Mtundu wa khansa ya m'mawere woopsa pang'ono: Tiyeni tikambirane za khansa ya m'mawere yoipa katatu (TNBC)

Tonse tamva zambiri kapena zochepa za khansa ya m'mawere. Koma kodi mukudziwa kuti pali mitundu yosiyanasiyana ya khansa ya m'mawere? Mitundu ina ndi yosavuta kuchiza, koma mitundu ina ndi yoopsa komanso yoopsa. Lero tikambirana za mtundu wa khansa ya m'mawere yomwe ndi yoopsa pang'ono, koma imatha kulamulidwa ngati ikumvedwa bwino ndikuchiritsidwa. Umu ndi momwe madokotala amatcha "Kansa ya M'mawere Yoipa Katatu" kapena `(Kansa ya M'mawere Yoipa Katatu - TNBC)`.

Kodi Triple-Negative iyi ndi chiyani?

Mwachidule, pali zinthu zitatu zazikulu zomwe zimathandiza maselo a khansa ya m'mawere kukula. Ndi mahomoni otchedwa estrogen ndi progesterone, ndi puloteni yotchedwa HER2. Ganizirani izi ngati "zitseko" pa maselo a khansa. Madokotala amapereka "makiyi" (monga mankhwala monga mankhwala a mahomoni) omwe amakwaniritsa "zitseko" izi ndikuletsa khansa kukula.

Komabe, mu khansa ya triple-negative, maselo a khansa alibe zitseko zonse zitatuzi (estrogen, progesterone, HER2). Izi zikutanthauza kuti 'ndizoipa'. Chifukwa zitseko zimenezo sizikupezeka, zinthu monga mankhwala a mahomoni omwe nthawi zambiri amaperekedwa sizigwira ntchito pa khansa yamtunduwu. Pachifukwa ichi, khansa yamtunduwu imaonedwa kuti ndi yoopsa kwambiri, imafalikira mofulumira kuposa mitundu ina.

Kodi zizindikiro za khansa iyi ndi ziti?

Zizindikiro za khansa ya m'mawere ya triple-negative nthawi zambiri zimakhala zofanana ndi za mitundu ina ya khansa ya m'mawere. Ngati mukukumana ndi zizindikiro izi, musanyalanyaze ndipo pitani kwa dokotala nthawi yomweyo.

Ndani ali pachiwopsezo chachikulu chotenga khansa iyi?

Madokotala sakudziwabe chomwe chimayambitsa khansa yamtunduwu. Komanso ndi yosowa kwambiri, yomwe imakhudza akazi 10%-20% okha omwe amadwala khansa ya m'mawere. Komabe, anthu ena ali pachiwopsezo chachikulu.

• Azimayi osakwana zaka 40 .
• Anthu omwe ali ndi kusintha kwa majini a BRCA , makamaka jini la BRCA1. Uku ndi kusintha kwa majini komwe kumadutsa m'mibadwomibadwo.
• Azimayi onenepa kwambiri ndipo sachita masewera olimbitsa thupi atatha kusamba (kusiya kusamba) .

Kodi mungadziwe bwanji ngati muli ndi khansa?

Dokotala yekha ndi amene angakuuzeni mtundu weniweni wa khansa yomwe muli nayo. Izi zimaphatikizapo mayeso angapo.

1. Kujambula mammamu ndi ultrasound: Izi zimatha kuzindikira zotupa kapena zolakwika mkati mwa bere.

2. Kuyesa kwa Biopsy `(Biopsy)`: Ichi ndi chomweMayeso ofunikira komanso ofunikira kwambiri . Chomwe chikuchitika apa ndikutenga chidutswa chaching'ono kwambiri cha minofu kuchokera pa chotupa chokayikitsa pansi pa mankhwala oletsa ululu ndikuchitumiza kwa dokotala wapadera yemwe amafufuza minofuyo.

3. Kuyesa minofu: Chitsanzo cha minofu chimayesedwa pogwiritsa ntchito maikulosikopu kuti chione ngati ndi khansa kapena ayi. Ngati ndi khansa, chimafufuzidwa "zitseko" zomwe tidakambirana kale zotchedwa estrogen, progesterone, ndi `HER2`. Ngati zonse zitatu zilibe, zimapezeka kuti ndi khansa yopanda katatu.

Kudziwa gawo la khansa

Pambuyo poti khansa yapezeka, dokotala adzadziwa "gawo" lake. Izi zikutanthauza kukula kwa khansa komanso kufalikira kwake. Izi zitha kuphatikizapo mayeso monga MRI, CT scan, ndi PET scan.

Njira ya `TNM` ndi njira yovomerezeka padziko lonse lapansi.

• T (Chotupa): Kodi chotupacho ndi chachikulu bwanji? (Chiwerengero kuyambira 0-4)
• N (Ma Node): Kodi khansa yafalikira ku ma lymph node apafupi? (Ziwerengero za 0-3)
• M (Metastasis): Kodi khansa yafalikira ku ziwalo zakutali monga mapapo, chiwindi, kapena mafupa? (0 kapena 1)

Pachifukwa ichi, dokotala adzasankha chithandizo chomwe chili chabwino kwa inu.

Kodi mankhwala ake ndi otani?

Mankhwala ophatikizana nthawi zambiri amagwiritsidwa ntchito pa khansa ya triple-negative.

1. Mankhwala a Chemotherapy

Uwu ndiye mankhwala akuluakulu komanso ofunikira kwambiri a khansa yamtunduwu. Umaphatikizapo kupatsa thupi mankhwala amphamvu omwe amapha maselo a khansa. Ngati khansa iyi yapezeka msanga, imayankha bwino kwambiri ku chemotherapy.

• Neoadjuvant Chemotherapy: Chemotherapy yomwe imaperekedwa musanachite opaleshoni kuti ichepetse chotupa ndikupangitsa opaleshoni kukhala yosavuta.
• Chithandizo cha Chemotherapy: Chithandizo cha Chemotherapy chomwe chimaperekedwa pambuyo pa opaleshoni kuti chiwononge maselo otsala a khansa.

2. Opaleshoni

Pali mitundu iwiri ya opaleshoni.

• Kuchotsa chotupa cha khansa: Kuchotsa chotupa cha khansa ndi minofu yochepa yozungulira.
• Kuchotsa bere lonse. Chifukwa khansa iyi ndi yoopsa kwambiri, madokotala nthawi zambiri amalimbikitsa kuchotsa bere lonse (mastectomy).

3. Chithandizo cha Radiation

Pambuyo pa opaleshoni, chithandizochi chimaperekedwa kuti chiwononge maselo aliwonse a khansa omwe angakhalebe m'derali ndikuletsa khansayo kuti isabwererenso.

4. Chithandizo cha Immunotherapy

Iyi ndi njira yatsopano yochiritsira. Chomwe timachita pano ndikulimbikitsa chitetezo cha mthupi cha thupi lathu , kuthandizira kuzindikira ndikulimbana ndi maselo a khansa. Iyi ndi njira yothandiza kwambiri yochiritsira khansa ya triple-negative.

5. Chithandizo Cholunjika

Iyi ndi njira yatsopano yochiritsira. Ili ngati "bomba lanzeru." Chomwe mankhwalawa amachita ndikupeza maselo a khansa mwachindunji, kuwalumikiza, ndikupereka chemo mwachindunji ku maselo a khansa. Izi zimatchedwanso `Antibody-drug conjugate (ADC).' Izi sizimawononga maselo athanzi kwambiri.

Mwayi wochira ndi kubwereranso

Funso ili ndi lalikulu kwa anthu ambiri. N'zovuta kupereka yankho limodzi chifukwa limasiyana malinga ndi munthu ndi munthu. Mwayi wochira umadalira momwe khansa imapezekera msanga komanso momwe thupi limayankhira chithandizo.

• Kwa khansa ya m'mawere yomwe imapezeka m'derali, mwayi wopulumuka zaka 5 ndi wokwera kufika pa 91%.
• Ngati ifalikira ku minofu yapafupi (yachigawo), chiwerengero chimenecho ndi pafupifupi 65%.
• Ngati ifalikira ku ziwalo zakutali, chiwerengerocho chimatsika kufika pa 12%.

Khansa ya katatu ili ndi chiopsezo chobwereranso mkati mwa zaka zitatu zoyambirira mutalandira chithandizo. Komabe, chiopsezo chimenecho chimachepa mofulumira patatha zaka 5. Chifukwa chake, ndikofunikira kupitiliza kuyesedwa motsatira malangizo a dokotala wanu mutalandira chithandizo.