Oko kufuneka ukwazi malunga nomhlaza webele we-Luminal B!

Mhlawumbi ukhe weva okuninzi malunga nomhlaza webele. Kodwa ubusazi na ukuba kukho iintlobo ezahlukeneyo zomhlaza webele? Kaloku, namhlanje siza kuthetha ngohlobo olukhethekileyo olubizwa ngokuba yiLuminal B breast cancer. Eli gama lisenokuvakala linzima kancinci, kodwa ungakhathazeki. Siza kuthetha ngalo ngendlela elula kakhulu onokuyiqonda. Kuba ukwazi izinto ezinje kunokubaluleka kakhulu kuwe nakubantu obathandayo.

Yintoni iLuminal B? Ziziphi iimpawu zayo ezikhethekileyo?

Ngamafutshane, iLuminal B luhlobo lomhlaza webele olune-hormone receptor-positive (HR+). Oku kungenxa yokuba iiproteni ezithile (ii-receptors) ngaphakathi kweeseli zomhlaza zibopha kwi-hormone estrogen, nto leyo ebangela ukuba umhlaza ukhule. Igama elithi "luminal" libhekisa kwiiseli ezingaphakathi kwemisele yobisi ebeleni lakho. Cinga ngayo njengangaphakathi kwetyhubhu.

Ngoku makhe sijonge ezinye iimpawu ezikhethekileyo zeeseli zomhlaza zeLuminal B. Ezi zifana nekhadi lokuzazisa lalo mhlaza. Oogqirha baza kufunda ezi mpawu ngononophelo ukuze bagqibe ukuba loluphi unyango olulungele wena.

• I-estrogen receptor positive (ER+): Olu lolona phawu lubalulekileyo. Iiseli zomhlaza zeLuminal B zineproteni ezibizwa ngokuba yi-Estrogen Receptors (ER) ezinokubophelela kwi-hormone ye-Estrogen. I-Estrogen yi-hormone eveliswa ngokwemvelo emzimbeni womfazi. Ngoko ke, xa le hormone ibophelela kwiiseli zomhlaza, umhlaza ufumana amandla okukhula. Kufana nokunkcenkceshela nokondla isityalo.
• Iphantsi okanye imbi kwii-receptors zeProgesterone (PR- okanye i-PR ephantsi): Xa kuthelekiswa nohlobo lomhlaza webele lweLuminal A, iiseli zeLuminal B zineprotein ezimbalwa kakhulu, okanye ngamanye amaxesha azinazo kwaphela, ezibophelela kwenye i-hormone enkulu yabasetyhini, i-progesterone.
• Isimo se-HER2 (HER2-positive (HER2+) okanye HER2-negative (HER2-)): Le yinto ebaluleke kakhulu. I-HER2 imele iproteni ebizwa ngokuba yi-'Human Epidermal Growth Factor Receptor 2'. Le yinto edla ngokunceda iiseli zikhule. Nangona kunjalo, ezinye iiseli zomhlaza webele zenza le protein ye-HER2 eninzi kakhulu, ngendlela engalawulekiyo. Kwi-Luminal B cancers, le protein ye-HER2 inokuba khona ngokugqithisileyo (HER2-positive / HER2+), okanye ingaba khona kumanqanaba aqhelekileyo (HER2-negative / HER2-). Iindlela zonyango ziyahluka ngokuxhomekeke kwesi simo.
• Amanqanaba aphezulu eprotheyini yeKi-67 (Iphezulu kwiKi-67):I-Ki-67 yiproteni ekhethekileyo efumaneka kuphela kwiiseli ezahlulahlula ngokukhawuleza. Umhlaza we-Luminal B udla ngokuba namanqanaba aphezulu ale proteni. Oku kunceda oogqirha baqonde ukuba iiseli zomhlaza ziyahlukana ngokukhawuleza kangakanani, nto leyo ethetha ukuba umhlaza ukhula ngokukhawuleza kangakanani. Yiyo loo nto umhlaza we-Luminal B ukhula ngokukhawuleza kunee-Luminal A.
• Udidi oluphezulu: Udidi lomhlaza yindlela iiseli zomhlaza ezifana okanye ezahluke ngayo kwiiseli eziphilileyo xa zijongwa ngemakroskopu. Udidi oluphezulu luthetha ukuba iiseli zomhlaza zahlukile kakhulu kwiiseli eziphilileyo kwaye zinokukhula kwaye zisasazeke ngokukhawuleza. Umhlaza weLuminal B uhlala udidi oluphezulu kuneLuminal A. Oku kuthetha ukuba zinobundlongondlongo ngakumbi, zinokukhula zibe nkulu, kwaye zinokuphinda zibuye emva konyango.

Ungabona, zonke ezi nobumba, amanani, kunye nezifinyezo (ezifana no-ER, PR, HER2, Ki-67) zongeza ulwazi oluninzi malunga neeseli zomhlaza ezisemabeleni akho. Kungokuhlalutya olu lwazi apho oogqirha banokuceba unyango oluqondene nawe kwaye baqikelele ukuba loluphi uhlobo lweziphumo onokuzilindela kunyango.

Ixhaphake kangakanani i-Luminal B yebele?

Ngoku usenokuba uzibuza, 'Bangaphi abantu abanale sifo?' Enyanisweni, phakathi kwe-15% kunye ne-20% yeziganeko zomhlaza wamabele ezixeliweyo kwihlabathi liphela zinelolu hlobo lomhlaza. Olu luhlobo luncinci kancinci kunolo luqhelekileyo olubizwa ngokuba yiLuminal A. Kodwa, eli nani alibalulekanga kangako, akunjalo? Yiyo loo nto kubalulekile ukuqaphela oku.

Zithini iimpawu zomhlaza webele weLuminal B?

Rhoqo, oogqirha banokuyibona ngaphambi kokuba ube nazo naziphi na iimpawu, ngokuhlolwa kwamabele rhoqo , njenge-mammogram. Yiyo loo nto kubalulekile ukwenza olu vavanyo xa useneminyaka yakho. Kodwa ngamanye amaxesha unokufumana enye okanye ngaphezulu kwezi mpawu:

• Iqhuma elisebeleni: Eli liqhuma eliqinileyo, elifana nerabha elingashukumi lula.
• Intlungu yebele: Usenokuziva iintlungu kwelinye okanye omabini amabele.
• Ukukhupha iingono: Ufanele ukhathazeke ukuba ukhupha iingono, ingakumbi ukuba zixutywe negazi .
• Utshintsho lolusu: Ungabona ulusu lujika, lutyeba, okanye umbala wesikhumba sebele utshintsha.
• Ukudumba phantsi kwekhwapha: Amaqhuqhuva e-lymph akwindawo yekhwapha anokudumba.

Ukuba ubona uphawu olunje,Musa ukoyika uze ubone ugqirha ngoko nangoko. Asikuko konke ukudumba okunomhlaza, kodwa bubulumko ukukuhlola.

Yintoni ebangela umhlaza webele weLuminal B?

Enyanisweni, umhlaza webele weLuminal B uvela xa iiseli zebele eziphilileyo zitshintsha ngequbuliso zize ziqale ukukhula ngendlela engalawulekiyo. Kodwa iingcali azikayazi ukuba kutheni oku kusenzeka. Kunokubangelwa zizinto ezahlukeneyo.

Njengoko besitshilo ngaphambili, iiseli zeLuminal B ziqulathe iiproteni ezikhuthaza ukukhula komhlaza xa zibopha kwihomoni ye-estrogen. Ngoko ke, ukuba amanqanaba e-estrogen yakho aphezulu ixesha elide, inokunyusa kancinci umngcipheko wakho wokuba nalo mhlaza. Umzekelo:

• Ukuba ixesha lakho liqale ngaphambi kwexesha eliqhelekileyo, oko kukuthi, ngaphambi kokuba ube neminyaka eli-12 ubudala.
• Okanye ukuba ukunqamuka kokuya exesheni, okuthetha ukuyeka ngokupheleleyo ukuya exesheni, kwenzeka emva kwexesha eliqhelekileyo, emva kweminyaka engama-55.
• Okanye ukuba ubusoloko uthatha unyango lokutshintshwa kweehomoni (HRT) ixesha elide ukulawula iimpawu ezinxulumene nokuya exesheni.

Ukongeza kwezi zinto, kukho nezinye izinto ezininzi ezinokunyusa umngcipheko womhlaza webele we-luminal B:

• Imbali yosapho: Ukuba umama wakho, udadewenu, intombi yakho, okanye isalamane sakho esisondeleyo sikhe saba nomhlaza webele okanye umhlaza wesibeleko, usemngciphekweni omkhulu kancinci.
• Ubudala: Umngcipheko wokuba nomhlaza webele uyanda emva kweminyaka engama-50.
• Izicubu zebele ezixineneyo: Ukuba izicubu zebele zibonakala zixinene kwi-mammogram, loo nto nayo ikwangumngcipheko.
• Utshintsho kwizakhi zofuzo: Utshintsho oluzuzwe njengelifa kwiizakhi zofuzo ezithile, ezifana ne-BRCA1 kunye ne-BRCA2, lunokunyusa kakhulu umngcipheko womhlaza webele.
• Unyango lwe-radiation lwangaphambili: Ukuba ukhe wafumana unyango lwe-radiation esifubeni okanye kwindawo yebele ngesinye isizathu.

Ukuba nezi zinto zinobungozi akuthethi ukuba uza kuba nomhlaza ngokuqinisekileyo. Nangona kunjalo, kubalulekile ukuba uzazi.

Ufunyaniswa njani umhlaza webele weLuminal B?

Khawucinge ukuba uneempawu zomhlaza webele, okanye i-mammogram ibonisa into ekrokrisayo. Into yokuqala ugqirha aza kuyenza kukwenza uvavanyo lomzimba. Oku kuthetha ukuba baza kuhlola amabele akho ngokwasemzimbeni ukujonga amaqhuma okanye olunye utshintsho.

Emva koko, ukuze bafumane okungakumbi, badla ngoku-odola iimvavanyo ezongezelelweyo zomfanekiso ezifana nezi:

• I-mammogram yokuxilonga: Le yi-mammogram eneenkcukacha ezingaphezulu kune-mammogram eqhelekileyo.
• I-ultrasound scan: Oku kunokunceda ekuqinisekiseni ukuba iqhuma liqinile okanye liyi-cyst egcwele ulwelo.
• Iskeni ye-MRI (Magnetic Resonance Imaging): Oku kusenokufuneka nakwezinye iimeko ezikhethekileyo.

Emva kwezi mvavanyo, ugqirha ngokuqinisekileyo uza kuthatha isampuli yezicubu zebele (i-breast biopsy) aze ayithumele ukuze ivavanywe. Le yindlela yokuqinisekisa ukuba umhlaza ukhona okanye awukho, kwaye ukuba ukho, loluphi uhlobo lwawo. I-biopsy ibandakanya ukuthatha iqhekeza elincinci lezicubu kwindawo erhanelekayo uze ulithumele kwilebhu ukuze lihlolwe phantsi kwe-microscope.

Ingcali yezifo, ugqirha ochwephesha ekuhloleni izicubu, uza kuhlola isampuli yezicubu zakho ukuze abone ukuba kukho iiseli zomhlaza na. Ukuba kufunyenwe iiseli zomhlaza, ziza kwenza uvavanyo lwe-hormone receptor (lwe-ER, PR) kunye novavanyo lwe-HER2 ukuze kuchongwe uhlobo lomhlaza. Kwezi vavanyo, olusetyenziswa kakhulu luvavanyo olubizwa ngokuba yi -immunohistochemistry (IHC) . Olu vavanyo lusebenzisa iidayi ze-fluorescent kunye nee-enzymes ukugqamisa iimolekyuli ezithile kwiiseli zomhlaza. Ngamanye amaxesha, amanqanaba e-Ki-67 nawo ajongwa ngale ndlela.

Olu vavanyo kwisampuli yakho yezicubu lunokunceda iqela lakho lezonyango lazi ukuba loluphi unyango oluza kusebenza kakuhle kuwe, kunye nokukunika umbono wokuba umhlaza ungabuya kangakanani emva konyango.

I-Luminal B isetyenziswa njani ukunyanga umhlaza webele?

Unyango lomhlaza webele weLuminal B lunokwahluka kumntu nomntu. Luxhomekeke kwizinto ezininzi, kuquka imeko yakho, inqanaba lomhlaza, imeko yakho ye-HER2 (HER2+ okanye i-HER2-), inqanaba lakho le-Ki-67, kunye nempilo yakho iyonke. Iqela lakho lezonyango liza kuqwalasela zonke ezi zinto ukuze lenze isicwangciso sonyango esifanelekileyo kuwe.

Iindlela eziphambili zonyango ezisetyenziswayo zezi:

• Unyango lweeHormone: Ekubeni iLuminal B ingumhlaza ochaphazeleka ziiHormone (HR+), olu lolona nyango luphambili luqhelekileyo. Oku kusebenza ngokuthintela iHormone ye-estrogen ukuba ingafikeleli kwiiseli zomhlaza, okanye ngokunciphisa amanqanaba e-estrogen emzimbeni. Amayeza afana neTamoxifen kunye neAromatase Inhibitors asetyenziselwa oku.
• Utyando: Oku kuquka ukususa iiseli zomhlaza ebeleni.
• Ukususwa kwethumba: Oku kuquka ukususa kuphela ithumba elinomhlaza kunye nenani elincinci lezicubu eziphilileyo ezijikeleze lona, ​​​​ukushiya uninzi lwebele lungaphazanyiswa.
• Ukususwa kwebele: Oku kuquka ukususwa kwebele lonke.

Ngexesha lotyando, ii-lymph nodes ezikwikhwapha zinokususwa ukuze kubonwe ukuba umhlaza usasazekile na.

• Unyango ngemitha:Emva kotyando, unyango lwemitha lunikwa ukubulala naziphi na iiseli zomhlaza eziseleyo kuloo ndawo. Oku kudla ngokwenziwa, ingakumbi ukuba kwenziwe i-lumpectomy.
• Unyango olujoliswe kulo: Olu hlobo lonyango lujolise kwiimolekyuli ezithile ezinceda iiseli zomhlaza zikhule. Umzekelo, ukuba umhlaza weLuminal B une-HER2-positive (HER2+), amayeza ajolise kwiproteni ye-HER2 (umz. iTrastuzumab) anokunikwa. Ezi zimiselwa linqanaba lomhlaza kunye nezinye iiprofayili ze-receptor.
• Unyango lweKhemotherapy: I-chemotherapy encedisayo inokunikwa ukubulala iiseli zomhlaza ezingakhange zibulawe zezinye iindlela zonyango, okanye ukuthintela umhlaza ukuba ungasasazeki kwezinye iindawo zomzimba. Umhlaza weLuminal B ukhula ngokukhawuleza kuneLuminal A kwaye unezinga eliphezulu leKi-67, ngoko ke oku kuyacetyiswa kwezinye izigulana ezisengozini enkulu. Ugqirha wakho uza kukuxelela ukuba olu khetho lulungile na kuwe.

Khumbula, unyango lomntu onomhlaza we-Luminal B one-HER2-positive (HER2+) lunokwahluka kunyango lomntu onomhlaza we-Luminal B one-HER2-negative (HER2-). Yiyo loo nto kubalulekile ukwazi zonke ezi mpawu zomhlaza wakho.

Ithini ingqikelelo yabantu abanomhlaza webele weLuminal B?

Ingqikelelo, okanye ithemba lokusinda nokuphiliswa, komntu onomhlaza webele weLuminal B ixhomekeke ekubeni ithumba lihambe kangakanani xa lifunyaniswa (inqanaba lomhlaza). Njengakweminye imhlaza, okukhona uqala unyango ngokukhawuleza, kokukhona amathuba akho okusinda aba maninzi.

Ngokuxhomekeke kwinqanaba lokuxilongwa, umhlaza webele weLuminal B uyanyangeka , oko kuthetha ukuba esi sifo sinokuphela ngonyango. Nangona kunjalo, sinokuphinda sibuye. Umhlaza weLuminal B unamathuba amaninzi okuphinda ubuye kuneLuminal A.

Umngcipheko wokubuyela komhlaza uxhomekeke kwizinto ezininzi, kuquka inqanaba lesi sifo, izinga lokukhula kwaso, amanqanaba e-Ki-67, imeko ye-HER2, kunye nendlela esabela ngayo kunyango. Ke ngoko, nokuba uphilile, ugqirha wakho uya kuqhubeka nokujonga impilo yakho. Kubalulekile ukuba nolandelelwano rhoqo . Banokucebisa nonyango olongezelelweyo (njengonyango lweehomoni) emva kotyando kunye nonyango lwemitha ukunciphisa umngcipheko wokubuya komhlaza.

Amanqanaba okusinda kumhlaza webele weLuminal B

Ngoku masithethe kancinci ngezi zibalo. Kodwa ezi zixabiso nje eliqhelekileyo.Kufuneka ukhumbule ukuba ezi azizoqikelelo zichanekileyo zokuba uza kuphila ixesha elingakanani okanye uza kusabela njani kunyango oluthile. Zisekelwe kwidatha evela kwiqela elikhulu lezigulana.

• Izinga lokusinda iminyaka emihlanu kubantu abanomhlaza webele we-HR+/HER2+ (i-hormone receptor positive/human epidermal growth factor receptor 2 positive) limalunga ne- 91.5% . Oku kuthetha ukuba kubantu abali-100 abanolu hlobo lomhlaza, malunga nama-91 baya kuphila iminyaka emihlanu emva kokufunyaniswa ukuba banayo.
• Eli nani labantu abanomhlaza webele we-HR+/HER2- (i-hormone receptor positive/human epidermal growth factor receptor 2 negative) limalunga ne- 95.1% .

Eyona nto ibalulekileyo kukuthetha ngokukhululekileyo nogqirha wakho ukuze uqonde kakuhle indlela ezi zibalo ezikuchaphazela ngayo. Angakuxelela zona ngendlela efanelekileyo kwimeko yakho.

I-Luminal B iyinciphisa njani ingozi yomhlaza webele?

Asinakutshintsha ezinye izinto ezinobungozi, njengembali yosapho lwesifo. Nangona kunjalo, ukwenza utshintsho oluthile kwindlela yokuphila kunokunceda ukunciphisa umngcipheko wokufumana naluphi na uhlobo lomhlaza webele, kuquka i-luminal B:

• Kuphephe ukutshaya: Ukutshaya kuyingozi enkulu kwiintlobo ezininzi zomhlaza.
• Yandisa umthambo womzimba: Kulungile kakhulu ukuzilolonga ubuncinane imizuzu engama-30 iintsuku ezininzi ngeveki.
• Nciphisa utywala: Kubalulekile ukunciphisa utywala.
• Gcina ubunzima obusempilweni: Ukugcina ubunzima obusempilweni obuhambelana nobude bakho kubaluleke kakhulu, ingakumbi emva kokuya exesheni.
• Ukutya okunesondlo: Yitya ukutya okutyebileyo kwiziqhamo, imifuno, kunye neenkozo ezipheleleyo.

Ndingazinyamekela njani? Ndingenza ntoni xa ndiphila nomhlaza?

I-Luminal B Ukuphila nomhlaza webele kunokuba nzima kakhulu, emzimbeni nasengqondweni. Ngezinye iintsuku ungaziva uphilile, kwaye ngezinye iintsuku ungaziva uxinezelekile, udandathekile, kwaye usoyika. Yinto eqhelekileyo leyo. Ngoko ke, kubalulekile ukuzinyamekela kakuhle kulo lonke ixesha lokufunyaniswa kwakho isifo kunye nonyango.

Nazi ezinye izinto ezinokukunceda:

• Yitya kakuhle: Yitya ukutya okunesondlo. Faka iziqhamo, imifuno, iiproteni ezingenamafutha, kunye neenkozo ezipheleleyo ekutyeni kwakho. Ukuba ufumana ukuphelelwa ngumdla wokutya ngexesha lonyango, qhagamshelana nogqirha wakho okanye ingcali yesondlo.
• Fumana iindlela zokulawula uxinezeleko:Ungayiphumza ingqondo yakho ngokwenza izinto ezifana nokucamngca, i-yoga, umthambo wokuphefumla, kunye nokuzibandakanya kwizinto ozithandayo ezikuzisela uvuyo.
• Phumla ngokwaneleyo: Ukulala ngokwaneleyo kubaluleke kakhulu. Musa ukusebenza imini yonke, thatha ikhefu elincinci phakathi.
• Joyina uluntu oluxhasayo: Buza ugqirha wakho malunga neenkqubo zokusinda kumhlaza okanye amaqela enkxaso. La maqela anokukunceda udibane nabantu abadlula kwizinto ezifanayo nezakho, wabelane ngezimvo, kwaye unciphise iimvakalelo zokuba wedwa. Usapho lwakho kunye nabahlobo banokuba ngumthombo omkhulu wenkxaso.

Ndifanele ndimbone nini ugqirha?

Ngexesha nasemva konyango, ukuba ubonakalisa naziphi na iimpawu ezintsha okanye ukuba iimpawu zakho ziya zisiba mandundu, xelela ugqirha wakho ngoko nangoko. Kwakhona, xelela ugqirha wakho ukuba uziva iintlungu okanye ubuthathaka nakweyiphi na indawo yomzimba wakho. Ungaphoswa ziintlanganiso zakho zokulandelela.

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa ufumanisa ukuba unomhlaza webele weLuminal B, kuyinto eqhelekileyo ukuba nemibuzo emininzi engqondweni yakho. Musa ukoyika ukubuza ugqirha wakho nayiphi na imibuzo onayo. Nazi ezinye zemibuzo onokuyibuza:

• Ingaba umhlaza wam une-HER2-positive okanye i-HER2-negative?
• Umhlaza wam ungakanani kwaye ungakanani?
• Ziziphi iindlela zonyango endinazo?
• Lusebenza njani olu nyango?
• Kufuneka ndidibane nogqirha kangaphi emva konyango (ulandelelwano)?
• Zithini iziphumo ebezingalindelekanga zonyango? Ndingenza njani ukuze ndiziphathe?
• Ingakanani ipesenti yam yeKi-67? Ithetha ukuthini?
• Ungandixelela ntoni ngesifo sam?

Ukuva amagama athi "unomhlaza" kunokuba yeyona nto yoyikekayo oza kuyiva. Kuqhelekile ukuba nemibuzo emininzi edlula engqondweni yakho njengoko uqhelana nale meko intsha kunye nokungaqiniseki. Iqela lakho lezonyango likhona ukukunceda. Bathembe. Ngomhlaza webele weLuminal B, banokwenza isicwangciso sakho sonyango ngokusekelwe kulwazi olukwinqanaba leemolekyuli zeeseli zakho. Thetha nogqirha wakho ukuze ufunde ngakumbi malunga nendlela iziphumo zakho zelebhu eziya kuyichaphazela ngayo isicwangciso sakho sonyango. Khumbula, awuwedwa.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Umhlaza webele weLuminal B luhlobo lomhlaza webele oluchaphazeleka zii-hormone kwaye ludla ngokukhula ngokukhawuleza. I-estrogen receptor (ER) positive (+), imeko ye-HER2 inokuba ntle (+) okanye ibe negative (-), kwaye amanqanaba e-Ki-67 adla ngokuba phezulu.

• Lumka kwiimpawu:Ukuba ubona iqhuma ebeleni lakho, intlungu, ukuphuma kwamanzi kwingono yakho, okanye utshintsho lolusu, funa ingcebiso kagqirha ngokukhawuleza.
• Ukuxilongwa ngokuchanekileyo kubalulekile: I-biopsy kunye novavanyo oluhambelanayo yeyona ndlela yokwazi uhlobo oluchanekileyo lomhlaza.
• Kukho iindlela zonyango: unyango lwehomoni, utyando, unyango lwemitha, unyango olujoliswe kulo, kunye ne-chemotherapy. Ugqirha wakho uya kugqiba ukuba yintoni ekulungeleyo.
• Unyango lwangethuba lukhokelela kwiziphumo ezingcono: Ukuxilongwa kwangoko kunye nonyango kwandisa amathuba okuchacha.
• Awuwedwa: Kukho oogqirha, abahlengikazi, usapho, abahlobo, kunye neqela lenkxaso ukukunceda kolu hambo.

Siyathemba ukuba olu lwazi lukuncedile ukuba uqonde esi sifo. Hlala usempilweni!

Umhlaza webele weLuminal B, umhlaza webele, ii-hormone receptors, i-estrogen, i-HER2, iimpawu zomhlaza, unyango lomhlaza, impilo yabasetyhini