Ènya nu tso HER2-Negative Breast Cancer ŋua? Mina míaƒo nu!

Ðewohĩ èse nu geɖe tso no me dɔdzẽ ŋu. Gake ɖe nènya nusi woyɔna be kansa sia ƒomevi be ‘HER2-negative’ ŋutɔŋutɔa? Ewɔa nu wòto vovo vie tso no me dɔdzẽ ƒomevi bubu aɖewo gbɔ, eye atikewɔwɔ ate ŋu ato vovo. Mègatsi dzi o, egbea míaƒo nu tso `HER2-Negative Breast Cancer` sia ŋu le mɔ bɔbɔe aɖe nu si gɔme nàte ŋu ase, enyo?

Nukae nye No me Dɔdzẽ si me HER2-Negative le?

Kpuie ko la, `HER2-negative breast cancer` fia be protein tɔxɛ aɖe si woyɔna be `human epidermal growth factor 2 (HER2) mele kansa lãmenugbagbevi siwo le wò no me la me fũ alo mesɔ gbɔ akpa o. Ènya be zi geɖe la, no me dɔdzẽ dzɔna le lãmetsiŋusẽwo (vevietɔ estrogen kple progesterone) ta alo le `HER2` protein sia ta? Le kpɔɖeŋu me, le no me dɔdzẽ si nye `HER2-positive` me la, protein si nye `HER2` le lãmenugbagbeviawo ƒe anyime, si wɔnɛ be kansa lãmenugbagbeviwo ma kabakaba eye wowɔa dɔdzẽ.

Gake le `HER2-negative` ƒe nɔnɔmewo me la, kansa la medzɔna o elabena `HER2` protein sɔ gbɔ akpa. Eyae nye be nu bubuwo hã le eme.

Ne wò ɖɔkta kpɔe be no me dɔdzẽ le ŋuwò la, woadi wò `HER2` nɔnɔme godoo (i.e., nyui alo vɔ̃). Esiawo nye kansa lãmenugbagbeviwo ƒe nɔnɔme tɔxɛwo, siwo míeyɔna be `biomarkers` , eye ne wose wo gɔme nyuie la, ɖɔktawo ateŋu atso nya me le atikewɔwɔ si sɔ na wò wu eye wòwɔa dɔ nyuie wu ŋu. See?

Nukawoe nye no me dɔdzẽ ƒomevi vevi siwo me HER2 mele o?

No me dɔdzẽ siwo wokpɔ fifia ƒe akpa gãtɔ nye `HER2-negative` ƒomevi. Esia ƒomevi vevi eve li, mina míalé ŋku ɖe nusiwo wonye ŋu:

1. No me dɔdzẽ si me lãmetsiŋusẽ ƒe dɔléle le kple esi me HER2 mele o (HR+/HER2-) :

Esiae nye no me dɔdzẽ ƒomevi si bɔ wu, eye wònye no me dɔdzẽwo katã ƒe alafa memama 70 (70%) lɔƒo . Le go sia me la, lãmenugbagbevi siwo xɔa dɔdzẽ ƒe lãmenugbagbevi siwo sea veve ɖe estrogen hormone (ER+), progesterone hormone (PR+), alo evea siaa nu. Kpuie ko la, ne lãmetsi siawo bla ɖe lãmenugbagbevi siawo ŋu la, kansadɔlékuiawo dzea tsitsi gɔme. Gake HER2 protein la mesɔ gbɔ ɖe kansa ƒomevi siawo me o. Esia tae woyɔa wo be HR+/HER2- ɖo.

2. No me dɔdzẽ si me lãmetsiŋusẽ mele o kple esi me HER2 mele o (HR-/HER2-) :

Esia ƒomevie nye no me dɔdzẽwo katã ƒe alafa memama 11 (11%) lɔƒo. Dɔlékuiwutike siawo mekpɔa estrogen alo progesterone o. Azɔ hã, abe alesi míegblɔe va yi ene la, `HER2` protein la mesɔ gbɔ o. Esia fia be lãmetsiŋusẽwo alo protein si nye `HER2` mewɔa akpa aɖeke le kansa sia ƒe tsitsi me o . Ŋkɔ bubu si wotsɔ na esiae nye `Triple-Negative Breast Cancer` . Esia le alea elabena estrogen xɔla, progesterone xɔla, kple `HER2` protein katã nye `negative` le go sia me.

Nukae nye no me dɔdzẽ si me HER2 mele o ƒe dzesiwo?

Le nyateƒe me la, no me dɔdzẽ si me HER2 mele o ƒe dzesiwo sɔ kple no me dɔdzẽ bubu ɖesiaɖe tɔ ŋutɔ. Ele be nànya nu siwo gbɔna:

• Ne ède dzesi tɔtrɔ si mebɔ o le wò no ɖeka alo evea siaa ƒe lolome alo nɔnɔme me .
• Ne ède dzesii be ƒu yeye aɖe, ƒunukpeƒetetedɔ, alo sesẽ aɖe le wò no alo akɔta, vevietɔ ne ƒunukpeƒea metrɔna le wò dzinukpɔkpɔ ɣleti sia ɣleti me o.
• Tɔtrɔ siwo vaa no alo no ƒe ŋutigbalẽ me . Le kpɔɖeŋu me:
• Ŋutilã ƒe ʋuʋudedi, abe amititsetse ƒe aŋgba ene
• Ŋutilã ƒe ʋuʋu, ʋuʋu
• Ŋutilã si me ʋuʋudedi le
• Aɖuɖɔtoe si nɔa anyi ɖaa
• Ŋutilã ƒe amadede trɔna (dzẽ, aŋutiɖiɖi, aŋutiɖiɖi, alo viviti si mebɔ o).
• No me tsi si dona le no me . Esia ate ŋu anye dzĩ abe ʋu ene, tsi si me kɔ, alo amadede ɣi si le abe notsi ene (ne mèfɔ fu alo le no nam o).
• Nipple inversion (ne menɔ anyi tsã o).

Ele vevie be míade dzesii be menye ɣesiaɣie no me dɔdzẽ nana tɔtrɔ siwo dze ƒã le wò dzedzeme ŋu o . Azɔ hã, woate ŋu akpɔ tɔtrɔ siawo dometɔ geɖe le nɔnɔme siwo me dɔlékui aɖeke mele o, siwo sɔ hã me (e.g. cysts, fibroadenoma). Esia tae wòle vevie ŋutɔ be nàlé ŋku ɖe wò no ŋu edziedzi eye nàdo no me dɔdzẽ ƒe dodokpɔ siwo sɔ ɖe wò ƒexɔxɔ nu . Ne nane tsi dzi na wò le tɔtrɔ aɖe ŋu la, kpɔ egbɔ be yeyi ɖɔkta gbɔ be yeanya nenye be kansa alo nɔnɔme bubu aɖe ƒe dzesie.

Nukae hea no me dɔdzẽ si me HER2 mele o vɛ?

Kpuie ko la, no me dɔdzẽ si me HER2 mele o tsoa tɔtrɔ siwo vaa domenyiŋusẽfianu, alo DNA, si le no me lãmenugbagbeviwo me, si woyɔna be mutations , si nana lãmenugbagbevi mawo zua kansa lãmenugbagbeviwo gbɔ. Emegbe kansa lãmenugbagbevi siawo mãna hedzina ɖe edzi kabakaba evɔ womeɖua wo dzi o, eye wowɔa dɔdzẽ.

Afɔku Siwo Gbɔna

Eŋutinunyalawo menya nusi tututu gbɔ domenyiŋusẽfianu ƒe tɔtrɔ siawo tsona le no me dɔdzẽ siwo me HER2 mele o me kple kakaɖedzi haɖe o. Gake wode dzesi nu geɖe siwo ate ŋu ana no me dɔdzẽ xɔxɔ ƒe afɔkua nadzi ɖe edzi le goawo katã me. Esiawo dometɔ aɖewoe nye:

• Domenyiŋusẽfianu ƒe tɔtrɔ : Domenyiŋusẽ ƒe tɔtrɔ tɔxɛ aɖeke meli si do ƒome kple no me dɔdzẽ si do ƒome kple HER2 o. Gake ne ame aɖe nyi domenyiŋusẽfianuwo abe BRCA1 alo BRCA2 ene ƒe tɔtrɔ aɖe ƒe dome la, afɔku le eme be wòaxɔ no me dɔdzẽ (kple kansa bubu aɖewo) le goawo katã me.
• Wò alo wò ƒomea me tɔ aɖe xɔ no me dɔdzẽ kpɔ.: Ne no me dɔdzẽ nɔ ŋuwò kpɔ la, ke afɔku aɖe le eme be wòagatrɔ ava. Azɔ hã, ne no me dɔdzẽ le wò ʋumetɔwo (vevietɔ dawò, fofowò, nɔviwòwo, viwòwo) ŋu la, afɔkua le wò hã me vie.
• Estrogen alo progesterone lãmetsiwo zazã ɣeyiɣi didi : Ne èdze wò dzinukpɔkpɔ gbãtɔ gɔme le wò ɖevime (e.g., hafi nàxɔ ƒe 12), alo ne ètsi dzinukpɔkpɔ megbe (e.g., le ƒe 55 megbe) la, wò ŋutilã do go gbɔdɔdɔ ƒe lãmetsi siawo ɣeyiɣi didi aɖe. Esia ate ŋu anye afɔku hã. Lãmetsiŋusẽtike aɖewo hã ate ŋu ana wò afɔku nadzi ɖe edzi ne wozãe ɣeyiɣi didi.
• Ahanono : Numekukuwo ɖee fia be ahanono si wu ɖeka nono gbesiagbe hã nana no me dɔdzẽ xɔxɔ ƒe afɔkua dzina ɖe edzi.

Tsɔ kpe ɖe esia ŋu la, nusiwo nye tsitsi, lolo akpa, kple kamemademade hã ate ŋu ana no me dɔdzẽ xɔxɔ ƒe afɔkua nadzi ɖe edzi le goawo katã me.

Aleke wowɔa dea dzesi no me dɔdzẽ si me HER2 mele o?

Zi geɖe la, ɖɔktawo toa no me dɔdzẽ si me HER2 mele o dzi . Esia bia be woaɖe lãkusi sue aɖe (kakɛ aɖe) tso ƒuƒoƒo alo teƒe aɖe si ŋu ɖikeke le me atsɔe ayi dodokpɔxɔ me. Afimae dɔléleŋutinunyala aɖe léa ŋku ɖe kpɔɖeŋua ŋu le nusuekpɔmɔ̃ me be yeakpɔe ɖa be kansadɔlékuiwo le eme hã.

Ne woɖo kpe kansa lãmenugbagbeviwo dzi la, emegbe wowɔa dodokpɔ tɔxɛwo be woakpɔ `HER2` protein ƒe agbɔsɔsɔme si le kansa lãmenugbagbevi mawo ƒe anyime, alo `HER2` domenyiŋusẽfianu ƒe kɔpi nenie le eme.

• Ne `HER2` protein alo domenyiŋusẽfianu ƒe agbɔsɔsɔ si sɔ (si le sue) le ŋuwò la, ke `HER2-negative` no me dɔdzẽ le ŋuwò.

Dodokpɔ vevi eve siwo wowɔna le dodokpɔxɔ me hena esiae nye:

1. Immunohistochemistry (IHC) : Dodokpɔ sia zãa dɔlékuiwutike tɔxɛwo kple amadedewo tsɔ dea dzesi HER2 protein si le kansa lãmenugbagbeviwo ƒe anyime. Ne IHC ƒe emetsonu nye 0 alo 1+ la, wobua kansa la be HER2-negative. Ne emetsonua nye 2+ (woyɔnae ɣeaɖewoɣi be "equivocal" alo "borderline"), wowɔa dodokpɔ si woyɔna be FISH hã tsɔ ɖoa ​​kpe HER2 ƒe nɔnɔme dzi.

2. Fluorescence in situ hybridization (FISH) : Dodokpɔ sia léa ŋku ɖe HER2 domenyiŋusẽfianu si wɔa HER2 protein ƒe kɔpi nenie le kansa lãmenugbagbeviwo me ŋu. Esia zãa nusuekpɔmɔ̃ tɔxɛ aɖe kple dzesi siwo me keklẽŋusẽ le (siwo naa kekeli). Le nɔnɔme siwo me IHC dodokpɔa me tsonu metso nya me o, abe 2+ ene la, FISH dodokpɔa ate ŋu aɖo kpe HER2 ƒe nɔnɔme dzi godoo (menyo alo nyui o).

Tsɔ kpe ɖe `HER2` dodokpɔ siawo ŋu la, dɔléleŋutinunyala la alé ŋku ɖe biopsy ƒe kpɔɖeŋua hã ŋu eye wòadi be estrogen receptors (ETU) kple progesterone receptors (PR) le kansa la me hã.

Ðewohĩ ahiã hã be nàwɔ nɔnɔmetatawo abe no me dɔdzẽ, ultrasound, CT scan, alo MRI scan ene be nànya afisi wò kansa le (si fia be nàkpɔ alesi gbegbe dɔdzẽa loloe kple nenye be ekaka ɖe ʋukawo me alo ŋutilã ƒe akpa bubu siwo le didiƒe).

Wò ɖɔkta aƒo nyatakaka siawo katã nu ƒu (HER2 ƒe nɔnɔme, HR ƒe nɔnɔme, kansa ƒe afɔɖeɖe, kple kansa ƒe nɔnɔmewo) atsɔ awɔ atikewɔwɔ ƒe ɖoɖo si sɔ na wò wu.

Nukae nye no me dɔdzẽ si me HER2 mele o ƒe atikewo?

No me dɔdzẽ si me HER2 mele o ƒe atike nyuitɔ ate ŋu ato vovo tso ame ɖeka gbɔ yi bubu gbɔ. Enɔ te ɖe nu geɖe dzi, siwo dometɔ aɖewoe nye afisi wò kansa le, eɖanye lãmetsiŋusẽ ƒe dɔlélenutsiŋutete alo vɔ̃ (HR+/HER2- alo HR-/HER2-), kple wò lãmesẽ bliboa.

Le goawo katã me la, atikewɔwɔwo ate ŋu anye:

• No me dɔdzẽ ƒe amekoko : Kansa ƒe dɔdzẽa ɖeɖeɖa kple ɖewohĩ lãkusi aɖewo siwo le lãmesẽ me ƒo xlãe. Esia ate ŋu anye lumpectomy, si ɖea no ƒe akpa aɖe ɖa, alo mastectomy, si ɖea no bliboa ɖa.
• Kekeli ƒe atikewɔwɔ : Wozãa keklẽŋusẽ si me ŋusẽ geɖe le tsɔ tsrɔ̃a kansa lãmenugbagbevi ɖesiaɖe si ate ŋu asusɔ le amekoko vɔ megbe, alo tsɔ ɖea dɔdzẽa dzi kpɔtɔna hafi wowɔa dɔ nɛ.

Tsɔ kpe ɖe atikewɔmɔnu vevi siawo ŋu la, atikewɔmɔnu bubu aɖewo hã li siwo woate ŋu azã le kansa ƒomevi si le ame ŋu nu:

HR+/HER2- (hormone receptor-positive, HER2-negative) no me dɔdzẽ dada

Esi wònye be kansa sia ƒomevi nɔa te ɖe lãmetsiŋusẽ dzi ta la, atikewɔwɔ siawo hã le vevie tsɔ kpe ɖe amekoko kple/alo keklẽŋusẽdɔdamɔnu ŋu:

• Lãmetsiŋusẽtike : Dɔdamɔnu siawo wɔa dɔ to lãmetsi siwo nye estrogen alo progesterone siwo kpena ɖe kansa ŋu wòtsina ƒe agbɔsɔsɔ dzi ɖeɖe kpɔtɔ me, alo to lãmetsiŋusẽ mawo ƒe kadodo kple kansa lãmenugbagbeviwo dzi ɖeɖe kpɔtɔ me. Le kpɔɖeŋu me:
• Atike siwo xea mɔ na aromatase (e.g. Anastrozole, Letrozole, Exemestane) .
• Gonadotropin-releasing hormone (GnRH) agonists (dzudzɔa lãmetsiŋusẽ ƒe wɔwɔ tso azigolowo me) .
• `Estrogen xɔla ƒe tɔtrɔ tiatia (SERMs)` (e.g. Tamoxifen, Raloxifene)

Le go aɖewo me la, ahiã be woawɔ dɔ na wò (oophorectomy) be woaɖe wò azigolo siwo naa estrogen la ɖa. Woate ŋu ana lãmetsiŋusẽtike ɖeɖeko alo woatsɔe akpe ɖe atikewɔwɔ si woɖo taɖodzinu na ŋu ƒe geɖe.

• Targeted therapy : Dɔdamɔnu siawo tɔa ŋku gbɔdzɔgbɔdzɔ tɔxɛ siwo le kansa lãmenugbagbeviwo me eye wodzea wo dzi be woatɔ te kansa lãmenugbagbeviwo ƒe tsitsi kple woƒe kaka. Le HR+/HER2- kansa gome la, wozãa atike siwo woyɔna be CDK4/6 mɔxenuwo (e.g. Palbociclib, Ribociclib, Abemaciclib) kpe ɖe lãmetsiŋusẽtike ŋu. Esiawo xea mɔ na enzyme aɖe si kpɔa kansa lãmenugbagbeviwo ƒe mama dzi.
• Atikewɔwɔ: Le HR+/HER2- no me dɔdzẽ aɖewo gome la, vevietɔ ne kansa la kaka alo le sesẽm la, ɖɔktawo ate ŋu akafu atikewɔmɔnu tsɔ kpe ɖe lãmetsiŋusẽtike kple/alo atikewɔwɔ si woɖo taɖodzinu na ŋu.

HR-/HER2- (triple-negative) no me dɔdzẽ dada

Esi no me dɔdzẽ si me dɔlékui etɔ̃ le menɔ te ɖe lãmetsiŋusẽ dzi o ta la, lãmetsiŋusẽ ƒe atikewɔwɔ mewɔa dɔ o. Tsɔ kpe ɖe amekoko kple/alo keklẽŋusẽdɔdamɔnu ŋu la, wozãa atikewɔwɔ siwo gbɔna koŋ:

• Atikewɔwɔ : Atikewɔwɔ nye dɔdamɔnu vevi aɖe ŋutɔ na kansa si me dɔléle etɔ̃ le. Ðɔktawo zãa atike vovovo siwo wozãna tsɔ daa dɔlékuiwoe. Woate ŋu ana atike ɖeka alo atike geɖe siwo wotsɔ ƒo ƒui.
• Dɔlélenutsiŋutete ƒe atikewɔwɔ : Esia nye atike yeye aɖe ŋutɔ. Ewɔa dɔ to wò ŋutilã ŋutɔ ƒe dɔlélenutsiŋutete ƒe dɔwɔwɔ be wòade dzesi kansa lãmenugbagbeviwo ahagblẽ wo me. Pembrolizumab (Keytruda®) nye dɔlélenutsiŋutete ƒe atike si dzi Nuɖuɖu Kple Atike Ŋuti Dɔwɔƒe (FDA) da asi ɖo eye wonaa no kple atikewɔmɔnu na no me dɔdzẽ ƒomevi aɖewo siwo me dɔléle etɔ̃ le.
• Atikewɔwɔ si woɖo taɖodzinu na : Le kansa etɔ̃ siwo menyo o siwo me BRCA domenyiŋusẽfianu ƒe tɔtrɔ le gome la, wozãa atike siwo woɖo taɖodzinu na siwo woyɔna be PARP mɔxenuwo (e.g., Olaparib, Talazoparib). Azɔ hã, le dɔléle si kaka ɖe teƒe bubuwo gome la, atikewɔmɔnu yeye ƒomevi siwo woɖo taɖodzinu na (e.g., antibody-drug conjugates) li fifia.

Nukawoe nye atikeawo ƒe nugbegblẽ le ame ŋu?

Togbɔ be kansadɔdamɔnu ate ŋu awɔ avu kple kansa nyuie hã la, atikewɔmɔnuwo katã, siwo dometɔ aɖewoe nye atikewɔmɔnu, keklẽŋusẽdɔdamɔnu, lãmetsiŋusẽtikewɔwɔ, dɔdamɔnu si woɖo taɖodzinu na, kple dɔlélenutsiŋutete ƒe dɔdamɔnu, ate ŋu ahe nugbegblẽ aɖewo vɛ. Esiawo ate ŋu anɔ anyi ɣeyiɣi kpui aɖe alo ɣeyiɣi didi aɖe. Le kpɔɖeŋu me, ɖeɖiteameŋu, ʋuʋudedi, ʋuʋudedi, taɖa ƒe vuvu, nuɖuɖu ƒe dzodzro, nu me ƒoƒo, ŋutigbalẽ ƒe tɔtrɔ, aɖuɖɔtoe alo dɔmeɖui, kple ʋumenugbagbeviɣidɔ.

Kpɔ egbɔ be yeƒo nu kple wò ɖɔkta tso nusiwo nye nugbegblẽ le ame ŋu siawo, ɣeyiɣi didi si woanɔ anyi, kple alesi nàkpɔ wo gbɔe ŋu. Woate ŋu aɖo wò ɖe dɔlélenutsiŋutete ŋuti nunyala bibiwo hã gbɔ. Menye kansa ƒe akpa mamlɛawo koe beléle na ame ƒe dziɖeɖi nye o, ke ekpena ɖe ŋuwò hã be wò agbenɔnɔ ƒe nyonyome nanɔ anyi to dzesiwo kple eƒe nugbegblẽ le ame ŋu dzi kpɔkpɔ le atikewɔwɔ bliboa me.

Nukae nye no me dɔdzẽ si me HER2 mele o dada ƒe agbɔsɔsɔme?

Le no me dɔdzẽ siwo katã me HER2 mele o me la, agbetsitsi ƒe agbɔsɔsɔme sɔ gbɔ sã ne kansa la le no me ko eye mekaka o (nutoa me ƒe afɔɖeɖe) wu ne kansa la kaka ɖe ŋutilã ƒe ŋutinu didiwo me (e.g., aklã, lãkusi, ahɔhɔ̃, ƒuwo) (kansa si kaka alo afisi didi).Kansa siwo kaka ɖe ʋuka siwo te ɖe wo ŋu me ko gake womekaka ɖe ŋutinu siwo le didiƒe o (nutome ƒe afɔɖeɖe) ƒe agbetsitsi ƒe agbɔsɔsɔme le wo dome.

Gake ele vevie be nàɖo ŋku edzi be mɔnukpɔkpɔ si li be nàhaya, alo nyagblɔɖi, nɔ te ɖe nusiwo koŋ ku ɖe wò dɔlélea ŋu dzi. Esiawo dometɔ aɖewoe nye afisi kansa la kaka ɖo (afɔɖeɖe), nenye be lãmetsiŋusẽ ƒe xɔla ƒe nɔnɔme le kansa la ŋu (HR+/HER2- alo HR-/HER2-), alesi kansa lãmenugbagbeviwo wɔa adãe (dzesi), ƒe si nèxɔ, wò lãmesẽ bliboa, kple alesi nèwɔa nu ɖe ​​atikewɔwɔ ŋui. Esiawo nye nusiwo ŋu wò ɖɔkta ate ŋu aƒo nu tsoe na wò ahaɖe nusi nàkpɔ mɔ na me na wò. Akɔntabubuwo nye mamã dedie ko, eye womasɔ na amesiame o.

Aleke malé be na ɖokuinye? (Ðokuidzikpɔkpɔ) .

Eɖanye amesi ŋu no me dɔdzẽ si me HER2 mele o le eƒe gɔmedzedze alo amesi ŋu kansa deŋgɔ le o, ele vevie be nàdi ɣeyiɣi atsɔ akpɔ ɖokuiwò dzi. Esia akpe ɖe ŋuwò le ŋutilã kple susu siaa me. Nu siwo nàte ŋu awɔ dometɔ aɖewoe nye esi:

• Gbɔ ɖe eme ne ehiã : Esɔ be nàse le ɖokuiwò me be ɖeɖi te ye ŋu eye ɖeɖi te ye ŋu, le kansa kple kansa ƒe atikewɔwɔ siaa ta. Ne èse le ɖokuiwò me be ɖeɖi te ye ŋu la, gbɔ ɖe eme vie nàɖi ɖe eme. Ðo to wò ŋutilã.
• Ƒo nuɖuɖu si naa lãmesẽ, si me nunyiame le : Kansadɔdamɔnu aɖewo ate ŋu akpɔ ŋusẽ ɖe wò nuɖuɖudzroame kple wò vivisese dzi. Gake dze agbagba nàɖu nuɖuɖu si da sɔ be nunyiame siwo wò ŋutilã hiã la nasu asiwò. De atikutsetsewo, amagbewo, fibre, kple nuɖuɖu siwo me protein sɔ gbɔ ɖo hã eme. Ne mèka ɖe nuɖuɖu siwo nàɖu kple esiwo mèɖu o dzi o la, ke ƒo nu kple nuɖuɖuŋutinunyala aɖe be wòaɖo aɖaŋu na wò.
• Kamedede (gake mègawɔe wòagbɔ eme o) : Ele vevie be nàde kame edziedzi le agbɔsɔsɔ si sɔ na wò nu, abe alesi wò ɖɔkta kafui ene. Azɔlizɔzɔ bɔbɔe alo yoga gɔ̃ hã ate ŋu anyo. Ate ŋu ana ŋusẽ nanɔ ŋuwò, wò seselelãme nanyo ɖe edzi, eye wòakpe ɖe ŋuwò nàɖe nugbegblẽ le ame ŋu dzi akpɔtɔ. Ke hã, bia wò ɖɔkta be kamedede ka ƒomevie sɔ na wò kple agbɔsɔsɔme si wòle be nàwɔ, le dɔléle si nèkpɔ kple atikewɔwɔ nu.
• Dzra nuteɖeamedzi dzi : Esɔ be nàse le ɖokuiwò me be nuteɖeamedzi, dzimaɖitsitsi, kple vɔvɔ̃ le ye ŋu le dɔléle sia tɔgbe ta. Di mɔ siwo dzi nàto akpɔ egbɔ siwo awɔ dɔ na wò. Togbɔ be ŋugbledede kple gbɔgbɔ ƒe kamedede wɔa dɔ na ame aɖewo hã la, ame bubuwo adi be yewoaƒo yewo ɖokui ɖe nutovɛdɔwo abe agbalẽ xexlẽ, haƒoƒo sese, nutata, alo abɔdzikpɔkpɔ ene me. Ðo ɣeyiɣi aɖe ɖi gbesiagbe na dɔwɔna ɖesiaɖe si akpe ɖe ŋuwò nàɖe dzi ɖi ahaɖe dzi ɖi.
• Na susuŋutinunya ƒe kpekpeɖeŋu nasu asiwò: Ele vevie be nàƒo nu tso wò seselelãmewo ŋu na wò ƒometɔwo kple xɔlɔ̃ veviwo. Ate ŋu ado ŋusẽ ame ŋutɔ hã be nàdo ka kple ame bubu siwo le nu wɔm kple kansadɔ aɖe eye woagblɔ woƒe nuteƒekpɔkpɔwo. Bia wò ɖɔkta tso kpekpeɖeŋunahawo alo kansa ƒe agbetsitsi ƒe ɖoɖowo ŋu.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ele vevie ŋutɔ be nànɔ kadodo me kple wò ɖɔkta ɣesiaɣi, le atikewɔwɔ me kple le atikewɔwɔ vɔ megbe siaa.

• Ne dzesi yeyewo va dze ŋuwò (e.g., vevesese atraɖii, ƒunukpeƒetetedɔ yeye, gbɔgbɔ sesẽ, lolo dzi ɖeɖe kpɔtɔ si womenya o), alo ne edze abe wò dzesi siwo li fifia le sesẽm ɖe edzi ene la , yi ɖɔkta gbɔ alo nàna wòanya enumake .
• Le atikewɔwɔ vɔ megbe la, wò ɖɔkta awɔ ɖoɖo be yeakplɔe ɖo edziedzi . Kpɔ egbɔ be yewɔ ɖe ɖoɖo siawo dzi. Esiawoe nye be nàlé ŋku ɖe eŋu be egadzɔ ake hã, akpɔ atikewɔwɔ ƒe nugbegblẽ le ame ŋu ɣeyiɣi didi gbɔ, eye nàlé ŋku ɖe wò lãmesẽ bliboa ŋu. Ɣeyiɣi siawo siwo wowɔna tsɔ kplɔa ame ɖo la le vevie ŋutɔ le ƒe atɔ̃ gbãtɔ siwo kplɔa ame ɖo le atikewɔwɔ vɔ megbe . Esiae nye ɣeyiɣi si me kansa gadzena ake zi geɖe.

Nya kawoe wòle be mabia nye ɖɔkta?

Ne èle nu ƒom na wò ɖɔkta la, mègavɔ̃ be yeabia nya aɖeke si le asiwò o, aleke kee wòɖale sue o. Nyabiase aɖewo siwo nàte ŋu abia be woakpe ɖe ŋuwòe nye esi:

• Ðe nye kansa ƒe lãmetsiŋusẽ ƒe xɔla le ŋunye loo alo ɖe mele eme oa?
• Nukae nye nye kansa ƒe ƒomevi sue kple afisi wòle?
• Atikewɔwɔ kae nèkafu nam? Nu ka ta?
• Nukae nye ɣeyiɣi kpui kple ɣeyiɣi didi ƒe nugbegblẽ le ame ŋu si woakpɔ mɔ na tso atikewɔwɔ siawo me? Nukae woate ŋu awɔ be woaɖe wo dzi akpɔtɔ?
• Ɣeyiɣi didi kae atikewɔwɔ xɔa?
• Nukae nàte ŋu agblɔ nam tso nye nyagblɔɖi ŋu?
• Ðe mate ŋu ayi nye gbesiagbedɔwo (dɔwɔwɔ, aƒemedɔwo) dzi le atikewɔwɔ mea?
• Ðe nu tɔxɛ aɖewo li siwo ŋu wòle be malé ŋku ɖo ku ɖe nye nuɖuɖu kple kamedede ŋua?
• Nukae mate ŋu awɔ atsɔ aɖe kansa ƒe tɔtrɔgbɔ ƒe afɔkua dzi akpɔtɔ?
• Ne mehiã kpekpeɖeŋunadɔwo alo aɖaŋuɖoɖo la, ɖe mate ŋu axɔ ame aɖe si woaɖo ɖem ɖe eta?

Anyo be nàŋlɔ nya siawo ɖi ahabia wo, ale be màŋlɔ naneke be o.

Ðe wònyo wu be nànye HER2-positive alo negative?

Nya sia nye nya si ame geɖe biana. Gake esesẽ be míana ŋuɖoɖo bɔbɔe aɖe na esia, elabena nyateƒeae nye be ‘enɔ te ɖe edzi’ .

Le kpɔɖeŋu me, no me dɔdzẽ siwo me HER2 le la tsina kabakaba eye wowɔa adã wu kansa siwo me HER2 mele o. Ke hã, viɖe aɖe le esia ŋu. Atikewɔmɔnu tɔxɛ aɖewo li siwo ate ŋu aɖo taɖodzinu na HER2 proteinwo, e.g., Herceptin, Perjeta, eye wowɔa dɔ ŋutɔ na kansa siwo me HER2 le. Atikewɔwɔ siawo mewɔa dɔ na kansa siwo me HER2 mele o, elabena HER2 protein geɖe mele kansa mawo si woatsɔ aɖo taɖodzinui o.

Le go bubu me la, ne `HER2-negative` kansa nye `HR+` (hormone receptor-positive), si nye `HR+/HER2-` ƒomevi la, ekema lãmetsiŋusẽtike siwo wɔa dɔ ŋutɔ kple atikewɔmɔnu siwo woɖo taɖodzinu na abe `CDK4/6 inhibitors` ene li. Le nyateƒe me la, wobu `HR+/HER2-` no me dɔdzẽ be eyae nye eƒe ŋgɔdonya nyuitɔ kekeake le no me dɔdzẽ ƒe hatsotso sue siwo li fifia dome.

Gake ne kansa la nye `HER2-negative` (HR-) (hormone receptor-negative), si fia be triple-negative la, zi geɖe la, ate ŋu anye esi nu sẽ wu ƒomevi bubuwo, eye edada ate ŋu asesẽ vie. Gake fifia atikewɔmɔnu, dɔlélenutsiŋutete ƒe dɔdamɔnu, kple atikewɔmɔnu yeye siwo woɖo ɖe ema hã ŋu li.

Eyata manya wɔ be woagblɔ be ɖeka "nyo" alo "vɔ̃ɖi" wu evelia o. Nu vevitɔ kekeakee nye be nàde dzesi wò kansa ƒe ƒomevi sue tɔxɛa pɛpɛpɛ eye nàxɔ atike si wɔa dɔ wu si sɔ nɛ.

Mlɔeba la, ele nam be magblɔe na wò... (Take-Home Message)

Ne wokpɔ no me dɔdzẽ `HER2-negative` le ŋuwò la, esɔ be nàvɔ̃ eye nàtsi dzimaɖi. Gake ɖo ŋku edzi be menye xexeame ƒe nuwuwue nye esia o. Dzɔdzɔmeŋutinunya kple atikewɔwɔ ŋuti mɔ̃ɖaŋununya de ŋgɔ ŋutɔ egbea, eye atike nyui geɖewo li na kansa sia ƒomevi.

Nu vevitɔ kekeakee nye:

• Be woana nyanya ame nyuie tso nɔnɔme sia ŋu.
• Lé ŋku ɖe tɔtrɔ siwo le wò ŋutilã me ŋu ɣesiaɣi, vevietɔ wò nowo.
• Ne ɖikeke aɖe le mewò la, yi ɖɔkta gbɔ ɖe game dzi eye nàdo wò kpɔ.
• Ðo dze kple wò ɖɔkta gaglãa kple anukwareɖiɖi, bia wò nyawo katã, eye nàse atikewɔmɔnu siwo nàte ŋu azã la gɔme nyuie.

Ðo ŋku edzi be menye wò ɖeka koe le mɔzɔzɔ sia me o. Ðɔkta bibiwo, dɔnɔdzikpɔlawo, wò ƒomea, kple xɔ̃wò veviwo li siwo le afima be yewoakpe ɖe ŋuwò ahakpe ɖe ŋuwò. Na nɔnɔme nyui nanɔ asiwò, wɔ ɖe wò ɖɔktawo ƒe mɔfiamewo dzi pɛpɛpɛ, eye nàxɔ kpekpeɖeŋu si nèhiã, eye kakaɖedzitɔe la, àte ŋu anɔ te ɖe nɔnɔme sia nu dzidzedzetɔe ahahaya. Neva eme be ŋusẽ nanɔ ŋuwò!

` No me dɔdzẽ, HER2-mawɔmawɔ, kansa ƒe dzesiwo, kansa dada, nyɔnuwo ƒe lãmesẽ, lãmetsiŋusẽ ƒe atikewɔwɔ, etɔ̃-vɔ̃ɖi