Yɛn mu pii suro bere a yɛte asɛmfua ‘Nufu mu Kokoram ’ no, ɛnte saa? Nanso so wunim sɛ eyi nyɛ yare biako pɛ, ɛsono emu biara? Kokoram ko a wowɔ ankasa a wubehu no ho hia yiye wɔ ayaresa a wubenya no a wubehu no mu. Enti momma yɛnka eyi ho asɛm tiawa na yɛmfa adamfofa kwan so nnɛ. Saa nneɛma yi a wubehu no bɛyɛ ahoɔden kɛse ama wo.
Kokoram a wɔkyekyɛ mu sɛnea baabi a efi ase te
Ɔkwan biako a nnuruyɛfo fa so ka nufu mu kokoram ho asɛm ne baabi a efii ase wɔ nipadua no mu ne sɛ ebia atrɛw anaa.
Sɛ yɛbɛka no tiawa a, nufu mu kokoram dodow no ara yɛ nea wɔfrɛ no carcinoma. Eyi kyerɛ sɛ wofi ase wɔ ntini a ɛwɔ nufu no mu ne akwaa afoforo no mu. Eyinom mu dodow no ara hyɛ subtype a wɔfrɛ no adenocarcinoma mu. Eyinom yɛ kokoram ahorow a efi ase wɔ nufu no mu ntini a ɛde nufusu kɔ anaa ntini a ɛma nufusu (lobules) no mu.
Ductal Carcinoma a Ɛwɔ Ntini Mu
Eyi ne nufu mu kokoram a abu so sen biara. Ɛsan nso wɔ afã atitiriw abien.
1. Ductal Carcinoma In Situ (DCIS): Eyi ne nufu mu kokoram a edi kan koraa . Asɛmfua 'In Situ' kyerɛ "baabi a ɛwɔ." Eyi kyerɛ sɛ kokoram nkwammoaa no da so ara wɔ nufusu ntini no mu nkutoo. Wɔntrɛw nkɔ abɔnten. Saa ɔkwan yi na ɛde nufu mu kokoram a wɔahu no foforo 5 biara mu bɛyɛ 1 ba. Nea eye sen biara ne sɛ ɛkame ayɛ sɛ wotumi sa saa ɔkwan yi koraa.
2. Invasive Ductal Carcinoma (IDC): Eyi ne nufu mu kokoram a abu so sen biara . Ɛyɛ nufu mu kokoram a wɔahu nyinaa mu bɛyɛ 80%. 'Invasive' kyerɛ "aggressive." Eyi kyerɛ sɛ kokoram nkwammoaa no atrɛw wɔ nufusu ntini no akyi na akɔ ntini a atwa ho ahyia no mu. IDC a ɛte sɛɛ no mu ahorow nketewa pii wɔ hɔ. Ɛwom sɛ wɔn ho yɛ den kakra de, nanso momma yɛnhwɛ wɔn tiawa.
| IDC Subtype a Wɔde Yɛ Adwuma | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Medullary Kokoram a Ɛma Ntini Mu | Enya ne din efisɛ ɛte sɛ ntini a ɛyɛ mmerɛw wɔ amemene no mu. Ɛntaa nsi koraa (ennu 5%). |
| Mucinous Kokoram a Ɛyɛ Nwonwa | Nneɛma a ɛte sɛ nsu (mucin) pii atwa kokoram nkwammoaa no ho ahyia. Eyi nso ho yɛ na (ennu 2%). |
| Tubular Carcinoma a Ɛwɔ Ntini Mu | Kokoram nkwammoaa wɔ nneɛma a ɛte sɛ nsukorade wɔ wɔn mu. Eyinom taa nyin akuwakuw na wɔyɛ wɔn ade yiye bere a wɔde sa yare no. |
| Papillary Kokoram a Ɛma Nnipa Yɛ Adwuma | Mmeae a kokoram nkwammoaa a ɛkɔ soro te sɛ nsateaa (papules) wɔ hɔ. Wɔtaa ba mmea a wɔn mfe akɔ anim mu. |
| Cribriform Kokoram a Wɔde Di Dwuma | Wobetumi ahu nsusuwso bi a ɛte sɛ koko wɔ kokoram a wɔntaa nhu yi nkwammoaa ntam. |
Lobular Kokoram
Wɔ saa su yi mu no, nkwammoaa a ɛnteɛ nyin wɔ nufu no mu ntini a ɛma nufusu (lobules) no mu.
- Invasive Lobular Carcinoma (ILC): Eyi ne nufu mu kokoram a ɛto so abien a abu so sen biara. Saa kokoram yi fi ase wɔ nufu no mu na ɛtrɛw kɔ ntini a atwa ho ahyia no mu. Afei etumi trɛw kɔ nipadua no afã afoforo te sɛ ntini a ɛma mogya tu no.
- Lobular Carcinoma in Situ (LCIS): Mma edin yi nnyɛ wo hu. Nnuruyɛfo mmu LCIS sɛ kokoram ankasa efisɛ ɛntrɛw nkɔ nufu no akyi. Nanso, sɛ wowɔ LCIS a, ɛkyerɛ sɛ asiane a ɛwɔ hɔ sɛ wubenya nufu mu kokoram daakye no dɔɔso kakra .
Nufu mu kokoram ahorow afoforo a wɔntaa nhu
Eyinom nyɛ nea abu so kɛse, nanso ɛfata sɛ wuhu ho asɛm.
- Nufu mu kokoram a ɛyɛ hyew: Eyi yɛ nea ɛntaa nsi koraa (ennu 5%) na emu yɛ den. Ɛsono ne sɛnkyerɛnne ahorow wɔ afoforo no ho. Kokoram nkwammoaa siw ntini a ɛma mogya tu wɔ nufu no mu no kwan. Eyi ma nufu no hohoro, ɛyɛ kɔkɔɔ, na honam ani yɛ den . Ɛtɔ mmere bi a, nufu no honam ani hwɛbea betumi ayɛ sɛ borɔdɔma . Saa ɔkwan yi betumi atrɛw ntɛmntɛm.
- Phyllodes Tumor: Eyinom yɛ akisikuru a wɔntaa nhu a ɛba wɔ nufu no ntini a ɛka bom no mu. Wɔn mu 4 biara mu 1 pɛ na onya kokoram. Nea aka no yɛ akisikuru a ɛnyɛ hu.
- Angiosarcoma: Saa kokoram yi ba mogya ntini ne ntini a ɛma mogya tu no mu. Ɛtaa ba nnipa a wɔadi boro mfe 70 so.
- Paget Yare : Eyi nso ho yɛ na yiye. Ɛyɛ kokoram a ɛba nufu no mu ne baabi a atwa ho ahyia (areola). Ebia nufu no honam ani ayɛ mmerɛw, ayɛ kɔkɔɔ, na ayɛ mmerɛw . Nnipa pii a wɔwɔ Paget yare no nso wɔ kokoram bi a wɔfrɛ no DCIS anaa IDC.
- Nufu mu Kokoram a Ɛtrɛw: ‘Metastatic’ kyerɛ sɛ kokoram no atrɛw wɔ nufu no akyi akɔ nipadua no afã afoforo. Nnuruyɛfo nso frɛ eyi sɛ "ɛkɔ anim" anaa "ɔfã 4." Ɛtaa trɛw kɔ mmerɛbo, amemene, nnompe, anaa ahurututu mu.
Nea ɛho hia ne sɛ, ɛmfa ho kokoram ko a obi wɔ no, hokwan a ɛwɔ hɔ sɛ ne ho bɛtɔ no no yɛ kɛse kɛse bere a wohu no ntɛm na wɔasa no yiye no.
Kokoram a wɔkyekyɛ mu sɛnea awosu mu nkwaadɔm ne hormone ahorow te
Sɛ wohu sɛ wowɔ nufu mu kokoram wie a, wo duruyɛfo bɛyɛ nhwehwɛmu titiriw bi wɔ kokoram nkwammoaa no so ahwɛ sɛ ebia nkwaadɔm a wɔfrɛ no estrogen anaa progesterone , anaasɛ awosu mu nkwaadɔm pɔtee bi wɔ hɔ a, ɛrenya kokoram no nyin so nkɛntɛnso anaa.
Ɛyɛ nhwehwɛmu ahorow yi mu na oduruyɛfo no paw ayaresa a ɛfata sen biara, a wɔde wɔn ani asi so ma wo.
- HER2-positive: Bɛyɛ nufu mu kokoram 5 biara mu 1 kura protein bi a wɔfrɛ no `HER2` (Human Epidermal Growth Factor Receptor 2). Saa protein yi boa ma kokoram nkwammoaa nyin. Kokoram a ɛwɔ HER2 no betumi ayɛ nea ano yɛ den kɛse. Nanso ayaresa ahorow bi wɔ hɔ a wɔde wɔn ani si so a wɔde wɔn ani si protein yi so, na ɛma ɛyɛ mmerɛw sɛ wɔbɛsa.
- Hormone Receptor-positive anaa negative: Kokoram nkwammoaa binom wɔ mmeae titiriw (receptors) wɔ wɔn ani a hormone betumi abata ho. Fa no sɛ nkwammoaa no sɛ ɔpon, na saa nneɛma a ɛma wogye nneɛma yi te sɛ safe ntokuru a ɛwɔ mu no.
- ER-positive: Kokoram nkwammoaa wɔ nneɛma a ɛma nipadua no tumi kyekyere hormone estrogen.
- PR-positive: Kokoram nkwammoaa wɔ ntini ahorow a etumi kyekyere hormone progesterone no.
- Hormone receptor-positive kyerɛ sɛ abien yi mu biako anaa abien no nyinaa wɔ hɔ. Esiane sɛ hormone boa ma kokoram ahorow yi nyin nti, wobetumi de nnuru a esiw hormone ano (hormone therapy) asa no yiye.
- Hormone receptor-negative kyerɛ sɛ saa nkwaadɔm abien yi nyinaa nni hɔ.
- Triple-negative: Saa ɔkwan yi na ɛyɛ bɛyɛ 15% wɔ nsɛm no mu. Sɛnea edin no kyerɛ no, saa kokoram nkwammoaa yi wɔ estrogen receptors (ETRs)., progesterone receptors (PR) ne HER2 nyinaa nni hɔ. Enti, wontumi mfa hormone therapy anaa HER2 a wɔde wɔn ani asi so sa. Eyi betumi ama ayaresa ayɛ den kakra, nanso ayaresa afoforo wɔ hɔ a wobetumi de adi dwuma, te sɛ nnuru a wɔde sa yare.
Sɛ wuhu kokoram ko a wowɔ wie a, wo ne wo duruyɛfo nkasa pefee mfa sɛnea ɛka hokwan a wowɔ sɛ wo ho bɛtɔ wo ne ayaresa a eye sen biara a wubetumi apaw ho. Nsuro sɛ wubebisa nsɛm no nyinaa.
Nkrasɛm a Wɔde Kɔ Fie
- Nufu mu kokoram nyɛ yare biako, ɛsono emu biara.
- Kokoram ko a wowɔ no gyina baabi a efii ase wɔ nufu no mu (nufusu ntini/ntini ahorow), sɛ ebia atrɛw, ne sɛ ebia hormone ahorow bi (ER, PR) anaa protein ahorow (HER2) aka no so.
- Ahorow bi te sɛ DCIS wɔ ayaresa dodow a ɛkɔ soro yiye, bere a ahorow te sɛ Inflammatory Breast Cancer betumi ayɛ basabasa kɛse.
- Wo kokoram no hormone ne awosu (receptor) tebea a wubehu no ho hia na ama woanya ayaresa a etu mpɔn sen biara na wɔde wɔn ani asi so.
- Mma ntwentwɛn wo nan ase da sɛ wo ne wo duruyɛfo besusuw nsɛmmisa biara a wowɔ wɔ sɛnea wɔahu wo, kokoram ko, ne ayaresa nhyehyɛe ho. Sɛ́ wɔbɛbɔ wɔn amanneɛ no yɛ ɔko a wodii nkonim no fã.
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