Okudingeka ukwazi ngomdlavuza webele i-Luminal B!

Cishe uke wezwa okuningi ngomdlavuza webele. Kodwa ubuwazi ukuthi kunezinhlobo ezahlukene zomdlavuza webele? Namuhla sizokhuluma ngohlobo olukhethekile olubizwa ngokuthi umdlavuza webele we-Luminal B. Leli gama lingase lizwakale liyinkimbinkimbi kancane, kodwa ungakhathazeki. Sizokhuluma ngalo ngendlela elula kakhulu ongayiqonda. Ngoba ukuqaphela izinto ezinjengalezi kungaba yinto ebaluleke kakhulu kuwe nakubantu obathandayo.

Iyini i-Luminal B? Yiziphi izici zayo ezikhethekile?

Kalula nje, i-Luminal B uhlobo lomdlavuza webele olune-hormone receptor-positive (HR+). Lokhu kungenxa yokuthi amaprotheni athile (ama-receptor) ngaphakathi kwamaseli omdlavuza abopha i-hormone estrogen, okwenza umdlavuza ukhule. Igama elithi "luminal" libhekisela kumaseli angaphakathi kwemisele yobisi ebeleni lakho. Cabanga ngakho njengengaphakathi lepayipi.

Manje ake sibheke ezinye izici ezikhethekile zamaseli omdlavuza we-Luminal B. Lezi zifana nekhadi lokuhlonza lo mdlavuza. Odokotela bazofunda lezi zici ngokucophelela ukuze banqume ukuthi yikuphi ukwelashwa okungcono kakhulu kuwe.

• I-Estrogen receptor positive (ER+): Lesi yisici esibaluleke kakhulu. Amaseli omdlavuza we-Luminal B anamaprotheni abizwa ngokuthi ama-Estrogen Receptors (ER) angabopha i-hormone i-Estrogen. I-Estrogen iyi-hormone ekhiqizwa ngokwemvelo emzimbeni wesifazane. Ngakho-ke, lapho le hormone ibopha amaseli omdlavuza, umdlavuza uthola amandla okukhula. Kufana nokunisela nokunakekela isitshalo.
• Aphansi noma Angemahle kuma-receptor e-Progesterone (PR- noma i-PR ephansi): Uma kuqhathaniswa nohlobo lomdlavuza webele lwe-Luminal A, amaseli e-Luminal B anamaprotheni ambalwa kakhulu, noma ngezinye izikhathi awanawo nhlobo, abophezela kwenye i-hormone enkulu yabesifazane, i-progesterone.
• Isimo se-HER2 (HER2-positive (HER2+) noma HER2-negative (HER2-)): Lesi futhi yisici esibaluleke kakhulu. I-HER2 imele iphrotheni ebizwa ngokuthi 'i-Human Epidermal Growth Factor Receptor 2'. Lokhu kuyinto evame ukusiza amaseli akhule. Kodwa-ke, amanye amaseli omdlavuza webele enza kakhulu le phrotheni ye-HER2, ngokungalawuleki. Kumdlavuza we-Luminal B, le phrotheni ye-HER2 ingaba khona ngokweqile (HER2-positive / HER2+), noma ingaba khona emazingeni ajwayelekile (HER2-negative / HER2-). Izindlela zokwelapha ziyahlukahluka kuye ngalesi simo.
• Amazinga aphezulu e-Ki-67 protein (Ephezulu ku-Ki-67):I-Ki-67 iyiprotheni ekhethekile etholakala kuphela kumaseli ahlukana ngokushesha. Umdlavuza we-Luminal B uvame ukuba namazinga aphezulu ale protheni. Lokhu kusiza odokotela baqonde ukuthi amangqamuzana omdlavuza ahlukana ngokushesha kangakanani, okusho ukuthi umdlavuza ukhula ngokushesha kangakanani. Yingakho umdlavuza we-Luminal B uvame ukukhula ngokushesha kunomdlavuza we-Luminal A.
• Izinga Eliphezulu: Izinga lomdlavuza liwukuthi amangqamuzana omdlavuza afana noma ahluke kangakanani kumaseli anempilo uma ebhekwa ngesibonakhulu. Izinga Eliphezulu lisho ukuthi amangqamuzana omdlavuza ahluke kakhulu kumaseli anempilo futhi kungenzeka akhule futhi asakazeke ngokushesha. Umdlavuza we-Luminal B uvame ukuba yizinga eliphezulu kune-Luminal A. Lokhu kusho ukuthi unolaka kakhulu, ungakhula ube mkhulu, futhi kungenzeka ukuthi uphinde uvele ngemva kokwelashwa.

Uyabona, akunjalo? Zonke lezi zinhlamvu, izinombolo, kanye nezifinyezo (njenge-ER, i-PR, i-HER2, i-Ki-67) zengeza ulwazi oluningi mayelana namaseli omdlavuza esifubeni sakho. Kungokuhlaziya lolu lwazi lapho odokotela bengakuhlelela khona ukwelashwa okwenzelwe wena futhi babikezele ukuthi hlobo luni lwemiphumela ongayilindela ekwelashweni.

Uvame kangakanani umdlavuza webele we-Luminal B?

Manje ungase uzibuze, 'Bangaki abantu abanalesi sifo?' Eqinisweni, phakathi kuka-15% no-20% wezigameko zomdlavuza webele ezibikwe emhlabeni wonke zinalolu hlobo lomdlavuza. Lokhu kuncane kancane kunohlobo oluvame kakhulu olubizwa ngokuthi i-Luminal A. Kodwa, leli phesenti alibalulekile, akunjalo? Yingakho kubalulekile ukuqaphela lokhu.

Ziyini izimpawu zomdlavuza webele we-Luminal B?

Ngokuvamile, odokotela bayakwazi ukukubona ngaphambi kokuba ube nezimpawu, ngokuhlolwa kwamabele okuvamile , njenge-mammogram. Yingakho kubalulekile ukwenza lezi zivivinyo useminyakeni yakho. Kodwa ngezinye izikhathi ungase ube nezimpawu eyodwa noma ngaphezulu:

• Iqhubu elisesifubeni: Lokhu kuvame ukuba yiqhubu eliqinile, elifana nerabha elingashukumi kalula.
• Ubuhlungu bebele: Ungase uzwe ubuhlungu kwelinye noma kuwo womabili amabele.
• Ukuphuma kwengono: Kufanele ukhathazeke uma uphuma ingono, ikakhulukazi uma ixubene negazi .
• Izinguquko zesikhumba: Ungase uqaphele ukufiphala kwesikhumba, ukuqina, noma ukushintsha kombala wesikhumba sesifuba.
• Ukuvuvukala ngaphansi kwekhwapha: Ama-lymph node endaweni yekhwapha angavuvukala.

Uma ubona uphawu olufana nalolu,Ungesabi bese ubona udokotela ngokushesha. Akuzona zonke izigaxa ezinomdlavuza, kodwa kuwukuhlakanipha ukuzihlola.

Yini ebangela umdlavuza webele we-Luminal B?

Eqinisweni, umdlavuza webele we-Luminal B uqala lapho amaseli ebele aphilile eshintsha ngokuzumayo futhi eqala ukukhula ngokungalawuleki. Kodwa ochwepheshe abasazi kahle ukuthi kungani lokhu kwenzeka. Kungabangelwa yinhlanganisela yezici.

Njengoba sixoxile ngaphambili, amaseli e-Luminal B aqukethe amaprotheni akhuthaza ukukhula komdlavuza uma ebopha i-hormone i-estrogen. Ngakho-ke, uma amazinga akho e-estrogen ephezulu isikhathi eside, kungandisa kancane ingozi yakho yokuthola lo mdlavuza. Isibonelo:

• Uma isikhathi sakho siqale ngaphambi kwesikhathi esijwayelekile, okungukuthi, ngaphambi kweminyaka engu-12.
• Noma uma ukunqamuka kokuya esikhathini, okusho ukuthi ukuyeka ngokuphelele ukuya esikhathini, kwenzeka ngemva kweminyaka engu-55.
• Noma uma usuthathe isikhathi eside uthatha ukwelashwa kokushintsha ama-hormone (HRT) ukuze ulawule izimpawu ezihlobene nokunqamuka kokuya esikhathini.

Ngaphezu kwalokhu, kunezinye izici eziningana ezingandisa ingozi yomdlavuza webele we-luminal B:

• Umlando womndeni: Uma umama wakho, udadewenu, indodakazi yakho, noma isihlobo sakho esiseduze sibe nomdlavuza webele noma umdlavuza wesibeletho, usengozini enkulu kancane.
• Ubudala: Ingozi yokuba nomdlavuza webele iyanda ngemva kweminyaka engu-50.
• Izicubu zebele eziqinile: Uma izicubu zebele zibonakala ziqinile ku-mammogram, lokho nakho kuyisici esiyingozi.
• Ukwehlukahluka kwezakhi zofuzo: Ukuguqulwa kwezakhi zofuzo okuzuzwe njengefa kwezinye izakhi zofuzo, njenge-BRCA1 kanye ne-BRCA2, kungandisa kakhulu ingozi yomdlavuza webele.
• Ukwelashwa ngemisebe ngaphambilini: Uma uke wathola ukwelashwa ngemisebe esifubeni noma esifubeni ngesinye isizathu.

Ukuba nalezi zici eziyingozi akusho ukuthi uzokuthola umdlavuza nakanjani. Kodwa-ke, kubalulekile ukuzazi.

Umdlavuza webele we-Luminal B utholakala kanjani?

Ake sithi unezimpawu zomdlavuza webele, noma i-mammogram ikhombisa okuthile okusolisayo. Into yokuqala udokotela angayenza ukuhlola umzimba. Lokhu kusho ukuthi bazohlola amabele akho ngokomzimba ukuze bahlole amaqhubu noma ezinye izinguquko.

Bese, ukuze bathole okwengeziwe, bavame uku-oda ukuhlolwa okwengeziwe kwezithombe okufana nalokhu:

• I-mammogram yokuxilonga: Lokhu kunemininingwane eminingi kune-mammogram evamile.
• Ukuskena nge-ultrasound: Lokhu kungasiza ekunqumeni ukuthi iqhubu liqinile noma i-cyst egcwele uketshezi.
• Ukuskena kwe-MRI (Magnetic Resonance Imaging): Lokhu kungadingeka nakwezinye izimo ezikhethekile.

Ngemva kwalezi zivivinyo, udokotela uzothatha isampula yezicubu zebele (i-breast biopsy) ayithumele ukuze iyohlolwa. Lena ukuphela kwendlela yokuqinisekisa ukuthi umdlavuza ukhona noma cha, futhi uma kunjalo, uhlobo luni. I-biopsy ihilela ukuthatha ingxenye encane yezicubu endaweni esolisayo bese uyithumela elabhorethri ukuze ihlolwe ngaphansi kwe-microscope.

Udokotela wezifo, udokotela ogxile ekuhloleni izicubu, uzohlola isampula yezicubu zakho ukuze abone ukuthi kukhona yini amangqamuzana omdlavuza. Uma kutholakala amangqamuzana omdlavuza, azokwenza izivivinyo ze-hormone receptor (ze-ER, PR) kanye nezivivinyo ze-HER2 ukuze kutholakale uhlobo lomdlavuza. Kulezi zivivinyo, ezisetshenziswa kakhulu ukuhlolwa okubizwa ngokuthi i-immunohistochemistry (IHC) . Lokhu kusebenzisa amadayi e-fluorescent nama-enzyme ukugqamisa ama-molecule athile kumaseli omdlavuza. Ngezinye izikhathi, amazinga e-Ki-67 nawo ayahlolwa ngale ndlela.

Lokhu kuhlolwa kwesampula yezicubu zakho kungasiza ithimba lakho lezokwelapha ukuthi yiziphi izindlela zokwelapha ezizokusebenzela kangcono, kanye nokukunikeza umbono wokuthi kungenzeka kangakanani ukuthi umdlavuza uphinde ubuye ngemva kokwelashwa.

I-Luminal B isetshenziswa kanjani ukwelapha umdlavuza webele?

Ukwelashwa komdlavuza webele we-Luminal B kungahluka kuye ngomuntu nomuntu. Kuncike ezintweni eziningi, okuhlanganisa isimo sakho, isigaba somdlavuza, isimo sakho se-HER2 (HER2+ noma i-HER2-), izinga lakho le-Ki-67, kanye nempilo yakho iyonke. Ithimba lakho lezokwelapha lizocabangela zonke lezi zici ukuze lenze uhlelo lokwelashwa olungcono kakhulu kuwe.

Izindlela zokwelapha eziyinhloko ezisetshenziswayo yilezi:

• Ukwelashwa ngama-hormone: Njengoba i-Luminal B ingumdlavuza ozwela ama-hormone (HR+), lena yindlela yokwelapha evame kakhulu. Lokhu kusebenza ngokuvimbela i-hormone estrogen ukuthi ingafiki kumaseli omdlavuza, noma ngokunciphisa izinga le-estrogen emzimbeni. Kusetshenziswa izidakamizwa ezifana ne-Tamoxifen kanye ne-Aromatase Inhibitors kulokhu.
• Ukuhlinzwa: Lokhu kuhilela ukususa amangqamuzana omdlavuza ebeleni.
• Ukususwa kwe-Lumpectomy: Lokhu kuhilela ukususa kuphela isimila esinomdlavuza kanye nenani elincane lezicubu ezinempilo ezisizungezile, okushiya ingxenye enkulu yebele ingathintekile.
• Ukususwa kwebele: Lokhu kuhilela ukususa lonke ibele.

Ngesikhathi sokuhlinzwa, ama-lymph node asekhwapheni angasuswa ukuze kubonakale ukuthi umdlavuza ususakazeke yini.

• Ukwelashwa ngemisebe:Ngemva kokuhlinzwa, ukwelashwa ngemisebe kunikezwa ukubulala noma yimaphi amangqamuzana omdlavuza asele endaweni. Lokhu kuvame ukunikezwa, ikakhulukazi uma kwenziwe i-lumpectomy.
• Ukwelashwa okuqondiwe: Lolu hlobo lokwelashwa luhlose ama-molecule athile asiza amangqamuzana omdlavuza akhule. Isibonelo, uma umdlavuza we-Luminal B une-HER2-positive (HER2+), imithi ehlose iphrotheni ye-HER2 (isb. i-Trastuzumab) inganikezwa. Lokhu kunqunywa yisigaba somdlavuza kanye namanye amaphrofayili e-receptor.
• Ukwelashwa ngamakhemikhali: I-chemotherapy engeziwe ingase inikezwe ukubulala amangqamuzana omdlavuza angazange abulawe ngezinye izindlela zokwelapha, noma ukuvimbela umdlavuza ukuthi ungasabalali kwezinye izingxenye zomzimba. Umdlavuza we-Luminal B ukhula ngokushesha kune-Luminal A futhi unamazinga aphezulu e-Ki-67, ngakho-ke lokhu kunconywa kwezinye iziguli ezisengozini enkulu. Udokotela wakho uzokutshela ukuthi lokhu kuyindlela enhle yini kuwe.

Khumbula, ukwelashwa komuntu onomdlavuza we-Luminal B one-HER2-positive (HER2+) kungase kuhluke kunokwelashwa komuntu onomdlavuza we-Luminal B one-HER2-negative (HER2-). Yingakho kubalulekile ukwazi zonke lezi zici zomdlavuza wakho.

Iyini i-prognosis kubantu abanomdlavuza webele we-Luminal B?

Isibikezelo, noma ithemba lokusinda nokwelashwa, komuntu onomdlavuza webele we-Luminal B kuncike ekutheni isimila sithuthuke kangakanani uma sitholakala (isigaba somdlavuza). Njenganoma yimuphi umdlavuza, uma uqala ukwelashwa ngokushesha, amathuba akho okusinda ayanda.

Kuye ngesigaba sokuxilongwa, umdlavuza webele we-Luminal B uyelapheka , okusho ukuthi lesi sifo singaphela ngokwelashwa. Kodwa-ke, singaphinde sibuye. Umdlavuza we-Luminal B unamathuba amaningi okuphinde ubuye kune-Luminal A.

Ingozi yokubuyela emuva komdlavuza incike ezintweni eziningana, okuhlanganisa isigaba sesifo, izinga lokukhula kwaso, amazinga e-Ki-67, isimo se-HER2, kanye nokusabela ekwelashweni. Ngakho-ke, noma ngabe usesimeni esihle, udokotela wakho uzoqhubeka nokuqapha impilo yakho. Kubalulekile ukuba nokulandelela njalo . Bangase batuse futhi ukwelashwa okwengeziwe (njengokwelashwa ngama-hormone) ngemuva kokuhlinzwa kanye nokwelashwa ngemisebe ukuze kuncishiswe ingozi yokubuya komdlavuza.

Amazinga Okusinda Komdlavuza Webele we-Luminal B

Manje ake sixoxe kancane ngalezi zibalo. Kodwa lezi yizilinganiso nje ezimaphakathi.Kudingeka ukhumbule ukuthi lokhu akuzona izilinganiso ezinembile zokuthi uzophila isikhathi esingakanani noma ukuthi uzosabela kanjani ekwelashweni okuthile. Kusekelwe kudatha evela eqenjini elikhulu leziguli.

• Izinga lokusinda kweminyaka emihlanu kubantu abanomdlavuza webele we-HR+/HER2+ (i-hormone receptor positive/human epidermal growth factor receptor 2 positive) licishe libe ngu -91.5% . Lokhu kusho ukuthi kubantu abayi-100 abanalolu hlobo lomdlavuza, cishe abangu-91 bazophila eminyakeni emihlanu ngemva kokuxilongwa.
• Leli phesenti labantu abanomdlavuza webele we-HR+/HER2- (i-hormone receptor positive/human epidermal growth factor receptor 2 negative) licishe libe ngu -95.1% .

Into ebaluleke kakhulu ukukhuluma ngokukhululekile nodokotela wakho ukuze uqonde kahle ukuthi lezi zibalo zikuthinta kanjani. Angakuchazela zona ngendlela efanele isimo sakho.

I-Luminal B iyinciphisa kanjani ingozi yomdlavuza webele?

Asikwazi ukushintsha ezinye izinto eziyingozi, njengomlando womndeni walesi sifo. Kodwa-ke, ukwenza izinguquko ezithile endleleni yokuphila kungasiza ekunciphiseni ingozi yokuthola noma yiluphi uhlobo lomdlavuza webele, okuhlanganisa ne-luminal B:

• Gwema ukubhema: Ukubhema kuyimbangela eyingozi yomdlavuza eminingi.
• Khulisa umsebenzi womzimba: Kuhle kakhulu ukuzivocavoca okungenani imizuzu engama-30 izinsuku eziningana ngesonto.
• Nciphisa ukuphuza utshwala: Kubalulekile ukunciphisa ukuphuza utshwala.
• Gcina isisindo esinempilo: Ukugcina isisindo esinempilo sobude bakho kubaluleke kakhulu, ikakhulukazi ngemva kokunqamuka kokuya esikhathini.
• Ukudla okunomsoco: Yidla ukudla okucebile ngezithelo, imifino kanye nokudla okusanhlamvu okuphelele.

Ngizinakekela kanjani? Yini okufanele ngiyenze uma ngiphila nomdlavuza?

I-Luminal B Ukuphila nomdlavuza webele kungaba yinselele enkulu, ngokomzimba nangokwengqondo. Ngezinye izinsuku ungase uzizwe kahle, kanti ngakusasa ungase uzizwe ukhungathekile, ucindezelekile, udabuke futhi wesaba. Lokho kuvamile. Ngakho-ke, kubalulekile ukuzinakekela kahle phakathi nokuxilongwa kwakho kanye nokwelashwa.

Nazi ezinye izinto ezingakusiza:

• Yidla kahle: Yidla ukudla okunomsoco. Faka izithelo, imifino, amaprotheni angenawo amafutha, kanye nokusanhlamvu okuphelele ekudleni kwakho. Uma uzizwa uphelelwa yisifiso sokudla ngesikhathi sokwelashwa, xhumana nodokotela wakho noma isazi sokudla okunempilo.
• Thola izindlela zokuphatha ukucindezeleka:Ungaphumuza ingqondo yakho ngokwenza izinto ezifana nokuzindla, i-yoga, ukuvivinya umzimba ngokuphefumula, kanye nokuzibandakanya nomsebenzi wokuzilibazisa ozokulethela injabulo.
• Phumula kakhulu: Ukulala ngokwanele kubaluleke kakhulu. Ungasebenzi usuku lonke, thatha ikhefu elincane phakathi.
• Joyina umphakathi osekelayo: Buza udokotela wakho ngezinhlelo zokusinda emdlavuza noma amaqembu okusekela. La maqembu angakusiza uhlangane nabantu abadlula ezintweni ezifanayo nawe, wabelane ngemibono, futhi unciphise imizwa yokuba nesizungu. Umndeni wakho nabangani bakho nabo bangaba umthombo omuhle wokusekela.

Kufanele ngimbone nini udokotela?

Ngesikhathi sokwelashwa nangemva kokwelashwa, uma uba nanoma yiziphi izimpawu ezintsha noma uma izimpawu zakho ziba zimbi kakhulu, tshela udokotela wakho ngokushesha. Futhi, tshela udokotela wakho uma uzwa ubuhlungu noma ubuthakathaka kunoma iyiphi ingxenye yomzimba wakho. Ungaphuthelwa ama-aphoyintimenti akho okulandelela.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uthola ukuthi unomdlavuza webele we-Luminal B, kuvamile ukuba nemibuzo eminingi engqondweni yakho. Ungesabi ukubuza udokotela wakho noma yimiphi imibuzo onayo. Nansi eminye imibuzo ongayibuza:

• Ingabe umdlavuza wami une-HER2-positive noma i-HER2-negative?
• Iyini izinga kanye nesigaba somdlavuza wami?
• Yiziphi izindlela zokwelapha enginazo?
• Lokhu kwelashwa kusebenza kanjani ?
• Kukangaki ngidinga ukubona udokotela ngemva kokwelashwa (ukulandelela)?
• Yiziphi imiphumela emibi yokwelashwa? Kufanele ngibhekane kanjani nayo?
• Liyini iphesenti lami le-Ki-67? Lisho ukuthini?
• Yini ongangitshela yona ngesibikezelo sami?

Ukuzwa amagama athi "unomdlavuza" kungaba yinto eyesabekayo kakhulu oyoke uyizwe. Kuvamile ukuba nemibuzo eminingi egijima engqondweni yakho njengoba uzivumelanisa nalesi simo esisha kanye nokungaqiniseki. Ithimba lakho lezokwelapha likhona ukukusiza. Bathembe. Ngomdlavuza webele we-Luminal B, bangakwazi ukulungisa uhlelo lwakho lokwelashwa ngokusekelwe olwazini olusezingeni lama-molecule amaseli akho. Khuluma nodokotela wakho ukuze ufunde kabanzi mayelana nokuthi imiphumela yakho yelebhu izothinta kanjani uhlelo lwakho lokwelashwa. Khumbula, awuwedwa.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Umdlavuza webele we-Luminal B uhlobo lomdlavuza webele oluzwela kuma-hormone futhi luvame ukukhula ngokushesha. Lune-estrogen receptor (ER) positive (+), isimo se-HER2 singaba sihle (+) noma sibe sibi (-), kanti amazinga e-Ki-67 avame ukuba phezulu.

• Qaphela izimpawu:Uma ubona iqhubu esifubeni sakho, ubuhlungu, ukuphuma koketshezi engonweni yakho, noma izinguquko zesikhumba, funa iseluleko sezokwelapha ngokushesha.
• Ukuxilongwa okunembile kubalulekile: Ukuhlolwa kwe-biopsy kanye nokuhlolwa okuhlobene nakho kuyindlela kuphela yokwazi uhlobo oluqondile lomdlavuza.
• Kunezindlela zokwelapha: ukwelashwa ngama-hormone, ukuhlinzwa, ukwelashwa ngemisebe, ukwelashwa okuqondiwe, kanye ne-chemotherapy. Udokotela wakho uzonquma ukuthi yikuphi okungcono kakhulu kuwe.
• Ukwelashwa kusenesikhathi kuholela emiphumeleni engcono: Ukuxilongwa kusenesikhathi kanye nokwelashwa kwandisa amathuba okululama.
• Awuwedwa: Kukhona odokotela, abahlengikazi, umndeni, abangani, kanye neqembu lokusekelana ukuze bakusize kulolu hambo.

Sithemba ukuthi lolu lwazi lukusizile ukuthi uqonde lesi sifo. Hlala uphilile!

Umdlavuza webele we - Luminal B, umdlavuza webele, ama-hormone receptors, i-estrogen, i-HER2, izici zomdlavuza, ukwelashwa komdlavuza, impilo yabesifazane