Ukuxilongwa, unyango, iRhafu yokuPhila
Isigaba se-3 somhlaza wesifuba siphumelele ngaphezu kwesigaba sesi-2 , kodwa asiqwalaselwa njengemetastatic. Ngenxa yokuxilongwa, umhlaza awuzange usasaze kwibele kunye neziza okanye kwezinye iindawo ezikude emzimbeni, kodwa iiseli zomhlaza ziye zaya kwi-underarm (i-axillary) i-lymph nodes, okanye zifakwe kwi-lymph nodes phantsi kwebele (sternum) okanye phantsi yakho collarbone.
Sibanzi
Isigaba se-3 sesifuba sesifuba singaba nobukhulu besuka ngaphantsi kwe-2 cm ukuya ngaphaya kwe-5 cm, kodwa ngezinye izihlandlo asikho isisu esitholakala kwiisisu zebele. Eli nqanaba lomhlaza wesifuba elingenakunokuthi libandakanya i-wall muscle phantsi kwebele, okanye kunokuchaphazela isikhumba sebele. Ukuba isikhumba sebele sivuvuka okanye sisilonda ngumhlaza, sinokuba ngumhlaza webele webele (IBC).
Isigaba sesi-3 sisifo somhlaza wesifuba esingenayo esingachazwa ngemibandela emithathu: 3A, B, kunye neC. Ezi zigqityiwe ngokugqithisa ngesisu kunye nesimo se-node, njengoko kuchazwe yi- TNM . Nangona i-lymph nodes ingabandakanyeka, isigaba sesi-3 asithathwa njengemetastatic.
I-TNM Isalathiso sesigaba se-3 sesifo somhlaza
Isigaba somhlaza wesibeleko se-3 siphule kwisigaba 3A, 3B, no-3C. Ekubeni iingcebiso zonyango kwakunye nokuhlaselwa kwangaphambili kunokuba zihluke kakhulu phakathi kwezi ziqendu, kufuneka kube nokucwangcisa ngokucophelela. Ekuqaleni, inkqubo ye-TNM ingadideka. Sekunjalo ukuchazwa kweT, N, kunye ne-M, kuvumela oogqirha ukuba baqaphele ngokucacileyo isigaba.
TNM ibhekisela ku:
- T: ubungakanani besisu. I-T0 ibhekisela kumdlavuza wesifuba ongazange ufumaneke kwisisu sakho sebele kodwa sele ufunyenwe kwenye indawo. I-T1 iquka izicubu ezi-2 cm (malunga no-intshi enye) okanye ubuncinci ngobukhulu. I-T2 iquka izibilini eziphakathi kwe-2 cm kunye no-5 cm ububanzi. Iimvumi zeT3 zikhulu kunama-5 cm. Iimvumi ze-T4 zinokuba ziphi na ubukhulu kodwa ziye zahlasela udonga lwesifuba okanye isikhumba. I-T4 iquka umdlavuza webele.
- N: iinombolo. I-N0 ithetha ukuba i-tumor ayizange isasaze kwi-lymph nodes. I-N1 ibhekisela kwiidumbu eziye zasasaza kwii-lymph nodes eziseduze (ukuya ku-3). I-N1mi ithetha ukuba kukho i-micrometastases, okanye iiseli zesisu ezinokubonakala kuphela phantsi kwe-microscope. I-N2 ithetha ukuba i-tumor isasazeke kwi-lymph nodes ezi-4 ukuya kwe-9 phantsi kwengalo okanye kukho ukusabalala okubonakalayo kwi-lymph nodes zangaphakathi. I-N3 ingabhekisela kwiimeko ezininzi ezahlukeneyo, ezifana nokufumana i-lymph nodes ezili-10 okanye ngaphezulu ezithembekileyo okanye ukuba umhlaza usasazeke kwiindawo ezincinci (phantsi kwe-collarbone).
- M: iimitha zesistim. I-M0 ithetha ukuba akukho zixhobo ezikude. I-M1 ibhekisela kwiimvumi eziye zazinziwayo (ziyi-4 isigaba) kwaye zisasazeka. Xa umdlavuza wesifuba usasazeka kwiindawo eziqhelekileyo zezidumbu zenyama , amathambo, ingqondo, okanye imiphunga.
Isigaba 3A Umhlaza webele
- Isigaba 3A: I-T0, i-N2, i-M0: Akukho sikhomba sitholakale kwiisisu zomfuba, kodwa iiseli zomhlaza zifake kwii- lymph nodes kwi-underarm yakho okanye kwibele.
- Isigaba 3A: T1, N2, M0: I-tumor i-2 cm okanye encinci, OKANYE iye yahlasela kakhulu emathunzini asebele. Ukongezelela, umdlavuza usasazeke kwi-lymph nodes kwi-underarm yakho okanye izibilini zakho.
- Isigaba 3A: I-T2, i-N2, i-M0: I-tumor ingaphezu kwama-2 cm, kodwa ngaphantsi kwe-5 cm ngaphesheya. I-Cancer iye yaya kwii-lymph nodes kwi-underarm yakho okanye izibilini zakho.
- Isigaba 3A: I-T3, N1, M0: Le mbola inkulu kunama-5cm ngaphaya kwaye ayizange ifake isikhumba sesifuba okanye izidumbu zesikhumba sesifuba. I-Cancer ifunyenwe kwi-lymph nodes.
- Isigaba 3A: I-T3, i-N2, i-M0: Le mbola inkulu kunama-5cm ngapha nangapha kwaye ayizange ichaphazele izihlunu zesikhumba sebele. I-Cancer ifunyenwe kwi-sarmy nodes okanye i-node ebusini yakho.
Isigaba 3B I-Cancer Breast
- Isigaba 3B: I-T4, i-N0, i-M0: I-tumor ingaba nayiphi na ubukhulu kwaye ifuthe kwesikhumba sebele, okanye ikhule kwindonga yakho yesifuba, ngaphandle kokubandakanya umsila we-pectoralis. Ngamanye amaxesha umhlaza ufinyelela kwisibilini sakho sesibini kunye nodonga lwesifuba. Le ngqumbo ingaba ngumhlaza wesifuba ovuthayo.
- Isigaba 3B: I-T4, N1, M0: Esi sikhomba sinakho na ubukhulu kwaye sinokuqhotyosheliswa eludongeni okanye eludongeni lwesifuba, nokuba sisifo somhlaza wesibeletho. I-Cancer ifunyenwe kwakhona kwi-sarmy nodes eduze nebele echaphazelekayo.
- Isigaba 3B: I-T4, i-N2, i-M0: Esi sikhomba sinakho na isayizi, esichaphazela isikhumba sebele okanye udonga lwesifuba, okanye nokuba ngumhlaza wesibeleko. I-Cancer ifunyenwe kwakhona kwi-sarmy nodes okanye i-nodes ngaphakathi kwebele.
Isigaba 3C I-Cancer Cancer
- Isigaba 3C: T (nayiphi na), N3, M0: Esi sikhomba naluphi na ubukhulu, kodwa luqulethwe ngaphakathi kweethambo zebele. Udonga lwesifuba sakho kunye nekhumba lesikhumba akufanele lichaphazeleke. Ubume be-lymph node buyahlukahluka ngolu hlobo lulandelayo: umhlaza unokufumaneka kwiindawo eziphantsi kwengalo yakho, ngaphakathi kwebele yakho, phezu kwekholeji yakho, okanye ngaphantsi kwekholasi yakho. Ngokufanayo, umhlaza ungabonakalisa kwiindawo ezininzi zezi ndawo.
Umlinganiselo wokuSinda
Umlinganiselo wonyaka wesi-5 wokusinda kwi-scala 3 yomhlaza wesifuba unama-73 ekhulwini, kodwa oku kuyahluka ngokusekelwe kumhlathi kunye nezinye izinto ezininzi.
I-oncologists ixubusha malunga neengcambu zokusinda umdlavuza ngomhlaza ngokweminyaka emihlanu yokusinda. Oko akuthethi ukuba isigulane esiphezulu siya kuba neminyaka emi-5 ukuhlala emva kokuxilongwa! Kuthetha ukuba abo bagulane baphila ubuncinane kwiminyaka emihlanu ngaphaya kokuxilongwa, kwaye abaninzi babo bahlala ixesha elide. Akunabo bonke abagulane abaya kunqanda umdlavuza webele, kodwa bangafa kwezinye izinto.
Ugqirha wakho uya kuthetha nawe malunga nombono wakho oyingqayizivele wokusinda, ngokusekelwe kwimpilo yakho jikelele, ubudala, ezinye iimeko kunye nesimo sakho se- hormone yomhlaza. Amanqaku asebenza ngayo oogqirha asekelwe kwiinkcukacha ezivela kwiqela elikhulu labantu, kodwa alinakho ukulungelelisa imeko yakho. Ukongezelela, la manani abonakalisa ukusebenza kwangaphambili kwezi zonyango; Iimpawu ziye zenyuka kwiminyaka embalwa edlulileyo.
Unyango
Isicwangciso sonyango sakho siya kubandakanya ukuhlinzwa, i-chemotherapy, kunye namaxesha amaninzi, i-radiation. Ukuba i-tumor yakho i- HER2-positive , uza kunikwa i-Herceptin, kwaye ukuba yayiyi-hormone-sensitive (estrogen kunye / okanye i-progesterone-positive), unokulindela ukuthatha imithi ye-hormones iminyaka engama-5 emva kokuba unyango oluphambili luphela.
Izibilini ezincinci ezingazange ziphulwe kwi-sikhumba okanye kumisipha zingasuswa kunye ne- lumpectomy , kunye ne-nodeinel node biopsy kuyakufuneka ukuba ufumane ukuba umhlaza wesibele uhambe ngaphaya kwebele. Izibilini ezikhulu, kuquka abo baye bahlasela udonga lwesifuba, kuya kufuna imastectomy kunye ne-lymph node biopsy. Ukuvuselelwa kwesisu kusenokunikezelwa kuwe, kodwa ngamanye amaxesha kufuneka kulibazisekile ngenxa yonyango lomlingo .
I-Chemotherapy inikezelwa ukugxotha nayiphi na isifo somhlaza wesifo emzimbeni wakho; Oku kunceda ukunqanda ukuphindaphinda. Kodwa i-chemo inokuphinda inikezwe phambi kokuhlinzwa ukuze uphephe i-tumor. Xa i-chemotherapy inikezelwa emva kokuhlinzwa ngethuba lokuqala lomdlavuza webele, kubizwa ngokuba yi "chemotherapy adjuvant". Xa kunikwa ngaphambi kokuhlinzwa, kuthiwa "i-neoadjuvant chemotherapy."
Maxa wambi xa ulusu lwebele lubandakanyeka nomhlaza, kuthiwa ngumhlaza wesibeletho. Ulwaphulo olusisigxina njengokhemotherapy luqhelekileyo kwiklasi yokuqala yonyango lomhlaza wesifuba; Oku kokubili kunciphisa i-tumor enkulu, okwenza kube lula ukuba ugqirha uyisuse, kwaye ibulale neeseli zesisu ezijikelezayo kumgama kunye nommandla ongacacanga ngokucacileyo kumaseli omhlaza. Ngaphandle kokucima ezi ntlupheko zeeseli zomhlaza, iindawo ezisentlabeni zihlala zibonakalisa zilungile, zivame ukuphumela ekusebenzeni ngokuphindaphindiweyo kunye nokubonakala okubi kakhulu emva kokubonakala. Umdlavuza ovuthayo obusondeleyo uhlala ufuna i-mastectomy kunye ne- axillary lymph node dissection.
Inkathalo yokuLandela
Iimpawu zokulandela ziya kuxhomekeka kwi-hormone yakho kunye neHER2. Xa unyango olusebenzayo luphelile, uya kuba nexesha elilandelelweyo lokulandelela ixesha eli-5 kunye ne-oncologist yakho, ngexesha apho ungadinga ukuthatha unyango lwe-hormone ukuba i-tumor yakho yayiyi-hormone. Uya kuba ne-mammogram yakho yonyaka kwaye kufuneka uhlale uhamba kunye neentloko zakho zokuhlolwa , ekubeni nje unesisundu sebele emva kokuhlinzwa. Ngokusekelwe ekubeni nomhlaza wesifuba, ugqirha wakho unokuncoma i-MRIs ngezihlandlo zakho. Yiya kwisicwangciso sokutya esinempilo, kwaye uthethe nodokotela wakho ngomsebenzi oqhelekileyo wokuzilolonga oya kuvuselela kwakhona amandla akho kunye nokuphila kakuhle.
ILizwi Elivela kwiSigaba 3 I-Cancer Breast
Isigaba sesi-3 sisona sihlandlo esiphezulu kakhulu somhlaza wesifuba kodwa sisaphathwa kakhulu. Yaye unyango luya kuphucula. Ngokomzekelo, ngo-2017 ukongezwa kwe-bisphosphonates kwongezwa kwi-esrogen enomdlavuza wamabele ekunciphiseni umngcipheko wokuba umhlaza uza kufaka amathambo. Gcina ukhumbule ukuba izibalo oziva ngazo xa ufunda malunga nokuphila aziqwalasela ezi zonyango. Ukufikelela kwabanye kuye kwaboniswa ukuphucula izinga lokusinda. Joyina iqela lokuxhasa okanye ufumane umdlavuza wesizwe. Uninzi lwazo zonke, yiba ngummeli wakho kwinkathalo yakho yempilo, kungekhona nje ngomdlavuza webele, kodwa ugcine impilo yakho yonke emva kokunyanga.
> Imithombo:
> I-AJCC Inkcazo yokuThengisa umdlavuza weCancer 6. Springer Verlag, eNew York, NY. 2002, iphepha 223-240.
> I-American Cancer Society. I-Cancer Yokusinda kwiiRhafu ngeSigaba.
> I-American Cancer Society. Unyango lweCarcer Breast Invitous, By Stage.
> INational Cancer Institute. Izigaba zeCanscer Breast. Isigaba IIIA-C.
> Uthando, uSusan M. Luhlobo luni lweCarcer Breast Ngaba ndinayo: Ukugxininisa. Pp. 303-321. UDkt Susan Love's Breast Book. UMqulu weSihlanu, ngo-2010.