Uma uke waba ne-breastpiece, i- lumpectomy , noma i- mastectomy eyenziwe futhi yabuyisela emuva imiphumela kusukela ebhodini le-pathology, uzofuna ukuqonda lokho okushiwo yi-stage ingxenye yombiko. Ukugxila kuhlobene nokukhethwa kokwelapha kanye namanani okusinda.
Enye yezinto zokuqala ongazibuza ukuthi, "Ingabe umdlavuza usakaze ngaphesheya kwesisu, noma konke kusendaweni eyodwa?" Okwamanje, asikho ukuhlolwa okulula okukunikeza impendulo yalo mbuzo, kodwa kukhona uhlelo lokuhlukanisa umdlavuza ngezigaba, ngokusekelwe ezintweni ezintathu.
Uhlelo lwe-TNM lwe-Stage Cancer Staging
Uhlelo lwesiteji esisetshenziselwa kakhulu uhlelo lwe-TNM.
- I-T isetshenziselwa ubukhulu besisu. Esikhathini esithombeni (i-mammogram noma i-ultrasound) ye-tumor, i-radiologist ingenza isilinganiso sesayizi yethambo. Ngezinye izikhathi lokhu kunzima ukukwenza, kuye ngokuthi i-angle ye-tumor maqondana nefilimu yesithombe, noma uma i-tumor ejulile ngaphakathi kwebele. I-tumor inezinhlangothi ezingekho emthethweni, noma ezingavamile, ngezinye izikhathi ezibizwa ngokuthi i-spiculated shape. Akuzona njalo nxazonke, futhi zingaba isikhathi eside kunazo zonke. Indlela enembile kunazo zonke yokuthola ubukhulu besisu kufanele ukukhipha konke, bese uyilinganisa. Ubukhulu be-Tumor buhlukaniswe ngezigaba ezine: T-1 ivela ku-0 - 2 amasentimitha, i-T-2 ivela ku-2 - 5 cm, i-T-3 ingaphezulu kuka-5cm, futhi i-T-4 iyisisu esinoma yisiphi isayizi esiphukile (ulcerated) isikhumba noma ifakwe emgqeni wesifuba.
- I isetshenziselwa isimo se-Lymph Node. Njengoba umdlavuza ungahamba ngomzimba wakho ohlelweni lwakho lwe-lymph, kubalulekile ukuthi ube ne- lymph nodes yakho esiseduzane ne-tumor ehlolwe umdlavuza kanye ne-micro-metastasis. Kunezindlela ezimbili zokuhlola ama-lymph nodes: ngokuthinta, nangokuhlinzwa. Uma izilonda zakho zitholakala ngokuthinteka, udokotela wakho ohlinzayo uzozizwa (isikhumba) ngaphezulu kwezingqimba ze-lymph, futhi uzilinganise. Uma udokotela ohlinzayo engeke azizwe noma yikuphi ukuguqulwa kwama-node, ukulinganisa ngu-N-0, uma udokotela ohlinzayo ezwa ukuvuvukala futhi ecabanga ukuthi ama-node ayenayo (umdlavuza) isilinganiso ngu-N-1. Uma i-lymph nodes izwa sengathi ivuvukala futhi ihlanganiswe ndawonye (kunalokho i-lumpy), ivalwe i-N-2, noma uma iseduze ne-collarbone, ivalwe N-3. Indlela yesibili yokuhlola i-lymph nodes i- sentinel node biopsy.
- M isetshenziselwa iMetastasis. I-Metastasis ithinta isigaba somdlavuza. Uma isampula yama-node esuliwe ngokuhlinzwa futhi sivivinywa, futhi ecacile ngomdlavuza, zilinganiselwa ku-M-0, kodwa uma zinamaseli omdlavuza noma i-micrometastasis kuwo, zilinganisiwe M-1. Lokhu kukutshela ukuthi i-tumor ichithe amaseli ngaphesheya kwendawo yayo yangempela, nokuthi umdlavuza ungaba kwezinye izingxenye zomzimba.
Lonke ulwazi lwe-TNM luzohlanganiswa kabili, kanye nodokotela ohlinzayo kanye, futhi futhi nomhlengikazi kulebhu. Isazi ngasinye sizokunikeza umbono ngomdlavuza ngokwemigomo yayo ye-TNM. Ayikho yale mibono kuyoba yimpendulo ngqo "yimuphi umgqa lo mdlavuza?" Kungase kudingeke ukwazi okwengeziwe mayelana nayo, njengokuthi
- isimo se-receptor ye-hormone (ekhishwa yi-hormone)
- ibanga le-tumor (ijubane lokukhula)
- futhi uma isakaze (isisetshenzisiwe)
- lapho uye waya emzimbeni wakho
Zonke lezi zinto zithinta ukuxilongwa kwakho futhi zizocatshangelwa uma ubheka izinketho zakho zokwelapha.
Izigaba ezine zesifo somdlavuza webele
Kunezigaba ezine zomdlavuza webele, futhi ukuxilongwa kwakho kuxhomeke kwisilinganiselwa se-TNM yesisu. I-carcinomas e-precancerous in situ ibizwa ngokuthi i- Stage Zero . Nansi indlela isigaba kanye nezinombolo ze-TNM ezihlobene ngayo.
- Isigaba 1 sisho ukuthi une-T-1 tumor futhi usula ama-lymph nodes ngaphandle kobufakazi bemetastasis, noma i-T1N0M0.
- Isigaba 2 okungenani iziqephu ezintathu, okuyi-inhlanganisela ye-T1, T2, noma i-T3, i-lymph nodes emihle noma engalungile, futhi akukho metastasis; isibonelo T1N0M0.
- Isigaba sesi-3 sinezigaba ezingenani ezintathu, okuvela ekuxubeni kwanoma yisiphi isayizi se-tumor, ama-lymph node amahle noma ama-node asezindaweni ze-collarbone, futhi akukho metastasis; isibonelo T3N1M0.
- Isigaba sesi-4 sibizwa nangokuthi umdlavuza wesifuba se-metastatic futhi silinganiswa ngokuba nesayizi ye-tumor, i-lymph nodes enhle noma emibi, nesimiso se-metastasis esicacile, isibonelo, i-T1N1M1.
Yeka ukuthi ubukhulu bomzimba bulinganisani
Ubukhulu be-tumor bulinganiswa nomshini we-radiologist usebenzisa i-mammogram noma isithombe se-ultrasound esithathwe esifuba sakho. Kodwa akuzona zonke izicubu ezilula, izinhlobo ezizungezile ezilula ukulinganisa. Isibonelo, i-tumor ingaxiliswa njengamazambane aphekiwe futhi isithombe singase sibe ngecala lapho i-radiologist ingakwazi ukubona zonke izilinganiso. Futhi ezinye izicubu ziba nemiphetho engavamile ngakho kunzima ukulinganisa ububanzi bomthamo.
Ukuthola Isithombe Esihle Sokuhlukumeza
Ekuqaleni kokuthola yonke imininingwane ngomdlavuza wakho, uthola isithombe esicacile se-tumor. Uma kuziwa ekuhloleni ubukhulu besisu sakho ngaphambi kokuhlinzwa, odokotela bathembele emiphumeleni yezifundo ze-imaging. Ake siqhathanise nezindlela zokucabangela zesifuba ezijwayelekile:
- I-Mammogram: I- movie yendabuko yemifanekiso ingasetshenziswa ukuveza izicubu zesifuba, kodwa ingenembile kakhulu emathisini amathunjini aminyene. Uma ngabe ungumama we-menopausal noma ungakaze ukhulelwe, amabele akho angase abe namandla kakhulu ukufihla izixuku, okwenza kube nzima ukukala. Kodwa uma u-post-menopausal, unezicubu ezincelisayo, noma ukhulelwe, ifilimu mammography ingakwazi ukukala ngokunembile isisu sakho. I-Digital mammography isebenza kahle kakhulu emathisini amathunti aminyene futhi ingasetshenziswa ukuthola isilinganiso esihle sobuningi.
- I-Breast Ultrasound: Ngaphandle kokusebenzisa ukucindezela, i- ultrasound inkulu ukuhlukanisa phakathi kwe- cyst egcwala amanzi kanye nesisindo esikhulu esinjengomzimba. I-Ultrasound ingasetshenziswa ukwenza isilinganiso se-tumor yebele. Kodwa kungase kube nenembile kancane kune-mammogram, njengoba itholakale ukuthi iyanciphisa ubukhulu besisu.
- I-Breast MRI: I- MRI ayiyona engavamile futhi ayibuhlungu, futhi ayisebenzisi imisebe yokwenza uchungechunge lwezithombe zezincuba zakho zesifuba. Ngenkathi i-mammogram ingase ithole isisindo sakho, i-MRI ingadingeka ukuba uyihlole uma izicubu zakho zesifuba zikhulu noma uma i-biopsy yakho ibonisa ukuthi ubukhulu bukhulu kunalindelekile. I-MRI ingabuye isetshenziswe ngesikhathi se-neoadjuvant chemotherapy ukuqapha intuthuko yokwelapha. Ngenkathi i-MRI ingenza isithombe esicacile se-tumor yakho, ijwayele ukulinganisela ngaphezu kwesayizi langempela ngobukhulu obuthathu.
Imiphumela Yokuhlinzeka Ngezifo Eziphuthumayo
I-Biopsies nezifundo ze-imaging zinikeza ukukhanya kwe-ballpark eseduze kwesisu sakho. Kodwa udinga usayizi we-tumor wangempela ukuze wenze izinqumo zokwelapha ezingcono kakhulu. Udokotela wakho ohlinzayo uzosebenzisa ulwazi oluvela ezivivinyweni zangaphambilini njengesiqondiso lapho ususa isisu sakho. Ngemuva kwe-lumpectomy noma i-mastectomy, izicubu zakho ze-excised ze-excised zizohlanganiswa nezicubu zakho ze-biopsy, futhi udokotela ozohlola izifo uzohlola ubukhulu obunjalo. Ukulinganisa kwe-tumor yakho yisilinganiso segolide sesayizi yethambo. Umbiko wakho we-pathology we-post-surgical uzofingqa ukuxilongwa kwakho okuphelele komdlavuza webele.
Izizathu Zezokwelapha Ezizimele
Manje ukuthi uyazi ukuthi umbiko wakho wezokuthutha we-post-operation uyindlela engcono kakhulu yokuthola usayizi wakho we-tumor, ungase ubuze, "Pho kungani singakwenzi nje ukuhlinzwa kuqala futhi siphume zonke lezi ezinye izivivinyo?" Izifundo zakho ze-biopsy nokuzicabangela zenziwa ukuze zikuqondise wena nodokotela wakho ohlinzayo ekwenzeni ukukhetha okunamandla kakhulu ekuhlinzekeni kwebele.
Uma i-lumpectomy izosusa umdlavuza wakho, ungase ukwazi ukugwema i-mastectomy. Kodwa uma i-neoadjuvant chemo ingase isheshe isisu sakho ngaphambi kokuhlinzwa, khona-ke ungadinga izicubu ezincane zisusiwe. Kwezinye izimo, ezifana nomdlavuza webele wezinsaba ohlakazeka kabanzi, isisindo somzimba singase sibe yindlela yokukhetha kuphela. Ukuba nolwazi olubanzi nokuqonda ukuthi izivivinyo zakho zithinta kanjani kukusiza wenze ulwazi, izinqumo zokwelapha ezihlakaniphile.
Ukuhlela Ukuqokwa Ngodokotela Wakho
Uma uhlela uvakashele udokotela, futhi uyazi ukuthi uzoxoxa nge-diagnosis yakho, imiphumela yebhu, noma izinhlelo zokwelapha, ungafuna ukucela othile ukuba eze nawe, athathe amanothi. Uma kungenakwenzeka, ukuthatha i-tape encane yokuqopha kanye nomqondo omuhle. Ngezinye izikhathi lapho sithola izindaba ezingathandeki, kushuswa izingqondo zethu noma imizwelo yethu, futhi singase siyeke ukuthatha yonke ingxoxo. Ukuba nomngani ohlobene noma osizayo kungasiza ngempela, kokubili ukugcina irekhodi lemibuzo nezimpendulo nangokukunika umsizi womzwelo. Qiniseka ukuthi umngane wakho noma isihlobo angagcina ulwazi lwakho lwezempilo luyimfihlo uma yilokho oyifisayo.
Imithombo
Ukunyathelisa i-Cancer, iNational Cancer Institute.