I-Cancer ye-Breast Look-Alikes on Exam and Mammogram
Uninzi lwethu lwazi umntu obenomdlavuza wesifuba nangona i-mammogram evamile. Kwiphepha le-flip, kukho iinguqu ezinomdla (ezingengomhlaza) ezitshintshayo ezinokulinganisa umdlavuza webele. Ukubukeka kweengxaki zomhlaza wesibeleko kubangele ukuxhalaba kunye nokuxinezeleka. Ziziphi ezinye iimeko ezinokuphosakelwa ngomhlaza wesifuba kodwa zincinci?
Masiqale ngokukhangela ngokufutshane kwiimpawu kunye nempawu zesifo somhlaza wesibeleko kwiimviwo nakwiingcamango zengcamango.
Impawu zeCanscer Breast
Ngokuqinisekileyo izibilini zesifuba ezinobungozi zingamaxesha athile zivakalelwa, kodwa zikhona ezinye iimpawu eziqhelekileyo ngomhlaza. Ezi ziquka:
- Isalathisi sesifuba esivakalelwa sisigxina
- Ubunzima besifuba obunqamlekileyo kwaye abukwazi ukujikeleza ngaphantsi kwesikhumba
- Ubomvu nokuvuvukala (iimpawu zesifo somhlaza wesifuba)
- Ukwandisa i-lymph nodes phantsi kwengalo
Iimpawu zeMatmogram Ukufumana iCanscer Breast
Njengoko uvavanyo lwakho lweklinikhi, ngamanye amaxesha kunzima ukuhlula phakathi kwenkqubo yokuziphatha emdlalweni webele kunye nesifo somhlaza. Enyanisweni, ngamanye amaxesha le nto iyakunqumla ngokupheleleyo (injongo yale nqaku). Amammograms acingelwa ukuba angama-60 ukuya kuma-90 ekhulwini anengqiqo, oku kuthetha ukuba i-60 ukuya kwe-90 ekhulwini yexesha ukuba umhlaza unakho, i-mammogram iya kuyifumana. Amammogram aneenkcukacha ezingama-93 ekhulwini. Oku kuthetha ukuba i-93 ekhulwini yexesha, into ekhangeleka njengomdlavuza kwimimmogram iya kuba ngumhlaza.
Oko kuthetha ukuba iipesenti ezi-7 zexesha le-mammogram libonisa kakhulu umdlavuza, yinto enye.
Iziphumo zeMammogram ezibonisa ukuba umdlavuza uquka ukubalwa kwamabele , imibala enemizimba engavumelekanga, kunye nobuninzi obuninzi (ubunzima bubukeka beentambo eziphuma ngaphandle ukusuka kwinqununu enkulu).
Izazi ze-Radiologists zinika i-mammogram inombolo eyaziwa ngokuba yiNgxelo yokuBaliswa koBusiso kunye neNkqubo yeDatha okanye udidi lwe -BI-RADS . Kule nkqubo, ingxelo ye-mammogram inikwa inombolo phakathi kwe-1 no-6 echaza amathuba okuba nomhlaza. Inani elingu-1 lithetha ukuba akukho zibonakaliso zomhlaza kwaye inani elingu-5 lithetha ukuba i-mammogram iphakamisa kakhulu umhlaza (ininzi ye-6 ithetha umhlaza kwaye inikwa kuphela emva kokuba i-biopsy yenziwe).
Iqondo lokumkhumbula eliqhelekileyo ukusuka kwi- mammogram yokuhlola i-98 yeepesenti, ithetha i-9,8 ekhulwini yabasetyhini abanezintlu (abanalo naziphi iimpawu) babuyiselwa ukwenza ezinye izifundo. Kula mabhinqa, iipesenti ezili-12 ziya kufuna i-biopsy eyenziwe. Kule mijelo ye-biopsies, iipesenti ezingama-60 ziya kuba zizinzi. Ngamanye amagama, nangona unesifo esingaqhelekanga, kwaye nokuba ngaba uphando olulandelayo luyacetyiswa ukuba unokwenziwa kwe-biopsy, usenokwenzeka ukuba unesifo senzobo kunomdlavuza.
Iziphumo ze-Breast Ultrasound With Cancer Cancer
Uvavanyo lwebrain lwe-ultrasound lubonelelo olubalulekileyo xa lusetyenziswa kunye nemimmograms. Ngamanye amaxesha bayakwazi ukwahlula i-cyst kwi-mass mass, kwaye xa i-cyst ikhoyo ingasuswa phantsi kwekhompyutheni ye-ultrasound ukulungisa ingxaki. I-ultrasounds ingasetyenziselwa kunye ne-mammogram njengethuluzi lokuhlola abantu besetyhini ngamabele amanzi, kodwa banokulinganisela okuphezulu okungalunganga.
Oko kuthetha ukuba banomlinganiselo ophakamileyo wokubonisa umhlaza nangona umhlaza awukho.
Kwi-ultrasound, iimpawu ezibonisa umhlaza ziquka umlinganiselo osisigxina ongaqhelekanga, iimitha eziqhelekileyo, kunye "nolwazi oluqhelekileyo."
Iziphumo ze-MRI ze Breast Cancer
I-MRIs yesisu ihlala igcinwe kubasetyhini abanomngcipheko ophezulu wokuba nomdlavuza webele, sele sele benomdlavuza wesifuba, okanye njengesifundo sokulandela ukufumana iziphumo ezingenangqiqo kwi-mammogram, ultrasound, kunye novavanyo. Kwi-MRI, iziphumo ezibonisa ukuba umdlavuza webele uquka ubunzima obunemizila echaziweyo, ukuphakanyiswa kwesigxina kummandla obuninzi, okanye into eyaziwa ngokuba yi "washout kinetics."
Isisu se-Breast and Cancer
I- biopsy yebele iyimvavanyo echanekileyo ukuba umhlaza uphelelwa. Oku kunokwenziwa njengenaliti efunayo yentsholongwane (ngokuqhelekileyo igcinelwe i-cysts zebele), ingqungquthela yesazi eyintloko, i-biopsy yebele , okanye i-biopsy evulekile. Ukuba iziphumo zeengcamango ze-biopsy kunye nezo-imaging azihambisani, i- breastpiece (evulekileyo) i-biopsy ijwayele ukulandela.
I-biopsy nayo inokumisela uhlobo lomhlaza ukuba umntu ukhona kwaye ubukho be-estrogen, i-progesterone, kunye ne-HER2 receptors. Njengoko kuphawuliwe ngasentla, nakwabasetyhini abaneempawu ze-mammogram kunye ne-ultrasound ezifunyaniswa ngumhlaza, kusenokwenzeka ukuba i-biopsy iya kuba yintsholongwane.
Ngoko ke yintoni iimeko zesifuba ezifanisa umdlavuza webele kwiimvavanyo okanye iingxelo zengcamango eziyimfuneko yokuba i-biopsy? Kukho ezininzi esiza kujonga apha. Ezinye zezi zinto ziqhelekileyo kunabanye, kwaye imiqathango engezantsi ayibhalwanga ngokulandelelana.
I-Cancer yaBestile I-Alikekes
Kungabonakala ngathi kufuneka kubekho umahluko ocacileyo phakathi kweenguqu zesifo somdlavuza kunye nokungenazo umdlavuza, kodwa ngamanye amaxesha oku kunokuba nzima kakhulu. Nangona sikhathazeka ngakumbi malunga nokulahleka ukuxilongwa komhlaza wesifuba, ukukhathazeka ukuba utshintsho olubi ngumhlaza lubangele uxhalaba kunye nentlungu.
Ngamanye amagama, ukuba unomntu ongaqhelekanga onokuziva ngathi unomdlavuza kwisivivinyo, okanye ukhangeleka njengomhlaza wesibeleko, gcina ukhumbule ukuba usenokuba ngumdla. Kuze kube yilapho i-biopsy eyenziwe kwaye iiseli zibukele phantsi kwe-microscope ukuba oogqirha banokukuxelela ngokuqinisekileyo. Imiqathango efana nesifo somhlaza ekuhlolweni okanye kwiingcamango zidweliswe ngezantsi. Makhe sijonge nganye kwezi zifutshane.
Fat Necrosis
I-fat necrosis yesifuba isho ukuthi "amafutha afileyo." I-fat necrosis yinto eqhelekileyo yesohlwayo sesifuba esiswini kwaye sinokuvakalelwa kwaye sibonakale kakhulu njengomdlavuza kwi-mammogram. Ngokuqhelekileyo kulandelwa ukulimala kwibele ngenxa yengozi yemoto okanye ukulimala kwezemidlalo. Imimandla ye-fat necrosis iphinda ilandele iinkqubo zokuhlinzwa ezifana nokunciphisa ibele, ukubuyiswa kwebele, okanye i-biopsies okanye utyando lomhlaza wesifuba. Isiza somhlaza wesifuba singabangela ne-necrost fat, ukukhathazeka ngokuphindaphinda .
Ezi zivame zivakala nzima kwaye ngamanye amaxesha zithenda. Kukho ukukhutshwa kwi-ingono. Mhlawumbi unothuswa kubo bonke abavame ukubangela ukukhutshwa kwekhumba okubangelwa ukuhoxisa ingono okanye inversion; uphawu oluqhelekileyo lwe-cancer yombele. Kwi-mammogram, banokuba nesimo esingavunyelwanga kunye nomda we-spikey kunye ne-microcalcifications. I-fatast necrosis ye-Breast inokubonakala ibanjwe nomhlaza kwi-PET. I-biopsy ingadinga ukuba yenziwe ukuze kuqinisekiswe ukuxilongwa.
Radial Scar
Amacwecwe omnxeba ayingxube yebhokhwe efana neenkwenkwezi ezisoloko zinobungozi kodwa zinokuthi zingabi nangoko . Amacwecwe omlilo awabangeli izibilini kodwa angabangela intlungu yebele . Kwi-mammogram, iinkohlakalo ezinkulu ezibonakalayo zingabonakala zifana neenkwenkwezi ngeemida zomnxeba. Ziyinto engaqhelekanga kwaye zivela rhoqo kubasetyhini phakathi kweminyaka engama-40 no-60. Zingabangelwa ukuvuvukala, ukuhlinzwa kwebele, okanye utshintsho lwe-hormonal.
I-biopsy imele ifuneke rhoqo, kodwa nangaphantsi kwe-microscope izibazi zomsakazo zingalingisa umdlavuza webele, ngokukodwa i -carbulaoma ye-tubular yebele . Ukudibanisa izinto nangakumbi, ngamanye amaxesha iiseli zomhlaza zifihla ngaphakathi kwinqaba yomlilo.
Mastitis
I-Mastitis yimeko apho kukho ukuvuvukala nokuvuvukala kwesifuba okanye ngaphandle kobukho besifo. Yinto eqhelekileyo echaphazela kuma-20 ekhulwini labamama abangabongikazi kodwa ingaba kwabasetyhini abangabancelisiyo. Ibele isoloko ibomvu kwaye ithenda kwaye inokudityaniswa nempawu ezinjengomkhuhlane njengemfiva, ukubola, kunye nezidumbu zomzimba. Uphulo luvame ukuquka i-antibiotics, ukuphumla, kunye nokuphathwa kokuncelisa.
Ingxaki kukuba umdlavuza wesifuba ovuthayo ukhangeleka kakhulu njenge-mastitis ekuqaleni, kwaye udla ngokufunyanwa kuphela emva kokuba umfazi uphathwe okokuqala ngesifo sokugaya imastitis (kaninzi kungenakho ukuphucula impawu). Iingxelo zomhlaza wesifuba ezivuthayo ezinama-1 ekhulwini lweengcingo zamabele kunye nabasetyhini abaqhelekanga kuba neqhekeza kwaye ayidla ngokubonakala kwi-mammogram. Xa kuthelekiswa nomhlaza wesifuba esiswini kunye ne-mastitis kukho ukufana okuninzi, nangona umdlavuza wesifuba ovuthayo unokuba ne-inversion yengono kunye nokubonakala kwesikhumba se-orange kwesikhumba. Nge-mastitis, kukuyakheka kweeseli ezimhlophe zegazi kunye nokunyuka kwegazi okubangele iimpawu, ngelixa umhlaza wesifuba ovuthayo, iimpawu zihambelana nobukho bomhlaza wamaseli anqanda iziteshi ze-lymphatic in the breast.
I-granulomatous mastitis yinto ehlukileyo ye-mastitis esoloko ibangelwa zizimo ze-rhumatoid, i-sarcoidosis, okanye isifo sofuba. Ikwaba nayo idiopathic. I-granulomatous mastitis iphumela kwixesha elide lokuvuvukala kwibele kwaye kungenakuqala ukuba kunzima ukuhlukanisa umdlavuza wesifuba ovuthayo kwi-mammogram, ultrasound, okanye i-MRI.
I-Cooper's Ligament Fibrosis kunye neeCars
Iimbogi ze-Cooper zizakhiwo ezixhasayo zesifuba, kwaye abaninzi abantu bayaziqhelana nale mijelo enqwenela ukuyigcina njengoko ubudala. Ukutshatyalaliswa kwezi ligamentshi emva kwexesha kusemva ukuhlawula "i-Coop's droop" ngokubhekiselele "kwenzalo" yamabele ngokudala.
I-Fibrosis ye-Cooper's ligaments ingenzeka ngenxa yokuguquka kwesisu kunye nesifo esilumkileyo. Le yindlela enye apho izifo eziphantsi zibangelwa ukuhoxiswa kweengono kunye nezinguqu kwimbonakalo yesikhumba. Kodwa iimeko zesifuba ezinobunzima, ezifana nokuvuvukala, i-necrosis ye-fat, kunye neentlobo ze-biopsy zingonakalisa le mijelo ebangela ukubonakala komzimba wesifo somhlaza.
Sarcoidosis
I-Sarcoidosis yimeko ebunobungozi ebhalwe ngokubunjwa kwama- granulomas kuwo wonke umzimba. Xa ikhoyo kwimiphunga, idla ukukhohlela nokuphefumula, nangona ama-50 ekhulwini abantu abaxhamli ngexesha lokuxilongwa.
Ingxaki ye-sarcoidosis yinkxalabo enkulu kubasetyhini abaye bafumanisa ukuba sele benomdlavuza wesibeleko. I-Sarcoidosis i-granulomas inokubonakala kakhulu njengomdlavuza we-metastatic kwi-PET yokutshekisha, kwaye neesampula ze-biopsy zinzima ukuzihlalutya. Ngokomzekelo, i-granulomas kunye nesifo somhlaza wesisu se-breastastases sinokubonakala sifana nendawo ye-sentinel okanye i-lymph node biopsy. Oku kunokukhokelela ekuxilongweni kwangonyani kwe-lymph node okanye umdlavuza webele we-metastatic kumntu osenokuba neengxaki zesifo se-lymph node-negative.
Isifo soTywala
Isifo sesifo sikasifo sesifo sesifo sesifo sesifo sesifo sikashukela singasifumaneka kubasetyhini (kunye namadoda) ngohlobo lwe-1 kunye nohlobo lwe-2 lwesifo sikashukela esisekelwe kwi-insulin. Kuvavanyo, isifo sikasifo sikashukela sibonakala njengesininzi esikhulu, esingenabuhlungu esiswini esingaxelisa umdlavuza webele. Yibangelwa ukudibanisa kunye ne-fibrosis eninzi kwiibele.
Ukucingwa kweziphumo kunokungaqhathaniswa nesifo somhlaza wesifuba kwi-mammogram, i-ultrasound (apho ikhangeleka ngokukrakra) kunye neMRI. Kule zifundo, imeko ibonakala njengabantu abachazwe kakubi. I-biopsy eyona ngundoqo iyadingeka ukuba ixilongwe.
Fibromatosis
Ubisi lwe-fibromatosis, obizwa ngokuba yi-tummy demoid, i-akhawunti engama-0.2 ekhulwini. Akuqinisekanga ukuba yintoni ebangela le meko kodwa ibonakala ihamba kwiintsapho. Kwi-mammogram kunye ne-ultrasound fibromatosis inokulinganisa iziphumo zomhlaza wesisu. Ukuxilongwa ngokuqhelekileyo kwenziwa nge-biopsy enkulu yenaliti.
I-Granular Cell Tumor
Iimvumi zeseli eziqhekezayo, ezibizwa ngokuba yi-breast granular cell myoblastomas, zinokubonakala zifana nomhlaza wesifuba. Ngexesha eliqhelekileyo lihlaselwa, lisuka kwiiseli zeSchwann, iiseli ezifunyenwe kwinkqubo yesantya.
Ezi zicubu zivame ukukhupha isikhumba kunye nokulungiswa kwi-fascia ephantsi kwebele. Oku kubangela ukuba isalathiso esibonakala sisigxina, esifana nomhlaza wesibele. Zihlala zikhuni kakhulu, zifana nomhlaza kunye. Kwizifundo zokucinga ezifana ne-mammogram nazo zifana nomhlaza. Bavame ukuba nemida echazwe kakuhle kodwa nge-spiculation ecetyiswa ngumhlaza.
Umyinge weminyaka yabantu abanesifo somzimba esiswini se-cell is 40, kwaye zivela kubini abasetyhini namadoda.
Izilonda zeeNtsundu zeeNtsholongwane
Izilonda zesisu eziqulethe iiseli zintsimbi zinzima kumanqanaba amaninzi. Izilonda zeseli zentsholongwane zivakalelwa kwaye zibonakala zingabonakaliyo kumdlavuza webele, kodwa ezi zilonda zinokubonakala zifana nomdlavuza phantsi kwe-microscope emva kwe-biopsy. Ukongezelela, zombini izibilini ezinomhlaza kunye neengqumbo zinokuthi zitshintshe iiseli. Ngethamsanqa, izilonda zeesilonda aziqhelekanga, kodwa kusenokwenzeka ukuba zithathelwe ingqalelo kwi-sampuli ye-breastpix.
I-Myofibroblastoma iyisisu esingaqhelekanga esiswini esilula phantsi kwesigaba sezilonda zeselonda. Zingenzeka kuzo zombini abasetyhini kunye namadoda kwaye zinokuba ngumngeni ekufumaneni.
I-Pseudoangiomatous Stromal Hyperplasia (PASH)
I-pseudoangiomatous stromal hyperplasia okanye i-PASH yimeko efunyenweyo ngokuqhelekileyo kubasetyhini malunga nexesha lokumisa umva kunye nokudala. Kubonakala ngathi iyaqhelekileyo kulabo bathathe amahomoni (njengamapilisi okulawula ukuzalwa okanye i-hormone therapy substitution), abo basebenzisa utywala kunye nabo banesisindo. Ezi zilonda ezinobunzima zivame ukukhula ngokubanzi, kwaye i-biopsy evulekile (kunokuba nje i-biopsy eyintloko) idla ngokufunekayo ukuze kwenziwe ukuxilongwa.
ILizwi
Njengoko kuphawuliwe ngasentla, kukho iimeko ezininzi ezinobulunga ezinokuthi zifanise umdlavuza webele, iimvavanyo, kunye nakwezinye iimeko nakwi-microscope. Nangona ulahlekelwa ngumhlaza wesifuba abantu abaninzi bayesaba, ngokugqithiseleyo bacinga ukuba utywala okanye utshintsho ngumhlaza xa kungenako ukuphazamiseka ngokomzwelo. Imiqathango ebonakala ngathi ngumhlaza wesisu ingakhokelela kwizifundo ezongezelelweyo zokucinga, i-biopsies eyintloko, kunye ne-biopsies evulekile, yonke into ethatha umonakalo.
Into ebaluleke kakhulu ongayenza xa ufumana nayiphi na indlela yokungaqhelekanga, okanye ukuva komnye kwi-mammogram yakho, kukubuza imibuzo eninzi. Hlala kwisihlalo somqhubi uze ulindele iimpendulo. Ukuba ngummeli wakho unokuhamba ixesha elide ekufumaneni ukhathalelo olufanelekileyo kunye nokunciphisa ubuninzi beengxaki ezibuhlungu eziqhelekileyo ezizisa ubomi bethu.
> Imithombo:
> Fazzio, R., Shah, S., Sandhu, N., noK. Glazebrook. Idiopathic Granulomatous Mastitis: Ukuhlaziywa komfanekiso nokuhlaziywa. Ukuqonda kwi-Imaging . 2016. 7 (4): 531-9.
> Kochoyan, T., Akhmedov, M., Shabanov, A., noTerekhov. I-Sarcoidosis Ukulingisa i-Breast Cancer Metastasis: ingxelo yeNgxelo kunye nokuHlola kweeNcwadi. I-Biology yeCansystem kunye neMedicine . 2016. 13 (3): 396-398.
> Mario, J., Venkataraman, S., Dialani, V., kunye noP. Slanetz. Izibilini zeBernign zesifo seMimic: Ukuqulunqa iRadioologic-Pathologic Concordance. I-Applied Radiology . 2015. 44 (9): 28-32.