Umdlavuza webele we-metaplastic (i-carcinoma ye-metaplastic yebele) uhlobo olungajwayelekile lomdlavuza webele. Kungaba yinkimbinkimbi yokwelapha futhi okuncane kakhulu kuyaziwa ngezimbangela noma ukubikezela isikhathi eside.
Umdlavuza wesifuba we-metaplastic uwuhlobo lomdlavuza we- ductal ongenawo umonakalo , okusho ukuthi ubumba emathangeni obisi bese uqhubekela kwezinye izicubu zesifuba.
Lezi zomshukela zihlukile kwezinye izinhlobo zomdlavuza webele ngoba lezi zicubu zivame ukuqukethe ezinye izinhlobo zezicubu ezingatholakali esithombeni. Isibonelo, lezi zicubu zingase zihlanganise amangqamuzana angama-squamous (isikhumba) noma amangqamuzana ososeous (amangqamuzana amathambo.)
I-Metaplastic vs. Metastatic
Igama elithi metaplastic lizwakala kakhulu njenge-metastatic, kodwa lezi zinezincazelo ezifani kakhulu. I-Metaplastic ivela enkulumweni yesiGreki yokuthi "ishintshwe ngesimo," 'yingakho isetshenziselwa ukuchaza amangqamuzana abonakala sengathi ashintshe abe yenye ingxenye yomzimba. I-Metastatic ivela emagameni esiGreki athi "ashintshiwe endaweni," 'kuchaza umdlavuza oye wasakazeka kusuka endaweni yawo yokuqala ukuya kwezinye izindawo.
Umdlavuza wesifuba we-metaplastic ungase udideke nesikhathi semetaplasia, njengoba ngezinye izikhathi isetshenziselwa ukuchaza okutholakala okungavamile ku-biopsy. Uma i-metaplasia yegama isetshenziswe embikweni wezokukhubazeka ochaza amangqamuzana angavamile kolunye uhlobo lwesicu, ngokuvamile kuvame ukusetshenziswa ukuchaza amangqamuzana angavamile kodwa engakabi nomdlavuza.
Izimpawu
Abanye besifazane abanomdlavuza webele we-metaplastic abanalo izimpawu nhlobo futhi babonakala ngokuhlola okujwayelekile. Kwabanye, izimpawu zifana nakwezinye izinhlobo zomdlavuza webele. Lokhu kungafaka:
- Ukuhamba noma ukuqina esifubeni okwakungekho ngaphambili
- Ukuthambekela, ukukhishwa noma ukuguquka ngokubukeka kwengono
- Izinguquko ekubukeni kwesikhumba sebele: ukubomvu, ukulinganisa, ukubhoboza noma ukuchofoza
- Ukuthukuthela kwesifuba, kufaka phakathi ubomvu, ukuvuvukala, nokuqhuma
- Ubuhlungu obungaziwa ebilweni , ikakhulukazi nganoma yiziphi izimpawu ezingenhla
Ukuxilongwa
Izivivinyo zokuxilonga umdlavuza webele zifana nanoma ngabe uhlobo luni lomdlavuza lukhona. Ukuhlola ukuhlolwa okungasetshenziswa kuhlanganisa:
- I-mammography yokuxilonga . Lokhu kufana nesimo sakho sokuhlolisisa umkhuba, ngaphandle kokuthi ukuhlolwa komdlavuza (kunokuba nje uhlole umdlavuza) kudinga izithombe eziningi okufanele zithathwe futhi zihlolwe.
- I-Ultrasound . Lokhu kusetshenziselwa amagagasi omsindo ophezulu wokukhiqiza izithombe zezincuba zesifuba. Lezi zithombe zisiza odokotela ukuba banqume ukuthi isifuba esiswini singumkhuhlane ogcwele amanzi noma isisu esiqinile.
- I-imagination resonance magnetic (MRI) . Lokhu kusetshenziswa amasimu amakhulu ukukhiqiza izithombe ngaphakathi ngaphakathi komzimba.
- Ukuskena kwe-Computed tomography (CT noma i-CAT) . Lokhu kudala izithombe eziningi "ngamacici" ngamaphakathi emzimbeni, bese uzihlanganisela esithombeni esinqunyiwe esinqunyiwe esingabonisa ukutholakala kwezicubu.
- Ukuskena kwe-Positron-emission tomography (PET) . Ngemuva kokujola kwama-sugar molecule, i-PET isithathwa ukuze ibone ukuthi yiziphi izindawo zomzimba ezithatha ushukela ngokushesha kakhulu. Ngenxa yokuthi amangqamuzana omdlavuza akhula ngoshukela, "avule" ku-PET scan.
- I-PET-CT scan. Lokhu kuhlanganisa ubuchwepheshe be-PET ne-CT, okwenza odokotela baqaphele ukuthi yimaphi amangqamuzana angaba nomdlavuza futhi anqume ngokuqondile ukuthi bangaphi emzimbeni.
Ku-mammography, umdlavuza webele we-metaplastic ungabonakala ufana kakhulu kokubili kwe-carticoma ye-ductal kanye nezixuku ezinobungozi ezingenza ukuthi ukuxilongwa kube nzima nakakhulu.
Isisu se-Breast
Noma yiziphi izivivinyo zokucabangela ezingenhla zingaba usizo ekufundeni okwengeziwe ngesifo, kepha i-biopsy yebele idingeka ukuthi inqume uhlobo oluqondile lomdlavuza webele futhi ufunde ngezici zesisu, njengebanga lesisu (ukuhlukunyezwa kwesisu) nesimo se-receptor.
Ukuze uhlolisise ngokuqondile umdlavuza webele we-metaplastic, izicubu zesifuba kumele zibe yi- biopsied , okusho ukuthi ezinye izicubu zisusiwe esiswini (ngokuhlinzwa noma ngenaliti ekhethekile) futhi zihlolwe ngaphansi kwe-microscope. I-biopsy ngokuvamile yayizolandela uhlobo oluthile lokucabanga ukuze kuqinisekiswe ukuthi kukhona isisu esinomdlavuza okwamanje (ngokungafani nesifo esibuhlungu, noma i -cyst egcwala amanzi ).
Izici
Kubalulekile ukuthi uqaphele ukuthi akukho mdlavuza webele womzimba ofanayo, ngisho nezicubu ezitholakala njengomdlavuza webele we-metaplastic. Noma iyiphi yalezi zici kungenzeka ingabi yiqiniso ngomdlavuza wakho othize. Amathumba we-mataplasti we-metaplasti avame ukuba nesibindi futhi akhule ngokushesha. Zibuye zivame ukuphikisa kokubili ukwelashwa kwamakhemikhali kanye nama-hormonal therapies.
Ukwelapha
Ngenxa yokungavamile, izindlela zokuphatha zokwelashwa ezingcono kakhulu aziwa ngempela, kodwa kubonakala sengathi ukuhlinzwa ukukhipha isisu kanye nokwelapha imisebe kunenzuzo enkulu kakhulu. Imvamisa ephansi yaloluhlobo lwesifo sikhombisa futhi ukuthi inkambo yokuzama nokuyiqiniso encwadini ishicilelwe kalula. Noma kunjalo, njengalo lonke umdlavuza, ukwelashwa kuqala kuholwa ngu:
- Ubukhulu nendawo yesikhumba
- Kungakhathaliseki ukuthi umdlavuza usakazeke (lokhu kufaka ukusabalalisa kwesifunda kuya kuma-lymph nodes kanye nokusabalala okude ezindaweni ezifana namathambo, isibindi, amaphaphu, nobuchopho)
- Impilo yomuntu jikelele
- Ukuguga lapho kutholakala khona
Ngemibuzo engqondweni, isinyathelo sokuqala kuvame ukuhlinzwa ukukhipha isisu esibonakalayo. Ukusuka lapho, imiphumela elandelayo evela ku-biopsy ingasiza ekutholeni isinyathelo esilandelayo:
- Ukuvivinywa kokuthola i-hormone. Izivivinyo zokubheka i-estrogen ne-progesterone receptor positivity inquma ukuthi amaseli omdlavuza azophendula kahle yini ukwelashwa kwe-hormone, njenge- tamoxifen , noma i-aromatase inhibitors njenge-adjuvant therapy. I-Tamoxifen isebenza ngokuvimbela ama-estrogen receptors kumaseli okubeletha angama-precancerous and cancerous, njengoba i-estrogen ibopha nalezi zitholampilo ukuze kubangele ukukhula kwezidumbu zesisu se-estrogen. I-Aromatase inhibitors isebenza ngokuvimbela ukuguqulwa kwama-hormone wesilisa (androgens) ku-estrogen, ngaleyo ndlela kunciphisa isici sokukhula kwamanye amagciwane ebele.
- Ukuvivinya amaprotheni angu-HER-2. Iprotheni ye-HER2 iningi ngaphezu kweyodwa-yesine yazo zonke izinhlobo zomdlavuza webele. Uma le phrotheni itholakala ku-tumor ye-biopsied, ukwelashwa no- Herceptin (trastuzumab) kungaba yindlela yokukhetha. I-FDA-eyamukelwa ngo-1998, i-Herceptin ibopha amaprotheni ama-HER-2 ngamangqamuzana omdlavuza, ukuze izici zokukhula emzimbeni zingakwazi ukubopha futhi zenze ukuba lesi sifo sikhule. Njengoba i-Herceptin ivunyelwe, kukhona imithi eyengeziwe etholakalayo kanye ne-HER2 emihle kakhulu.
Izinketho zokwelashwa ezingcono kakhulu (ngaphezu kwemithi yokwelashwa yama-hormonal noma okuhlosiwe uma isisu singumamukeli we-estrogen noma i-HER2 positive ihlanganisa:
- Ukuhlinzwa: I-lumpectomy noma i- mastectomy yindlela yokwelapha ecacile kakhulu. Njengoba isifo somdlavuza we-metaplastic sivame ukuba sikhulu kunezinye izinhlobo zomdlavuza webele uma kutholakala ukuxilongwa, imastectomy ingadingeka esikhundleni se-lumpectomy.
- I-Chemotherapy: Eziningi zalezi zomshukela zisesimweni esiphezulu kunesilinganiso somdlavuza webele esifundweni kanti ngakho-ke i-chemotherapy ivame ukuphakanyiswa. Lokho kusho ukuthi, i-chemotherapy ayibonakali ephumelelayo kumdlavuza webele we-metaplastic.
- Ukwelashwa kwezidakamizwa: Omunye wezifundo ezinkulu kuze kube yimanje, ukuhlola okwenziwa ngo-2017 okubheka ukwelashwa kwemithi kwakuthola ukuthi le mithi yokwelashwa kwe-adjuvant ibalulekile ekuvimbeleni ukuphindaphinda kwendawo kanye nesifundazwe emdlalweni we-metaplastic.
Ukubhekana
Ukuba nesimo esingavamile somdlavuza webele kungakusiza uzizwe ungakodwa futhi udidekile. Nazi ezinye zezindlela zokusiza ukunciphisa ukukhathazeka kwakho:
- Thola iqembu lokusekela . Isibhedlela sakho noma isikhungo sokwelashwa komdlavuza singase samukele amaqembu asekelayo for iziguli zomdlavuza webele, noma, okungenani, sikwazi ukukudlulisela kwelinye. Ngisho noma ngabe nguwe kuphela oqenjini le nalesi sifo sokuxilonga, cishe uzohlangana nabesifazane ababhekana nemithi efanayo futhi banemibuzo efanayo nawe.
- Thola ku-intanethi. Ukuxhuma nabanye abanomdlavuza webele we-metaplastic, ungajoyina imiphakathi e-intanethi lapho iziguli zihlanganyela khona nakho kwabo. I-American Cancer Society inehlu olukhulu lamaqembu asekelayo okuxhumeke ku-inthanethi ukuze uqale.
- Cabanga ngesilingo somtholampilo. Udokotela wakho angazi ngezivivinyo zemitholampilo ezihlose ukufunda kabanzi mayelana nesimo sakho. Ukungena ngemvume kulezi zivivinyo kungaba yindlela enhle yokukusiza uzizwe uxhumekile kwinqubo futhi ube nesandla ekutholeni izinketho zokwelapha ezintsha. Ukuze ufunde kabanzi mayelana nezinzuzo nezingozi zokuhlolwa kokuhlolwa kwemitholampilo nokuthi ungayithola kanjani, thintana ne-website ye-National Institutes of Health ye-trial trial.
> Imithombo:
> Levrer, C., Berriochoa, C., Agrawal, S. et al. Izinto ezibikezelayo ngemiphumela ye-Metaplastic Breast Cancer. Ucwaningo lwe-Cancer Research and Treatment . 2017 Julayi 8. (i-Epub ngaphambi kokuphrinta).
> McKinnon, E., noP. Xiao. I-Carcinoma ye-Metaplastic ye-Breast. I-Archives of Pathology kanye neLab Medicine . 2015. 139 (6): 819-22.
> Tzanninis, I., Kotteas, E., Ntanasis-Stathopoulos, I., Kontogianni, P., noG. Fotopoulos. Ukuphathwa kanye Nemiphumela ku-Metaplastic Breast Cancer. I-Cancer Clinical Cancer . 2016. 16 (6): 437-443.