I-Estrogen ne-Progesterone I-Cancer Positive Breast
Uma uye waba nesifo sokubeletha kwebele noma ukuhlinzeka ngomdlavuza wesifuba (noma i-mastectomy noma i-lumpectomy), enye yezinto zokuqala ezenziwa ukucacisa isimo se-receptor ye-tumor yakho. I-hormone receptor status, futhi, kubaluleke kakhulu ekukhetheni izinketho ezinhle zokwelashwa zomdlavuza wakho. Ake sihlole izivivinyo ezahlukene ze-hormone, ukuthi kusho ukuthini isimo esihle noma esibi, nokuthi lokhu kuthinta kanjani izinyathelo ezilandelayo ekuxilongweni nasekwelapha.
Ukuhlolwa kwe-Estrogen ne-Progesterone Receptor
Izivivinyo ze-Estrogen kanye ne-progesterone receptor yizivivinyo "ze-biomarker" ezenziwa kuzo zonke izifo zomdlavuza webele. Lezi zizovela emibikweni yakho yezokwelapha ngemuva kokubili kokubili kwe-biopsy nasemuva kokuhlinzwa. Abamukeli babuyiselwa emuva uma ubuyeke ukuphindaphindiwe, njengoba bangashintsha uma isisu siphindela noma sisakazeka. Ama-hormone receptors anqunywa ngokusetshenziswa kwe-microscope kusampula ye-biopsy.
Ukuqonda abalamukeli bamaHormone
I-Estrogen ne-progesterone receptors yizinhlelo zamaprotheni ezitholakala ebusweni bamaseli webele. I-Estrogen ne-progesterone zixhuma kulezi zitholampilo (njengesikhiye nesihluthulelo) ukukhombisa ukuthi iseli likhule futhi lihlukanise. Wonke amangqamuzana webele anama-receptors, kodwa atholakala ezinombolweni eziningi kakhulu kumaseli omdlavuza webele abhekwa njengento enhle.
Ukuze uvimbele isignali esakhiwe uma i-estrogen noma i-progesterone ibopha kulezi zamukeli, kubalulekile ukwenza enye yezinto ezimbili.
Unganciphisa inani le-estrogen emzimbeni (ngokusebenzisa ukwelashwa kwe-ovarian ukwelashwa ngaphambi kokuya esikhathini sokuqala noma ukusebenzisa i-inhibitor ye-aromatase ngemuva kokumisa isikhashana) noma uvimbele i-receptor ukuze i-estrogen ekhona emzimbeni ayikwazi ukubopha nge-receptor.
Ukubaluleka Kwe-Estrogen Ne-Progesterone Isimo Nge-Cancer Sebele
Amagciwane okubeletha okuyi-estrogen (kanye / noma i-progesterone) enhle "aqhutshwa" yi-estrogen.
Akuwona wonke amangqamuzana omdlavuza webele abhekwa yi-estrogen. Amanye amakhemikhali ebeletho esikhundleni salokho i-HER2 enhle. Nalezi zomshukela, izici zokukhula emzimbeni zibophezela kuma-receptors e-HER2 phezu kwamangqamuzana omdlavuza ukushayela ukukhula kwesisu. Amanye amakhemikhali webele ayinayo yalezi zamukeli futhi abizwa ngokuthi "amagciwane angama-triple".
Ezinye izifo zomdlavuza webele zizobili i-hormone receptor positive futhi i-HER2 enhle. Ngala makhambi, amangqamuzana angase avuselelwe ukuba akhule nge-estrogen / progesterone ebophayo kwi-estrogen noma i-progesterone receptors, noma ngezimo zokukhula ezibophezela kuma-receptors we-HER2. Lezi zomshukela zingase zibhekwe ngokuthi "zomshukela webele" kathathu. (Funda kabanzi mayelana nendima ye-estrogen emdlalweni webele).
Isimo Esihle Ne-Negative Estrogen
Amaphesenti e-Estrogen Receptor positive (ER +) asho ukuthi i-estrogen ibangela ukuba isisu sakho sikhule, nokuthi umdlavuza kufanele uphendule kahle ukwelashwa kwe-hormone. Uma lesi score si-Estrogen Receptor negative (ER-), khona-ke isisu sakho asiqhutshwa yi-estrogen, futhi imiphumela yakho izodinga ukuhlolwa kanye nezinye izivivinyo, njengezimo zakho ze- HER2 , ukucacisa ukwelashwa okuphumelela kakhulu.
Kufanele Ucele nini i-Numerical Score?
Uma ukuhlolwa kwesimo sakho se-hormone kuthathwa njengento engalungile, kuhle ukubuza udokotela wakho ngenombolo ekhombisa amaphuzu wangempela.
Ngisho noma inombolo ingaphansi, umdlavuza ungaphathwa kahle nge-hormone therapy.
Izikolo ze-Harmon Status Receptor
Embikweni wakho we-pathology, ungabona ama-Hormone Status. Lokhu kuboniswa njengenombolo ephakathi kuka-0 no-3. Nazi indlela yokuqonda izinombolo:
- 0 ayikho imitholampilo etholakalayo,
- I-1+ yinombolo encane,
- I-2+ yinombolo ephakathi, futhi
- I-3+ yinani elikhulu lama-receptors.
Ungathola futhi inani lamaseli angaphandle kwamangqamuzana angu-100 ahlolwe ama-hormone receptors. Lokhu kubhaliwe njengenombolo ephakathi kwamaphesenti angu-0 (ayikho i-receptors) namaphesenti angu-100 (wonke amaseli anemitholampilo).
Izinketho zokwelapha for Acrogen Receptor Positive Cancer Breast
Uma i-tumor yakho i-ER + futhi / noma i-PG +, ngokuvamile ukwelashwa kwama-hormonal kunconywa.
Nokho, ukukhetha imithi kuncike esimeni sakho se-menopausal.
Ngaphambi kokuya esikhathini, ama-ovari akhiqiza inani elikhulu kakhulu le-estrogen. Ukuze uvimbele le-estrogen ekuhlanganiseni amaseli omdlavuza ukuze akhulise, kusetshenziswa imithi ebizwa ngokuthi i-estrogen receptor modulator ekhethiwe. Lezi zidakamizwa, njenge- tamoxifen , zibophezela kumamukeli we-estrogen ukuze i-estrogen ingakwazi ukubopha.
Ngemuva kokuphuma esikhathini, isimo sihlukile. Kune-estrogen engaphansi kakhulu emzimbeni. Esikhundleni sama-ovari eshiqiza i-estrogen, umthombo oyinhloko we-estrogen emzimbeni ukuguqulwa kwe-androgens (ama-hormone ahlobo lwesilisa) ku-estrogen. Lokhu kusabela kuthathwa yi-enzyme eyaziwa njenge-aromatase. Imithi ebizwa ngokuthi i- aromatase inhibitors ingavimbela le enzyme ukuze i-estrogen ingabonakali, futhi ayikwazi ukubopha emangqamuzaneni omdlavuza ukuze akhulise.
Kunezinhlobo ezintathu ze-aromatase inhibitors manje ezitholakalayo:
- I-Arimidex (i-anastrozole)
- I-Aromasin (i-exemestane)
- I-Femara (letrozole)
I-Aromatase inhibitors ingase isetshenziswe ngezinye izikhathi kumama-premenopausal ngemuva kokwelashwa kwe-ovarian. Okokuqala, ukusetshenziswa kwezidakamizwa okuvimbela ama-ovari ukwenza i-estrogen. (Enye indlela, nakuba kungenjalo okokuqala, ukukhipha ama-ovari). Khona-ke, owesifazane angashintshwa kusuka ku-tamoxifen kwenye ye-aromatase inhibitors. Ukwenza kanjalo kubonakala kunenzuzo yokuphila yabesifazane abathile abanomdlavuza webele.
Kukhona nezinye izindlela zokwelapha ezingasetshenziswa ngezikhathi ezithile. I-Faslodex (fulvestrant) i-downrogen-receptor-regulator regulator (SERD) ekhethayo. Kungasetshenziselwa abesifazane abanokuqhubeka komdlavuza wabo ngenkathi ku-tamoxifen noma i-aromatase inhibitor. Ngaphezu kwalokho, kunezinye izindlela zokwelapha ze-hormonal zomdlavuza webele we-metastatic ezingase zibhekwe kwabanye abantu.
Abamukeli beHormone ne-Breast Cancer Recurrence noma iMetastases
Ngama-cancer amabele asekuseni okuyi-estrogen receptor, ama-hormonal therapies anganciphisa ukuphindaphinda cishe isigamu, kungakhathaliseki ukuthi i-tamoxifen isetshenziselwa abesifazane base-premenopausal noma i-aromatase inhibitors esetshenziselwa labo abangama-postmenopausal.
I-Estrogen Receptor I-Tumor Positive ne-Bisphosphonates
Muva nje, i- bisphosphonates yengezwe kanye nama-aromatase inhibitors ezincelweni zesifo se-postmenopausal zesifuba esesandulela isifo se-estrogen esifanele. Uma zisetshenziselwa i-aromatase inhibitors zibonakala zinciphisa ingozi yokuphindaphinda, ikakhulukazi ukusakazeka komdlavuza webele emathanjeni.
Ubude Bokwelashwa
Esikhathini esidlule, ukwelashwa nge-tamoxifen noma i-aromatase inhibitors ngokuvamile kuvunyelwe iminyaka emihlanu. Manje sekucatshangwa ukuthi ukusebenzisa i-aromatase inhibitor iminyaka engaphezu kwengu-5 kunciphisa ingozi yokuphindaphinda kwabesifazane abanomdlavuza webele abakhulu amathuba okuphindaphinda. Kubalulekile ukukhuluma nodokotela wakho mayelana nezincomo zamanje zesikhathi eside sokwelashwa ngokuhambisana nalezi zifundo ezintsha.
Ngezansi ku-Receptor Receptor Ukuhlolwa kwe-Cancer Breast
Isimo se-receptor ye-hormone yingxenye ebaluleke kakhulu yokuxilongwa komdlavuza webele. Uma i-tumor is receptor receptor positive (ER +) kusho ukuthi i-estrogen "umshayeli" ekukhuleni komdlavuza. Ngokufanayo, i-progesterone receptor positive (PG +) iqhutshwa ubukhona be-progesterone. Ngokuvamile, kodwa hhayi njalo, isisu sizoba yi-ER + no-PG + noma i-ER- ne-PG-.
Kwabesifazane be-premenopausal, ukuvimbela i-estrogen receptor kumaseli omdlavuza wesifuba kuyindlela evamile. Kwabesifazane be-postmenopausal, ukuvimbela ukwakhiwa kwe-estrogen ema-tissue e-peripheral yi-aromatase inhibitors kuyindlela evamile. Ukusebenzisa ukwelashwa kwama-hormonal kulabo abanesisindo sokuqala se-estrogen noma ama-progesterone receptor positives kunciphisa kakhulu ingozi yokuphindaphinda. Kulabo besifazane abanomdlavuza webele we-metastatic, ukwelashwa kwama-hormone kungakwandisa isikhathi sokuphila futhi ngokuvamile kunciphise izimpawu zesifo.
> Umthombo:
> National Cancer Institute. Ukwelashwa Kwemdlavuza Webele (PDQ) -Health Professional Version. Kubuyekezwe ngo-10/13/17. https://www.cancer.gov/types/breast/hp/breast-treatment-pdq