Ukuxilongwa, Ukwelashwa, Amanani Okusinda
Umdlavuza wesifuba we-Stage 3 uphambili kakhulu kunesigaba sesi-2 , kodwa akubhekwa njengemetastatic. Ngenxa yalesi sifo, umdlavuza awusakazeki kusuka esifubeni kuya ezithombeni noma kwezinye izindawo ezikude emzimbeni, kodwa amangqamuzana omdlavuza azodlulela ezithombeni eziseduzane (axillary) lymph nodes, noma afakwe emagqeni angaphansi kwesifuba sakho (sternum) noma ngaphansi i-collarbone yakho.
Sibutsetelo
Isisu sesifuba sesifuba sesi-3 singaba ngesayizi esingaphansi kwe-2 cm kuya ku-5 cm, kodwa ngezinye izikhathi asikho isidumbu esitholakala emathisini asebele. Lesi sigaba somdlavuza webele wezinyosi singasifaka isifuba sesifuba esingaphansi kwesifuba, noma singathinta isikhumba sebele. Uma isikhumba sesifuba siguqukile noma siguliswa ngumdlavuza, kungaba umdlavuza webele wesibindi (IBC).
Isigaba sesi-3 ngumdlavuza wesifuba ongenayo ongachazwa ngezimo ezintathu: 3A, B, noC. Lokhu kuqhutshelwa ngokuhlukunyezwa ngobukhulu be-tumor nesimo se-node, njengoba kuchazwe uhlelo lwe-TNM . Ngisho noma i-lymph nodes ingahileleka, isigaba sesi-3 asibhekwa njengemetastatic.
I-TNM Isiteji sesigaba 3 Igciwane lesisu
Umdlavuza wesifuba we-Stage 3 uhlehliselwe esigabeni 3A, 3B, no-3C. Njengoba izincomo zokwelapha kanye nesandulela-ngculazi zingahle zihluke kakhulu phakathi kwalezi zindawo, kudingekile ukulinganisa okucophelelayo. Ekuqaleni, uhlelo lwe-TNM lungadanisa. Kodwa ukuchazwa kwe-T, N, ne-M, kuvumela odokotela ukuba banqume ngokucacile isiteji.
I-TNM ibhekisela ku:
- T: usayizi we-tumor. I-T0 ibhekisela kumdlavuza webele ongakatholakali esithombeni sakho sebele kodwa sekutholiwe kwenye indawo. I-T1 ihlanganisa izicubu ezinama-2 cm (azungeze u-1 intshi) noma usayizi obuncane. I-T2 ihlanganisa izicubu eziphakathi kuka-2 cm no-5 cm ngobubanzi. Izicubu ze-T3 zikhulu kunama-5 cm. Izicubu ze-T4 zingaba yisayizi kodwa zihlasela udonga noma isikhumba sekhanda. I-T4 ihlanganisa umdlavuza webele wesibindi.
- I-N: nodes. I-N0 isho ukuthi isisu asizange sisakaze kuma-lymph nodes. I-N1 ibhekisela emathunjini asakaze ema-lymph nodes eseduze (kufika ku-3). I-N1mi isho ukuthi kukhona ama-micrometastases, noma amaseli we-tumor angabonakala kuphela ngaphansi kwe-microscope. I-N2 isho ukuthi i-tumor isakaze emakhanini angama-4 kuya kwangu-9 ngaphansi kwengalo noma kukhona ukusabalalisa okuphawulekayo emaphilini amancane angaphakathi. I-N3 ingabhekisela ezinkingeni eziningana ezihlukene, njengokungathi kunezintambo ezingu-10 noma ngaphezulu ezithandekayo noma uma umdlavuza usakaze emakhakheni angaphansi kwe-collarbone.
- I-M: i-metastases. I-M0 isho ukuthi ayikho imishini eseduze. I-M1 ibhekisela ezinhlakalweni eziye zahlukaniswa (ziyisigaba 4) futhi zisakazekile. Lapho umdlavuza webele usakazeka amasayithi avamile kakhulu okuyi-metastase amathambo, isibindi, ubuchopho, noma amaphaphu.
Isigaba 3A Igciwane lesisu
- Isigaba 3A: T0, N2, M0: Asikho isidumbu esitholakale esihlokweni sesifuba, kodwa amangqamuzana omdlavuza afakwe emagqabini e- lymph nesikhumbuzo sakho noma esifubeni sakho.
- Isigaba 3A: T1, N2, M0: I-tumor ingu-2 cm noma encane, noma ivule kancane emathunzini asebele. Ngaphezu kwalokho, umdlavuza usakaze kuma-lymph nodes e-underarm noma ama-node esifubeni sakho.
- Isigaba 3A: T2, N2, M0: I-tumor ingaphezu kuka-2 cm, kodwa ngaphansi kwe-5 cm ngaphesheya. Ikhansela liye laya kuma-lymph nodes ku-underarm yakho noma ama-node esifubeni sakho.
- Isigaba 3A: T3, N1, M0: Lesi sifo sikhulu kunama-5cm ngaphesheya futhi asizange sivame isikhumba sesikhumba noma imisipha yesikhumba sesifuba. I-Cancer itholakale ema-nymph nodes angaphansi kwe-underarm.
- Isigaba 3A: T3, N2, M0: Lesi sifo sikhulu kunama-5cm ngaphesheya futhi asikathinteki izikhumba zesikhumba samabele noma esifubeni. I-Cancer itholakale ku-nymph nodes noma ama-node esifubeni sakho.
Isigaba 3B I-Cancer Breast
- Isigaba 3B: T4, N0, M0: Isidumbu singase sibe nanoma yisiphi isayizi futhi sithinte isikhumba sebele, noma sakhulile sibe ngodonga lwakho lwesifuba, ngaphandle kokubandakanya umsizi we-pectoralis. Ngezinye izikhathi umdlavuza ufinyelela kokubili isikhumba sakho sebele kanye nodonga lwesifuba. Lesi sifo singase sibe nomdlavuza webele wesibindi.
- Isigaba 3B: T4, N1, M0: Lesi sifo singaba yisayizi futhi singahlanganiswa nesikhumba noma udonga lwesifuba, noma kungenzeka sibe nomdlavuza webele wesibindi. I-Cancer ibuye itholakale nasezikhungweni ze-symph nodes eduze nesifuba esithintekile.
- Isigaba 3B: T4, N2, M0: Lesi sifo singaba yisayizi, sithinta isikhumba sesifuba noma udonga lwesifuba, noma kungaba umdlavuza webele wesibindi. I-Cancer ibuye itholakale nasezikhungweni ze-symph nodes noma ama-node ngaphakathi kwebele.
Isigaba 3C Cancer Cancer
- Isigaba 3C: T (noma yikuphi), N3, M0: Lesi sifo sinoma yisiphi isayizi, kodwa siqukethe ngaphakathi kwezicubu zesifuba kuphela. Udonga lwakho lwesifuba nekhanda lesifuba akumele lithinteke. Isimo se-lymph node sizohluka kanje: umdlavuza ungatholakala emanzini ngaphansi kwengalo yakho, ngaphakathi kwebele, phezu kwe-collarbone yakho, noma ngaphansi kwe-collarbone yakho. Ngokufanayo, umdlavuza ungabonisa ezindaweni eziningana kulezi zindawo.
Isilinganiso sokusinda
Isilinganiso seminyaka emihlanu yokusinda emdlalweni wesibeletho sesifuba sesi-3 singamaphesenti angu-73, kodwa lokhu kungashintsha ngokusekelwe endaweni kanye nezinye izici eziningi ..
Ama-oncologists akhuluma ngamanani okusinda umdlavuza webele ngenxa yemali emihlanu yokuphila. Lokho akusho ukuthi isiguli esiphezulu sizoba neminyaka emihlanu yokuphila ngemva kokuxilongwa! Kusho ukuthi lezo ziguli zasinda okungenani iminyaka emihlanu engaphenduliwe, futhi iningi lazo lihlala isikhathi eside. Akuzona zonke iziguli ezizokwehliswa umdlavuza webele, kodwa zingase zife kwezinye izinto.
Udokotela wakho uzokhuluma nawe mayelana nemibono yakho eyingqayizivele yokusinda, ngokusekelwe empilweni yakho jikelele, ubudala, ezinye izimo, nesimo sakho se- hormone yomdlavuza. Izinombolo odokotela abasebenza nazo zisekelwe kwizibalo ezivela eqenjini elikhulu labantu, kodwa kungenzeka ukuthi azihambisani necala lakho ngokuqondile. Ngaphezu kwalokho, lezi zinombolo zibonisa ukusebenza kwangaphambilini kwalokhu ukwelashwa; Amagugu abelokhu ekhuphuka eminyakeni embalwa edlule.
Ukwelapha
Uhlelo lwakho lwezokwelapha luzofaka phakathi ukuhlinzwa, i-chemotherapy, futhi ezimweni eziningi, imisebe. Uma isisu sakho sine-HER2-positive , uzonikezwa u-Herceptin, futhi uma ngabe u-hormone-sensitive (estrogen kanye / noma i-progesterone-positive), ungalindela ukuthatha ukwelapha kwama-hormone okungenani iminyaka emihlanu ngemuva kokwelashwa okuyisisekelo kuphela.
Izicubu ezincane ezingazange zivele esikhunjeni noma emisipha zingasuswa nge- lumpectomy , futhi kudingeke ukuthi i-sentinel node biopsy idingeke ukuthi ikwazi ukuthola ukuthi imilavuza isebenze ngaphesheya kwesifuba sakho. Izicubu ezinkulu, kuhlanganise nalabo abaye bahlasela udonga lwesifuba, kuzodinga i- mastectomy kanye ne-lymph node biopsy. Ukuvuselelwa kwesisu kunganikezwa kuwe, kodwa ngezinye izikhathi kufanele kubambezelekile ngenxa yokwelashwa kwemisebe .
I-Chemotherapy inikezwa ukuxosha noma yimaphi amangqamuzana omdlavuza emzimbeni wakho; lokhu kusiza ukuvimbela ukuphindaphindiwe. Kodwa i-chemo ingaphinde yanikezwe ngaphambi kokuhlinzwa ukuze igweme isisu. Uma i-chemotherapy inikezwa ngemuva kokuhlinzwa ekuqaleni komdlavuza wesifuba kubizwa ngokuthi "i-adjuvant chemotherapy." Uma kunikezwa ngaphambi kokuhlinzwa kubizwa ngokuthi "i-neoadjuvant chemotherapy."
Ngezinye izikhathi lapho isikhumba sebele sihileleka ngomdlavuza, kubizwa ngokuthi umdlavuza webele wesibindi. Ukwelashwa okuvamile njengokhemotherapy ngokuvamile kuyindlela yokwelashwa yokuqala yomdlavuza webele wokuvuvukala; lokhu kokubili kunciphisa isisu esikhulu, okwenza kube lula ukuthi udokotela ohlinzayo asuse, futhi abulale amaseli amathumba ahambayo emzaneni nasendaweni engabonakali ngokucacile ngamaseli omdlavuza. Ngaphandle kokususa lezi zingxenyeni zamangqamuzana omdlavuza, amaphethelo avame ukuqhubeka ebonisa okuhle, ngokuvamile okuholela ekuhlinzekeni okuphindaphindiwe nokubukeka okubi kakhulu kokuthunyelwe kwe-post-op. Umdlavuza wesibindi wesifuba cishe njalo udinga i-mastectomy ne- axillary lymph node dissection.
Ukunakekelwa Okulandelwayo
Izindlela zokwelapha ezilandelayo zizoxhomeka ku-hormone yakho nesimo se-HER2. Uma ukwelashwa okusebenzayo sekuphelile, uzobe uneminyaka engu-5 yokulandela ukuhlolwa kokuhlolwa nge-oncologist yakho, lapho kungase kudingeke uthathe ukwelashwa kwe-hormone uma isisu sakho sibhekene nobuhlungu be-hormone. Uzobe une-mammogram yakho yaminyaka yonke futhi kufanele uhlale unamanje ngeziqu zakho zokuzihlola , uma nje usenayo izicubu zesifuba ngemuva kokuhlinzwa. Ngokusekelwe ekubeni nomdlavuza webele, udokotela wakho angancoma i-MRIs ngezikhathi ezithile zesifuba sakho. Hamba ohlelweni lokudla okunempilo, futhi uxoxe nodokotela wakho ngomsebenzi omuhle wokuzivocavoca ozokwakha kabusha ukuqina kwakho nenhlalakahle yakho.
Izwi Elivela Esigabeni 3 I-Cancer Breast
Isiteji sesi-3 yisigaba sokuqala somdlavuza wesifuba esithuthukisiwe kunazo zonke kodwa sisaphathwa kakhulu. Futhi ukwelashwa kuyaqhubeka. Isibonelo, ngo-2017 ukungezwa kwama-bisphosphonates kwanezelwa kumdlavuza wesifuba we-estrogen wokunciphisa ingozi yokuthi umdlavuza uzosakazeka emathanjeni. Khumbula ukuthi izibalo ozizwayo uma ufunda mayelana nokusinda azicabangi lezi zindlela zokwelashwa ezintsha. Ukufinyelela kwabanye kuye kwaboniswa ukuthuthukisa amanani okusinda. Joyina iqembu lokusekela noma uthole umphakathi womdlavuza onthanethi. Ngaphezu kwakho konke, yiba ngummeli wakho ekunakekelweni kwezempilo, hhayi nje ngomdlavuza wesifuba, kodwa ukugcina impilo yakho yonke emva kokwelashwa.
> Imithombo:
> I-AJCC Manual Staging Manual Umshicileli we-6. I-Springer Verlag, eNew York, NY. 2002, iphe. 223-240.
> I-American Cancer Society. I-Breast Cancer Ukusinda Amanani ngeSiteji.
> I-American Cancer Society. Ukwelashwa Kwesifo Sebelevuza Esisabekayo, By Stage.
> National Cancer Institute. Izigaba ze-Cancer Breast. Isigaba IIIA-C.
> Uthando, uSusan M. Nginjani uhlobo lweKhansela yesifuba: Ukugxila. Pp. 303-321. UDkt. Susan Love's Breast Book. UMqulu wesihlanu we-MD, ngo-2010.