamaphilisi okuvimbela ukubeletha noma ukwelashwa kwe-hormone esikhundleni), labo abasebenzisa utshwala, nalabo abakhuluphele ngokweqile. Lezi zicubu ezinobuthi zivame ukukhula kakhulu, futhi i-biopsy evulekile (kunokuba nje i-biopsy eyinhloko) ivame ukudingwa ukuze ihlolwe.
Izwi elivela
Njengoba kuphawuliwe ngenhla, kunezimo eziningi ezincelisayo zesifuba ezingalingisa umdlavuza webele ekuhlolweni, izifundo zokucabanga, futhi kwezinye izimo ngisho nangaphansi kwe-microscope. Nakuba belahlekelwa umdlavuza webele yilokho abantu abaningi abesabayo, ngokungaziphathi bacabanga ukuthi inhlama noma ukuguqulwa ngumdlavuza uma kungenakwenzeka ukuthi kube nokukhathazeka ngokomzwelo. Izimo ezibukeka njengomdlavuza webele zingabangela izifundo ezengeziwe zokuzicabangela, izingqungquthela ze-biopsies, ngisho nama-biopsies avulekile, konke okuthatha umonakalo ongokomzwelo.
Into ebaluleke kakhulu ongayenza uma uthola noma yikuphi uhlobo lokungajwayelekile, noma ukuzwa komunye kumammogram wakho, ukubuza imibuzo eminingi. Hlala esihlalweni somshayeli futhi ulindele izimpendulo. Ukuba ummeli wakho siqu kungakusiza kakhulu ekunakekeleni ukunakekelwa kwakho kokubili nokunciphisa inani lokuhlukunyezwa ngokomzwelo lokhu okungajwayelekile okujwayelekile okuletha ekuphileni kwethu.
> Imithombo:
> Fazzio, R., Shah, S., Sandhu, N., noK. Glazebrook. I-Idiopathic I-Mastitis Ye-Granulomatous: Ukubuyekeza Nokubuyekeza. Ukuqonda Ukufaka Ukufanekisa . 2016. 7 (4): 531-9.
> Kochoyan, T., Akhmedov, M., Shabanov, A., no I. Terekhov. I-Sarcoidosis Ukulingisa I-Breast Cancer Metastasis: Umbiko Wezehlakalo Nokubuyekeza Kwamabhuku. I-Biology Cancer and Medicine . 2016. 13 (3): 396-398.
> Mario, J., Venkataraman, S., Dialani, V., noP. Slanetz. Izilonda Zezinsana ZaseBenign I-Cancer Mimic: Ukunquma Radiologic-Pathologic Concordance. I-Radiology esebenzisiwe . 2015. 44 (9): 28-32.