Ukuba umdlavuza wakho webele usasazeke kwii-lymph nodes ukhetho lwakho lwezonyango luya kuba lukhuni. Ngethuba lokusasa ibele, asinakuqiniseka ukuba izidalwa zonyango zingasasazeka njani. Ekubeni i-metastases ijongene neepesenti ezingama-90 zesifo somhlaza wesifuba, esazi ixesha lokuphatha kakubi, kwaye xa unyango lwe-adjuvant olufana ne-chemotherapy lunokuba lukhuphe, lubalulekile.
Xa umdlavuza webele usasazeka kwii-lymph nodes uye wachaza "intliziyo" yayo yokumisa imitha. Ezi kancinci, xa zishiywe yedwa, ziza kusasazeka kuwo wonke umzimba kwaye ekugqibeleni zibangele ukufa.
Ziziphi ionyango zomhlaza wesifuba oye wasasazeka kwi-lymph nodes, kwaye oko kuthetha ukuthini ukuxela kwakho?
Kutheni i-Lymph Nodes ibalulekile kwiCancer Breast
Umhlaza wesifuba uqala kunye neeseli ezimbalwa, ezidibanisa ndawonye kwiisifuba zakho. Basenokuthi baxakeke kwinkqubo apho ubisi lwebele luveliswa khona: ubisi bakho kunye ne-lobes. Njengoko la maseli akhula kwaye ahlula, angaphinda ahlasele izicubu eziseduze.
I-tumor ekhulayo inokuchitha iseli okanye iqela leeseli. Lo mhlaza wesifo somhlaza ungasebenzisa igazi lakho okanye i-lymph system njengendlela yenethiwekhi yezendlela ukuze ukwazi ukuhamba kuwo wonke umzimba wakho. Iprogram yakho ye-lymph isebenza ngegazi lakho elijikelezayo ukubonelela izondlo kuzo zonke iiseli zakho, kunye nokukhupha iimveliso zamatye eselula.
I- lymph nodes "iimpawu zokugoba" kule nkqubo yeendlela, apho i-lymphatic fluid ihlungiwe, ixutywe ngamaseli omzimba (i-lymphocytes), kwaye idluliselwe kwi-lymph fluid yakho.
Ngoko ke, ukuba isalathisi esikrelekrele esenza ukuba i-lymph nodes yakho, kunokwenzeka ukuba umdlavuza unokuthunyelwa kwezinye iindawo zomzimba wakho.
Ukuba usufumana isifo, i-lymph node kufuphi nommandla ochaphazelekayo ungakhula ngenxa yokuba iqokelele iigciwane. Yaye ukuba uhlakulela umdlavuza webele, i-lymph nodes kwi-armpit yakho (i-lymph nodes) eyona ndawo eqhelekileyo ukuba iiseli zomhlaza ziza kufaka, zenze ukuba loo nodes ikhule.
Ukuxilonga Ukusebenzisa i-Sentinel Lymph Node Biopsy
Isisu sesifuba sinezinye i-lymph nodes, ezenza i-lymphatic fluid kwaye idlule. Iimvumbo zesisu zixhaphaza kwi-axilla yakho okanye kwindawo ye-underarm. Ukuhlolisisa indawo ye-lymph node ndawo kufuneka ibe yinxalenye yokuhlolwa kwebele, kunye nokuhlolwa kwakho kwebele . I-lymph nodes eziguqayo zingabakho ubungqina bokuba umdlavuza usasaze ngaphaya kwesifuba sakho, kodwa indlela yodwa yokwazi ngokuqinisekileyo kukuba ukukhutshwa kunye nokuvavanywa.
Kukho iinkqubo ezimbini ze-lymph node biopsy. Kwi- lynph node biopsy , idayi kunye nommakishi omsakazo ujojowe kumhlaza wakho webele. I-node yokuqala okanye i-node idayi ehamba kuyo ibizwa ngokuba yi-sentinel lymph nodes-iindawo zokuqala eziza kulindelwa ngumhlaza.
Enye indlela eya kwi-lymph node biopsy yenze i-lymph node dissection. Kule nkqubo, zonke i-lymph nodes ezingatholakala kwi-armpit yakho zisuswe.
Siye safunda ukuba ukufumana iiseli zomhlaza kwi-lymph node yakho ye-lymph node yinto efanelekileyo kakhulu yokuqikelela ukuba ingaba nomhlaza awufumaneki nakweyiphi i-lymph node yakho.
Ama-lymph nodes amaninzi aqhelekileyo kwindawo yokuqala apho umdlavuza webele usasazeka kodwa kukho ezinye izinto. Izifo zomhlaza zesisu eziphakathi kwesifuba sakho kunokuthi zize zitshelele kwii-lymph nodes phakathi kwamabele. Xa i-lymph nodes zisuswe zithunyelwa kwisebe lezilwanyana ukuba zijongwe kwi-visually and under the microscope.
Isimo seLymph Node
Ingxelo yokukhubazeka malunga ne-lymph node "isimo" sakho sichaza ukuba okanye akukho nawuphi na umqondiso womhlaza okhona kwii-lymph node zakho ezisuswe.
Unokuva amagama anjenge-macrometastases okanye i-micrometastases xa ugqirha wakho uxoxa ngezihloko zakho. I-Macrometastase ibhekisela ekusasazeni komhlaza kwi-lymph nodes ebonakala kwiso. Endaweni ye- Micrometastases kubhekisela kubungqina bomhlaza kwi-lymph nodes ezingabonwa kuphela phantsi kwe-microscope.
Ukuba i-lymph nodes yakho icacile ngomhlaza, imeko yakho ye-lymph node ibizwa ngokuba yimbi kwaye ilinganiswe nge-N0 ngokwemiqathango ye-TNM yesifo somhlaza wesifuba. Ukuba unesisu esincinci kunye namacwecwe acacileyo, akunakwenzeka ukuba uya kufuna imithi yonyango.
Ukuba unesifo somhlaza kwii-lymph nodes zakho, umhlaza wakho uya kuthathwa njengengqondo ye- lymph node-positive . Ngokusekelwe kwisigxina se-TNM, i-tumor yakho iya kuthiwa yi-N1, N2, okanye i-N3 isekelwe ukuba zingaphi i-lymph nodes zineengqambela zesifo kunye nokuba kude kangakanani ne-tumor.
Ezinye iziphumo ezibalulekileyo kwiNyango kunye neNgcebiso
Isimo se-lymph node esinye seziganeko ezibalulekileyo ekwenzeni izigqibo malunga nokunyangwa komhlaza webele, kodwa zikhona ezinye iimvavanyo ezidlala indima kwinkango kunye nokuxela. Ezi ziquka:
- Ubungakanani bomzimba: Ubunzima bomzimba budlala indima kwisifo somhlaza wesifuba .
- I-hormone receptor status: Ieseli zakho zomhlaza ziya kuhlolwe ukujonga imeko yakho ye-hormone receptor , oko kukuthi, ingaba iseli somhlaza wakho unemitholampilo ye-estrogen okanye ipresterone ebusweni, njengoko inceda ekukhokheleleni ukhetho lwonyango.
- Isimo se-HER2: Ukukhula komntu isifo se-epidermal receptor 2 , ukuba sikhona kumaseli omhlaza wakho, nayo idlala indima ekuxilongweni nasekunyangeni.
- Ibakala elixhamlayo: Ibanga le- tumor ngumlinganiselo wokutshatyalaliswa komhlaza kwaye olu vavanyo lunokukhokela iindlela zokunyanga.
- Ubukho beliphi na i-metastases: Ukuba umhlaza wakho usasazeke kwezinye iindawo zomzimba, umzekelo, amathambo akho okanye imiphunga yakho, oku kubalulekile ekukhetheni ukhetho lwezonyango.
Unyango lwabantu abaneNode ezifanelekileyo
Ukuba unayo i-sentinel node biopsy kwaye ayibi, mhlawumbi akukho mfuneko yokuba ube ne-lymph node dissection. Ngokwahlukileyo, ukuba unomdlavuza wamaseli ekhona kwi-lymph node yakho ye-sentinel, i-axillary node dissection ingabandakanywa kunye nokuhlinzwa komhlaza wakho webele. Ukuba i-lymph nodes yakho ilungile, kuya kufuneka uxoxe ngezinye iinketho zokwelapha kunye ne-oncologist yakho emva kokuhlinzwa.
Ukubandakanya i-lymph nodes kubonisa ukuba umdlavuza ubonise amandla okusasaza ngaphaya kwesifuba sakho kwaye uya kucebiswa ukuba ube neyeza ezichanekileyo zonyango ezifana ne-chemotherapy ukubulala nayiphi na iiseli zomhlaza eziqhubekayo emzimbeni wakho. Ulwaphulo lwe-Adjuvant lubhekisela kunyango olunikezwa kungekhona ngenxa yokuba nayiphi na umhlaza ubonakala, kodwa kuba kukhokwa ukuba kukho iiseli zomhlaza ezingaphezulu.
Kulabo abanesifo se-estrogen se-tumor, i-hormone ye-hormone ivame ukucetyiswa iminyaka emi-5 ukuya kwe-10 emva kokunyanga. Oku kunokuthiwa yi-tamoxifen kulabo abenza i-premenopausal kunye ne-aromatase inhibitor kulabo abasemva kwe-postmenopausal. Kubafazi besimo se-postmenopausal abaya kusebenzisa i-inhibitor ye-aromatase, iyeza le-bisphosphate i-Zometa icetyiswa kwaye ibonakala iyanciphisa umngcipheko wokuphucula i-metastases yeethambo. Amathambo yindawo eqhelekileyo yeemastastases kunye nomhlaza webele.
Ukunyangwa kwamayeza kunokwenziwa okanye kungenakucetyiswa kuxhomekeke kwinani lama-lymph nodes ezichanekileyo, kunye nezinye iziphumo zesisu sakho.
Prognosis
Iprognosis, ebizwa ngokuba yimbono, yindlela enye ugqirha ethetha ngayo malunga neengxaki zokusinda emva kwakho emva kokuba uzalise unyango. Khumbula, ukuba nomlenze omnye umhlaza emzimbeni wakho uninzi kakhulu. Unyango lwenzelwe ukubulala abaninzi, ukuba awunabo bonke, bamaseli omhlaza wakho ngangokunokwenzeka.
Ukuba unesifo se-lymph node kunye ne-small-grade-grade-tumor, ukuxela kwakho emva kokuba unyango luhle kakhulu. Kwesinye siphelo sembala, ukuba unayo i-lymph nodes echaphazelekayo okanye i-tumor enkulu, unyango lwakho luya kuba lukhuni, kwaye ukujonga kwakho kuya kuba nzima ukunquma emva kokugqiba zonke iipilisi. Inqaku elipapashwe kwiNew England Journal of Medicine lubonisa ingozi enkulu yokuphindaphinda kwizigulane ezine ezine-lymph nodes ezilungileyo. Kwakhona. ubungakanani besisu buyimpawu zokuzimela ezizimeleyo.
Kungakhathaliseki ukuba ukuxilongwa kwakho kuhambelana naluphi na umlinganiselo, nceda uyazi ukuba amazinga okusinda aphuculayo, unyango luya kuba lusebenza kakuhle kwaye lusebenza kakuhle, kwaye umdlavuza webele weemastanti ungadlalwa ixesha elide.
I-Lymph Node Rating
| I-Lymph Node Rating | I ntsi ngiselo |
| N0 | Ukungananto okanye kucace-akukho mhlaza kwaye akukho micrometastasis |
| I-N1, 2, 3: I- positive (inxaxheba) i-lymph nodes | |
| N1 | I-Cancer ifumaneka kwi-1-3 lymph nodes phantsi kwengalo okanye i-lymph nodes ngaphakathi kwebele |
| N2 | I-Cancer ifumaneka kwi-4-9 lymph nodes phantsi kwengalo okanye i-lymph nodes ngaphakathi kwebele |
| N3 | I-Cancer ifumaneka kwi-10 okanye ngaphezulu kwe-lymph nodes phantsi kwengalo okanye isasaze ngaphantsi okanye ngaphaya kwe-collarbone. Kusenokwenzeka ukuba ifunyenwe kwiindawo zokungena ngaphantsi kwee-underarm kunye ne-lymph nodes ngaphakathi kwebele |
Ngaphantsi
Ukuba unesifo sengculazi esilungileyo kunye nomhlaza wesifuba sokuqala, unyango luya kuba lukhuni kwaye luquka i-chemotherapy, unyango lwe-hormonal, unyango olujoliswe ku-HER kulabo abane-HER2 positive, kwaye mhlawumbi imisebe. Oko kwathiwa, abantu abaninzi abanomdlavuza we-lymph node-positive bahlala bengenawo umhlaza emva kokunyanga, kwaye isimo esilungileyo se-lymph node asitsho ukuba umhlaza wakho uza kubuya.
Imithombo:
Laronga, C. Ulwazi lweMonde: Isikhokelo soMhlaza weBester for the diagnosis and Treatment (Ngaphandle kweZiseko). Isemgangathweno.