So woate biribi a ɛte sɛɛ ho asɛm wɔ wo nufu mu pɛn? (Ductal Carcinoma in Situ - DCIS) Momma yɛnka eyi ho asɛm!

So woate edin `DCIS` no ho asɛm pɛn? Ebia oduruyɛfo bi kaa ho asɛm bere a woreyɛ wo nufu nhwehwɛmu `(Mammogram).` Eyi yɛ kokoram tebea ankasa a ɛba nufu no mu nufusu ntini mu, na wobetumi ahu no ntɛm ara. Mma ɛnhaw wo, sɛ wunim eyi a, ɛbɛma woanya ahotɔ pii.

Dɛn ne DCIS (Ductal Carcinoma in Situ)?

Sɛ yɛbɛka no tiawa a, DCIS yɛ kokoram a ɛba wɔ nufusu ntini a ɛwɔ wo nufu mu no mu. Saa ntini yi ne nea ɛde nufusu fi wo nufu mu kɔ wo nufu mu bere a worema nufu no. Asɛmfua "in situ" kyerɛ "wɔ beae." Eyi kyerɛ sɛ kokoram nkwammoaa no anyin afi ntini no mu na ennya ntrɛwee nkɔ nufu no afã afoforo.

Ɛtɔ mmere bi a nnuruyɛfo frɛ eyi nufu mu kokoram a ɛnyɛ nea wɔde hyɛ nipadua mu anaasɛ nea edi kan a ɛba . Eyi kyerɛ sɛ kokoram nkwammoaa no nnyinii nsen nufusu ntini no afasu. DCIS ntaa ntrɛw (metastasize) nkɔ nipadua no afã afoforo, te sɛ kokoram a ano yɛ den kɛse, a ɛkɔ nipadua no mu.

Nanso ɛwom mpo sɛ DCIS ntrɛw nkɔ nufu no akyi de, nanso wɔ tebea horow bi mu no, ebetumi abɛyɛ invasive ductal carcinoma . Ɛne sɛ, ebetumi atrɛw akɔ nufu no akyi. Ɛno nti na ɛho hia paa sɛ wo ne oduruyɛfo kasa fa eyi ho no. Afei mubetumi aka ayaresa ahorow a ebetumi atew asiane yi so ho asɛm.

DCIS abu so dɛn?

DCIS ne nufu mu kokoram a abu so sen biara wɔ mmea mu ankasa. Ɛyɛ nufu mu kokoram a wɔahu no foforo no mu 20% kosi 25% . Mmarima nso betumi anya DCIS, nanso ɛntaa nsi koraa (ennu 0.1% wɔ kokoram a wohu no mu).

Mprempren, nnipa dodow a wɔbɔ amanneɛ sɛ wɔanya DCIS no akɔ soro kakra. Nanso abenfo ka sɛ ɛnyɛ sɛ nnipa dodow a wɔanya DCIS no akɔ soro nti na eyi te saa, na mmom esiane sɛ wɔrehu nnipa pii na wɔresa wɔn yare nti . Ɛne sɛ, nhwehwɛmu te sɛ mammogram ama wɔatumi ahu tebea no ntɛm.

Dɛn ne DCIS ho sɛnkyerɛnne ahorow?

Mpɛn pii no, DCIS nkyerɛ sɛnkyerɛnne pɔtee biara . Ebia worenhu biribiara mpo. Nanso, ebia nnipa kakraa bi pɛ behu nneɛma te sɛ eyi:

• Sɛ wote nka sɛ akisikuru bi wɔ nufu no mu.
• Nufu no honam ani a ɛyɛ mmerɛw .
• Nsu a ɛtɔ (e.g., mogya) a efi nufu no mu ba.

Sɛ wuhu biribi te sɛ eyi a, ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn a ɛnkyɛ, ɛnte saa?

Dɛn na ɛde DCIS ba?

DCIS ba bere a nkwammoaa a ɛte apɔw a ɛwɔ wo nufusu ntini mu no sesa no., a ɛkyerɛ sɛ wɔn su asesa na wɔrenyin ntɛmntɛm a wontumi nni so. Te sɛ afifide ketewa bi nyin a wontumi nni so te sɛ nwura. Nanso abenfo da so ara nnim nea enti a nkwammoaa yi sesa mpofirim saa no ankasa, anaa nea enti a nnipa binom DCIS bɛyɛ kokoram a ano yɛ den bere a afoforo nyɛ saa no.

Dɛn ne asiane ahorow a ɛma obi nya DCIS?

Nneɛma bi wɔ hɔ a ebetumi ama asiane a ɛwɔ hɔ, anaasɛ ɛbɛyɛ yiye sɛ wubenya DCIS no ayɛ kɛse. Momma yɛnhwɛ nea wɔyɛ:

• Sɛ wo mogya abusuafo (ɛna, onuawa, ɔbabea) anya nufu mu kokoram a.
• Sɛ woadi kan anya nufu mu kokoram , anaasɛ wowɔ tebea bi a ɛma nkwammoaa a ɛwɔ nufu no mu nyin wɔ ɔkwan a ɛnteɛ so, te sɛ atypical hyperplasia .
• Woyɛ ɔbaa (eyi abu so wɔ mmaa mu).
• Sɛ́ wadi boro mfe 30 . Saa asiane yi kɔ soro kakra bere a obi nyin no.
• Sɛ wufii ase kɔɔ brayɛ mu ansa na woadi mfe 12 a .
• Sɛ wowoo wo ba a odi kan wɔ mfe 30 akyi a .
• Sɛ wo nufu mu ntini yɛ den dodo a, ebia wowɔ ``nufu mu ntini a ɛyɛ den'' . Mammogram nkutoo na wobetumi ahu eyi.
• Sɛ wowɔ awosu mu nkwaadɔm mu nsakrae bi (e.g., BRCA1 ne BRCA2 awosu mu nkwaadɔm) a ɛma asiane a ɛwɔ hɔ sɛ wubenya kokoram no yɛ kɛse a.
• Sɛ woadi kan anya mframa a wɔde sa wo nufu anaa wo moma so (ma tebea foforo).
• Sɛ woannyinsɛn anaasɛ woamma akokoaa nufu da a .
• Sɛ bratwa afi ase wɔ mfe 55 akyi a .

Nanso, sɛ wowɔ asiane ahorow yi mu biako anaa nea ɛboro saa a, ɛnkyerɛ sɛ wubenya DCIS, ɛnte saa? Sɛ nhwɛso no, sɛ obi anya nufu mu kokoram wɔ abusua mu a, ɛyɛ asiane a ɛde DCIS ba, nanso nnipa dodow no ara a wɔwɔ DCIS no nni abusua mu abakɔsɛm biara a ɛkyerɛ sɛ wɔanya nufu mu kokoram. Nneɛma a ɛde asiane ba no ma hokwan a ɛwɔ hɔ sɛ obi benya tebea bi no yɛ kɛse . Enti ɛho hia sɛ wohwɛ wɔn yiye.

Dɛn ne nsɛnnennen a ebetumi aba wɔ DCIS mu?

Ade a ɛho hia ne sɛ sɛ woansa DCIS a, ebetumi adan invasive ductal carcinoma . Eyi kyerɛ sɛ kokoram no betumi afi nufusu ntini no mu atrɛw akɔ nufu no mu ntini afoforo mu. Enti, sɛ wohu sɛ wowɔ DCIS a, ɛho hia yiye sɛ wubenya ayaresa ntɛm ara sɛnea wubetumi.

Bio nso, bere a wɔasa wo DCIS akyi no, wowɔ asiane mu sɛ wubenya akwahosan ho tebea afoforo bere a worenyin no. Nhwɛsoɔ:

• Osteoporosis (nnompe a ɛyɛ teateaa) .
• Mogya mmoroso
• Koma mu yare

Nea ɛbɛyɛ na asiane a ɛwɔ saa nsɛnnennen yi mu no so atew no, nyansa wom sɛ wubebisa wo duruyɛfo mpɛn dodow a ɛsɛ sɛ wokɔyɛ nhwehwɛmu ne nea wodi akyi.

Ɔkwan bɛn so na wohu DCIS?

Nnuruyɛfo nam mammogram ahorow so hu DCIS nsɛm bɛboro 90% . Ɛne sɛ, wo nufu ho X-ray. Sɛ wo mammogram aba no kyerɛ biribi a ɛyɛ adwenem naayɛ, te sɛ calcium nketenkete a ɛwɔ mu (microcalcifications) a, wɔbɛyɛ biopsy de asi so dua.

• Mammogram: Wɔ nufu mu nhwehwɛmu a wɔyɛ no daa (screening mammogram) akyi no, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ mammogram titiriw (diagnostic mammogram). Eyi betumi atwa wo nufu mu ntini ho mfonini a ɛkɔ akyiri afi mmeae ahorow. Eyi gye bere tenten kakra sen mammogram a wɔyɛ no daa.
• Nufu mu Nhwehwɛmu: Nnuruyɛfo yɛ nhwehwɛmu yi de hwɛ sɛ kokoram nkwammoaa biara nni wo nufu mu. Wɔ sɔhwɛ yi mu no, wɔfa ntini ketewaa bi na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwehwɛ mu.

So DCIS abasobɔde ahorow wɔ hɔ?

Yiw, nnuruyɛfo kyekyɛ DCIS mu abiɛsa. Sɛnea kokoram nkwammoaa no hwɛ sɛnea ɛte wɔ afiri a wɔde hwɛ nneɛma nketenkete mu ne sɛnea ɛda adi sɛ enyin ntɛmntɛm no na ɛkyerɛ saa abasobɔde ahorow yi.

• Low grade (ɛnyin brɛoo): Kokoram nkwammoaa no te sɛ nufu mu nkwammoaa a ɛte apɔw yiye. Wonyin nkakrankakra.
• Mfinimfini grade (ɛnyin ntɛmntɛm): Nkwammoaa a ɛnteɛ no te sɛ nufu mu nkwammoaa a ɛte apɔw kakra, nanso ɛsono kakra wɔ grade a ɛba fam ho.
• High grade (ɛnyin ntɛmntɛm na wontumi nni so): Kokoram nkwammoaa no hwɛbea yɛ soronko koraa wɔ nufu mu nkwammoaa a ɛte apɔw ho. Eyinom ne kokoram a enyin ntɛmntɛm sen biara na ɛda adi sɛ ɛbɛyɛ kokoram a ano yɛ den.

Dɛn ne DCIS no fã ahorow?

DCIS yɛ nufu mu kokoram a ɛto so 0 . Ɛyɛ nea wotumi sa no kɛse na wotumi sa. Nnuruyɛfo kyekyɛ kokoram ahorow mu fi ɔfã 0 kosi IV (4). Stage 0 kyerɛ sɛ kokoram no wɔ beae koro no ara a efii ase na ɛntrɛwee. Ɛwom sɛ DCIS yɛ ɔfã 0 bere nyinaa de, nanso akisikuru no betumi ayɛ kɛse biara na ebetumi aka nufusu ntini pii a ɛwɔ nufu no mu ho.

Dɛn ne ayaresa ahorow a wɔde sa DCIS?

Ɛwom sɛ DCIS nyɛ kokoram a emu yɛ den de, nanso ɛho hia sɛ wonya ayaresa . Anaasɛ ma oduruyɛfo nhwɛ wo tebea no so daa. Eyi te saa efisɛ DCIS ahorow bi, titiriw nea ɛkorɔn no, sɛ wɔansa a, ebetumi ayɛ nea ɛyɛ hu. Eyi kyerɛ sɛ kokoram no betumi atrɛw akɔ akyiri asen wo nufusu ntini no na akɔ nufu ntini a atwa wo ho ahyia no mu.

Ayaresa a wɔtaa de di dwuma ma DCIS ne:

• Nufu a Wɔkora So (BCS) anaa Lumpectomy: Eyi hwehwɛ sɛ woyi kokoram nkwammoaa no fã nkutoo fi hɔ, ne nufu mu ntini kakraa bi a ɛte apɔw a atwa kokoram no ho ahyia. Eyi yi ntini (margin) a ɛte apɔw kakraa bi fi hɔ de hwɛ hu sɛ nkwammoaa a ɛnteɛ biara nni hɔ. Wo duruyɛfo begyaw wo nufu no fã kɛse no ara a ɛnyɛ hwee.
• Mframa a wɔde sa yare: Wɔtaa de saa ayaresa yi ma bere a wɔayɛ BCS oprehyɛn akyi. Wɔde kum kokoram nkwammoaa biara a aka na ɛtew asiane a ɛwɔ hɔ sɛ kokoram no bɛsan aba no so. Nnipa binom hia saa ayaresa yi nna kakraa bi, afoforo nso hia adapɛn kakraa bi. Wo duruyɛfo no ne wo bɛkasa afa w’ankorankoro ayaresa nhyehyɛe no ho.
• Mastectomy: Eyi hwehwɛ sɛ woyi nufu a ayɛ no yaw no nyinaa, anaasɛ ɛtɔ mmere bi a woyi nufu abien no nyinaa (double mastectomy). Sɛ womfata sɛ wonya BCS (sɛ nhwɛso no, sɛ DCIS atrɛw akɔ nufu no nyinaa mu, akisikuru no sõ yiye, anaasɛ wompɛ mframa a wɔde sa yare a), ebia ɛho behia sɛ wotwa nufu no.

Sɛ wɔatwa wo nufu a, ebia wobɛpɛ sɛ wususuw nufu a wobɛsan ayɛ ho . Eyi yɛ oprehyɛn a wɔyɛ de sesa wo nufu. Wobetumi ayɛ eyi bere koro no ara mu bere a wɔatwa wo nufu no anaasɛ bere a wɔatwa wo nufu no akyi. Sɛ wowɔ BCS a, mpɛn pii no ɛho nhia sɛ wɔsan yɛ nufu no. Wo ne wo duruyɛfo nkasa mfa sɛnea wopɛ sɛ wo nufu hwɛ wɔ ayaresa akyi no ho.

Dɛn na ɛba wɔ DCIS oprehyɛn akyi?

Sɛ woyɛ oprehyɛn wie a, ebia wo duruyɛfo bɛkyerɛw nnuru ama wo na amma DCIS ansan mma bio, titiriw sɛ wo DCIS no yɛ nea ɛma nipadua no yɛ adwuma (ER-positive) a. Nnuru a wɔtaa de di dwuma ne:

• Tamoxifen (Tamoxifen - Nolvadex®) a ɛyɛ aduru a ɛma obi nya ɔyare mmoawa.
• Nnuru a esiw aromatase ano ( s.e. anastrozole, letrozole) .

Wɔfrɛ saa ayaresa yi hormone therapy . Saa nnuru yi yɛ adwuma denam hormone estrogen a esiw ano sɛ ɛbɛboa kokoram nkwammoaa ma anyin no so. Mpɛn pii no, bere a wɔde sa yare no nyinaa gye bɛyɛ mfe anum.

So wobetumi asiw DCIS ano?

Asiane pii a ɛde DCIS ba (e.g., abusua abakɔsɛm, awosu) nyɛ biribi a yebetumi adi so anaa yebetumi asiw ano ankasa. Nanso, sɛ wohu ntɛm a , ɛda adi kɛse sɛ wobetumi asa DCIS. Ɛno nti na mammogram ho hia kɛse no.

• Ɛsɛ sɛ mmea dodow no ara fi ase yɛ wɔn nufu mu nhwehwɛmu afe biara (anaasɛ mfe abien biara, a egyina wɔn duruyɛfo afotu so) bere a wɔadi mfe 40 akyi .
• Sɛ asiane kɛse wom sɛ wubenya nufu mu kokoram (sɛ nhwɛso no, sɛ obi a ɔwɔ w’abusua mu wɔ bi a), ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wubefi ase ayɛ nhwehwɛmu ntɛm mpo.

Ɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa akyerɛ mpɛn dodow a ɛsɛ sɛ woyɛ mammogram a egyina asiane ahorow a ɛwɔ wo mu so.

Dɛn ne nkwa nna a wɔhwɛ kwan wɔ DCIS ho?

Eyi ne asɛmpa a eye sen biara! Nnipa a wɔwɔ DCIS nkwa nna no dɔɔso yiye . Sɛnea Amerika Kokoram Fekuw kyerɛ no, ɛkame ayɛ sɛ wobetumi asa obiara a ɔwɔ DCIS (ne nea onya ayaresa) yare . Ɛno kyerɛ sɛ mfeɛ 10 nkwa nna bɛyɛ 98-99%.

Mpɛn pii no, nea efi mu ba wɔ ayaresa akyi no ye yiye. DCIS ntaa nsan mma bio. Sɛ ɛyɛ saa mpo (wɔ nufu koro no ara mu anaa nufu foforo no mu, ebia sɛ kokoram a ano yɛ den) a, mpɛn pii no wobetumi asa na wɔasa. Enti, DCIS nyɛ nea ɛde nkwa to asiane mu, sɛ wɔsa no yiye a.

Ɔkwan bɛn so na ɛsɛ sɛ mehwɛ me ho?

Wɔ DCIS mu no, ɛho behia sɛ wokɔ so tra oduruyɛfo hwɛ ase bere a wɔasa wo yare awie no.

• Mpɛn pii no, ebehia sɛ wokɔ oduruyɛfo nkyɛn kɔyɛ wo nipadua mu nhwehwɛmu asram 6 kosi 12 biara , anyɛ yiye koraa no mfe anum, na afei pɛnkoro afe biara.
• Afei nso, ɛda adi sɛ ɛho behia sɛ wɔyɛ wo nufu mu nhwehwɛmu afe biara.
• Sɛ worenom hormone therapy a, ɛsɛ sɛ wofa no sɛnea wo duruyɛfo ka kyerɛ wo no pɛpɛɛpɛ.

Nanso, ɛsono obiara tebea. Wo ne wo duruyɛfo nyɛ adwuma na kyerɛ wo nhyehyɛe a wode bɛhwɛ wo wɔ ayaresa akyi. Ɛho hia sɛ wudi wo duruyɛfo akwankyerɛ akyi yiye.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Mma wo nhwehwɛmu ne wo nufu mu nhwehwɛmu sɛnea wo duruyɛfo akyerɛ wo no nmpa wo ti so. Saa bere yi de, hwɛ wo nufu so yiye.

• Sɛ wuhu sɛ akisikuru foforo bi wɔ wo nufu mu a.
• Sɛ wuhu nsakrae wɔ wo nufu honam ani (ɛyɛ kɔkɔɔ, ɛyɛ mmerɛw, ɛyɛ nwi, anaasɛ ɛyɛ akutu a ɛyɛ mmerɛw).
• Sɛ wuhu nsakrae bi wɔ wo nufu mu (indentation, redness, skin flaking, discharge).
• Sɛ wowɔ ɛyaw a ɛkɔ so wɔ wo nufu anaa wo nsateaa mu a.

Sɛ wuhu nsakrae biara a ebetumi ayɛ nufu mu kokoram ho sɛnkyerɛnne a , mma wo ho nnpopo anaasɛ ntwentwɛn wo nan ase, na mmom kɔ oduruyɛfo nkyɛn ntɛm ara.

Nsɛm bɛn na ɛsɛ sɛ wubisa wo duruyɛfo?

Sɛ wuhu sɛ wowɔ DCIS a, ɛyɛ ade a ɛfata sɛ wubenya nsɛmmisa pii. Bisa wo duruyɛfo no wɔn nyinaa ho asɛm. Nhwɛso ahorow bi ni:

• DCIS grade bɛn na mewɔ?
• Ayaresa bɛn na mihia? Sɛɛgyiri? Mframa a wɔde sa yare? Hormone ayaresa?
• Dɛn ne ayaresa ahorow yi mu nsunsuanso bɔne?
• Bere tenten ahe na ayaresa gye?
• So metumi ayɛ adwuma bere a merenya ayaresa no?
• Hokwan bɛn na ɛwɔ hɔ sɛ DCIS bɛsan aba bio?
• Mpɛn ahe na ɛsɛ sɛ meba bɛdi akyi?
• Mpɛn ahe na ebehia sɛ wɔyɛ me mammogram?
• So m’abusua da asiane mu? Dɛn na ɛsɛ sɛ wɔyɛ?

Sɛ wuhu sɛ wowɔ kokoram a, ɛyɛ ade a ɛsakra w’asetra. Ɛyɛ awosu sɛ wobɛte ehu ne dadwen nka efisɛ wunnim nea wobɛhwɛ kwan. Wo duruyɛfo no wɔ ha sɛ ɔrebɛboa wo. DCIS yɛ kokoram bi a hokwan kɛse wɔ hɔ sɛ wɔbɛsa no . Wo duruyɛfo betumi ayɛ ayaresa nhyehyɛe a ɛfata wo.

Adeɛ a ɛho hia paa sɛ wobɛkae (Take-Home Message) .

Okay, enti nneɛma bi a ɛsɛ sɛ wokae fa `DCIS` (Ductal Carcinoma in Situ) a yɛkaa ho asɛm no ho ni:

• DCIS yɛ kokoram a edi kan koraa (Stage 0) a ɛwɔ nufu no mu nufusu ntini mu . Eyi kyerɛ sɛ ennya ntrɛwee wɔ nufu no akyi.
• Mpɛn pii no, ɛnkyerɛ sɛnkyerɛnne pɔtee biara . Wɔtaa hu no denam mammogram so .
• Esiane sɛ DCIS tumi bɛyɛ kokoram a ɛkɔ nipadua no mu nti, ɛho hia sɛ wohu no ntɛm na wɔsa .
• Mpɛn pii no, ayaresa no yɛ oprehyɛn (lumpectomy anaa mastectomy) . Wobetumi de mframa a wɔde sa yare ne hormone ayaresa nso ama.
• DCIS yɛ tebea a wotumi sa no yiye . Enti nsuro na fa akokoduru gyina ayaresa no ano.
• Hwɛ hu sɛ wobɛhwɛ wo na woayɛ wo nufu mu mfonini wɔ mmere a wɔahyɛ ato hɔ no mu sɛnea wo duruyɛfo de afotu ama wo no .

Nea ɛho hia paa ne sɛ ɛnyɛ wo nko ara. Wo duruyɛfo, w’abusua, ne wo nnamfo nyinaa ka wo ho. Wo ne wo duruyɛfo nkasa mfa nsɛmmisa anaa dadwen biara a ebia wowɔ wɔ eyi ho no ho. W’akwahosan a wobɛhwɛ so no ne mmoa kɛse a wubetumi ayɛ.

` DCIS, Ductal Carcinoma in Situ, Nufu mu Kokoram, Nufusu Ductal Kokoram, Mammogram, Biopsy, Lumpectomy, Nufu a wɔtwa, Nufu mu Akwahosan