Ulwazi lunamandla kodwa ukhetho alulula
UJennifer Davis wayeneminyaka eli-19 ubudala xa unina, owayeneminyaka engama-49 ubudala, wafunyaniswa nomhlaza wesibele. Ngendlela, akuzange kumangalise. Umhlaza wesifuba wabiza umama wakhe omama eneminyaka engama-28 ubudala. Unina wakhe omama wabulawa ngumhlaza wesibeleko kwi-69.
Emva koko, njengoko unina waqala ukuhlinzwa waza waqalisa i-chemotherapy, uDavis wathola isilonda esiswini sakhe . Nangona yayinobungozi, wayethusa.
U-Davis, waseWashington, DC, uthi: "Ndandibona nje umama ehamba nge-chemo kwaye ndandicinga ukuba ngaba ndizayo.
Ukuhlolwa kwe-Genetic kuqinisekisile ukuba uDavis uzuze iinguqu zokuguquka komzimba okwandisa umngcipheko wokuvelisa umdlavuza webele okanye we-ovari. Xa eneminyaka engama-23, unomdla ngokujonga kunye nendlela yokuphila enempilo, kwaye ucinga ngokugqithiseleyo ekugqibeleni ukukhupha amabele akhe kunye namaqanda njengendlela ephawulekayo, kodwa eyinqobo yokuthintela.
Ngenxa yokuba ukuhlolwa kofuzo kusekho mtsha, abaphandi abaqinisekanga ukuba bangaphi abantu abaneenguquko zomzimba ezinxulumene nomhlaza wesifuba. Kodwa, baqikelela ukuba ukuya kuma-30 ekhulwini amabhinqa aseMelika anelungu leentsapho ezisondeleyo elaphathwa ngumhlaza wesibele.
Oku kuthetha ukuba nabasetyhini abaselula abaneenkcukacha zentsapho yesi sifo bangaqala ukuthatha amanyathelo okukhusela impilo yabo. Nangona kunjalo, oku kubonisa ukhetho olunzima, kubandakanywa nokuba utyando lweprophylactic okanye uthathe amayeza anciphisa umngcipheko wesifo somhlaza wesisu kodwa kaninzi unemiqobo.
I-Degree 1, i-Degree ne-3rd Degree Relatives
Umfazi waseMelika oqhelekileyo uneepesenti ezingama-12 zokuvelisa umdlavuza webele ngexesha lokuphila kwakhe. Eli nani linokuphindwa kabini kwintombazana enomdla weentsapho zomdlavuza webele.
Ngokutsho kwamaziko ase-United States okuLawula kunye nokukhusela, abafazi abane-"degree-degree" -njengomama okanye udade-abanomdlavuza wesifuba banethuba elimalunga nama-30 ekhulwini lokuphuhliswa kwesifo.
Ukuba eso sihlobo esisezingeni lokuqala sitholwa ngokuba nomhlaza wesibeleko esiswini (isifo somhlaza esesibini kumabele) zombini, umngcipheko usondela kuma-36 ekhulwini.
Phakathi kwalabo "abaneesibini" izalamane-ugogo-ugogo, u-anti, okanye umntwana-mngcipheko wokuphila ubomi malunga neepesenti ezingama-22. Kwabo abanesibini "isihlobo" -zala, umkhulu-omkhulu, okanye umakhulukazi-obenomdlavuza wesifuba, umngcipheko ungama-16 ekhulwini.
Sekunjalo, imbali yentsapho ayiqinisekisi ukuba i-diagnosis yebele. Iingcali ziqikelela ukuba iipesenti ezihlanu kuphela ukuya kuma-10 ekhulwini lweengxaki zomhlaza webele. Ukongezelela, ukuguqulwa kwemizimba ehambelana nomngcipheko ophezulu webele kunye ne-ovarian umdlavuza kubonakala kungavamile kubantu bonke.
Ezi ziinguqu zenguqu ezibizwa nge-BRCA1 ne- BRCA2 ngabaphandi. I-BRCA ibonisa umdlavuza webele kwaye manani abonisa ukuba abaphandi bafumana ukutshintshwa kwemfuza.
Nangona ukuxhaphaka ngokuthe ngqo kweenguqu zengqungquthela engaziwayo, olunye uphando lufumanise ukuba phakathi kweqela elimalunga nama-2 300 amabhinqa, abaneminyaka engama-35 ukuya kuma-64, malunga nama-2.9 ekhulwini kwabasetyhini abamhlophe, ama-1.4 ekhulwini kwabasetyhini abamnyama, kunye ne-10.2 ekhulwini lamabhinqa angamaYuda ayeguquka kwe-BRCA1. Uphando lwafumanisa ukuba i-2.6 ekhulwini yabasetyhini abamnyama, i-2.1 ekhulwini yabasetyhini abamhlophe, kunye ne-1.1 ekhulwini yabasetyhini bamaYuda babenokuguqulwa kwe-BRCA2.
Uvavanyo lweGenesis
Amagqirha amaninzi ngoku anika iingcebiso kubafazi abanomdla wentsapho okanye umhlaza wesibeleko ukuze bafune ukuhlolwa kofuzo. Esi sigqibo somntu siqu sinokuzisa isabelo sawo kunye nolwazi oluncedo.
Ngokomsebenzi waseCanada onabantu abangama-39 abavavanywe kakuhle ngenxa yokuguquka kwemizimba, uninzi lwabangela iziphumo njengoko zinceda. Abathathi-nxaxheba bathi ukuvavanywa kwabakhokelela ukuba bathathe indlela ethe xaxa yokunakekelwa kwezempilo.
Kodwa, incinci yabonisa iimvakalelo zokungathembeki nokungaqiniseki. La bantu bathi baziva 'bengagula okanye bangaphili kakuhle.'
Ukongeza, ngelixa i-inshorensi yempilo kunye nokucalucalulelwa kwakunokukhathazeka kwangaphambili, uMthetho weNgcaciso loLwazi lweNgcaciso ngo-2007-2008 ngoku uqinisekisa ukhuseleko lwesizwe
Ukuqala Ukuhlola
Kwabaninzi abasetyhini abangaphantsi kweminyaka engama-35, ukuhlolwa kwesifo somhlaza wesibeleko akusiyo inxalenye yenkqubo yabo yempilo yonyaka. Kodwa, kubafazi abaneengxaki zentsapho yomhlaza wesifuba, iingcali zithi ukuhlola kufuneka kuqale ngo-25 ubudala.
ISikhumbuzo seSikhumbuzo seCroan-Kettering sikhuthaza ukuba abafazi abanesiqingatha sokuqala abaxilongwa ngumhlaza wesibeleko kufuneka baqale imimmogram kwiminyaka eyi-10 ngaphambili ngaphambili kokuba ilungu lentsapho liye lafunyanwa.
Umzekelo, ukuba umama ufunyanwe eneminyaka engama-42 ubudala, intombi yakhe kufuneka iqalise ukuhlolwa kwe-mammography yonyaka engama-32. 20 ubudala.
Kukho ingxoxo malunga nendima ye- MRIs kufuneka idlale ekuhlolweni komhlaza webele. Ezinye izifundo zibonise ukuba ukuhlolwa kwe-MRI kusebenza ngakumbi kunezinye iindlela zokuxilonga. Oogqirha kwiSelan Kettering batusa ukuba abafazi abaneembali zentsapho baneMRI kunye ne- mammogram ngonyaka. Nangona kunjalo, akukho zifundo zihambelana nokuhlolwa kwe-MRI ngokunciphisa ukubulawa komhlaza wesifuba.
Thintelo
Uphando lubonisa ukuba ukutshaya kunye nokutya okunamafutha kunceda ngakumbi kumngcipheko womhlaza. Ngoko, indlela yokuphila enempilo ibaluleke ngokukhethekileyo kumntu onentsapho yembali yesifo.
I-Chemoprevention yenye yezenzo zesenzo. Amanye amachiza afanayo anqunyelwe ukukhusela ukuphindaphinda anikwe nabasetyhini abanethemba lokuphepha umdlavuza webele, kodwa kuphela abo bangaphezu kweminyaka engama-35.
Ezi zi yobisi zivimba umsebenzi we-hormone western e-estrogen, ekholelwa ukukhuthaza ezinye iintlobo zomhlaza. Kodwa oko kuthetha ukuba banokuchaphazela ukuzala , ngoko ke abavunyelwanga ukusetyenziswa ngabasetyhini abasebancineni bexesha lokuzala.
Kubafazi abangaphezu kwama-35, izifundo zibonise ezi zi yobisi- Tamoxifen (Nolvadex) kunye no- Evista (Raloxifene) -nciphisa umngcipheko wesifo somhlaza wesifuba esingenayo ngokumalunga nama-50 ekhulwini. Kwaye, banokunciphisa umngcipheko wesibeleko sesifuba esingenasvasive ngama-30 ekhulwini. Nangona kunjalo, azinayo imiphumo emibi-ezinye zazo zilinganisa iimpawu zokunquma kwindoda, kubandakanya ukufumana ubunzima, ukutshisa okutshisa, kunye nokomama kwesisu.
Indlela eyingozi, kodwa esebenzayo yokuthintela ukususwa kwesibini okanye zombini amabele ngaphambi kokuba umhlaza uphuhlise. Abaphandi baqikelela ukuba ukuhlinzwa kunciphisa umngcipheko wesifo somdlavuza ngamabele angama-90 ekhulwini. Ukususa ii-ovane yindlela enye yokuhlinzwa, kodwa enye inomdla, ingakumbi kubasetyhini abaselula abathile ngelinye ilanga banethemba lokuba nabantwana.
ILizwi
UDavis, ovivinywe kakuhle kwiinguquko ze-BRCA1, wacetyiswa ngumcebisi wakhe wezakhi zofuzo ukuba abantwana bakhe bancinci, ke mabele basuswe amabele, ama-ovari, kunye nesisu-konke ngaphambi kokuba abe neminyaka engama-35. Nangona uneminyaka engama-23 ubudala, ukhathazeka ngokukwazi kufeza loo njongo. Kodwa ukholelwa ukuba utyando luya kumnceda. Ngoko, thatha ixesha lokuqwalasela ngenyameko nganye kwaye ufune ingcebiso yonyango othembekileyo okanye umcebisi wezofuzo kwiinkqubo zokwenza izigqibo.
Imithombo:
"I-ACS Iingcebiso ze-MRIs kwabanye kwiNgcipheko ephezulu yeCarcer Breast." I-ACS News Centre . 28 kuMatshi 2007. UMbutho weCancer Cancer. 17 kuMatshi 2008.
"Izikhokelo zokuHlola iCatal Breast". 21 kuMatshi 2006. Isiko soKhuseleko lweCroat-Kettering Cancer Centre.
de Agincourt-Canning, L. "Isipho okanye iYoke? Iimpendulo zabasetyhini kunye namadoda kwiiNgcaciso zengozi yeGenesis ukusuka kwi-BRCA1 kunye ne-BRCA2 Testing." I-Clinical Genetics 70, 6 kuMatshi 2006. 462-472. 17 kuMatshi 2008.
I-Cancer Breast Cancer kunye ne-BRCA iGenesis, ngo-Ephreli 6, 2015. Iziko zokuLawula izifo.
I-RON, i-JR Daling, i-DR Doody, i-L. Hsu, i-L. Bernstein, i-RJ Coates, i-Marchbanks, i-MS Simon, i-JA McDonald, i-SA Norman, i-BL Strom, i-RT Burkman, i-G. Ursin, iDeapen, iLK Weiss, i- S. Folger, JJ Madeoy, DM Friedrichsen, NM Suter, MC Humphrey, R. Spirtas kunye ne-EA Ostrander EA. "Ukunyamekela nokuQala kwangaphambili kwe-BRCA1 kunye ne-BRCA2 Utshintsho kwi-Population Based Based Study of Cancer Breast in White and Black American Age of 35 to 64 Years." Uphando lweCancer 66, 1615. Agasti 2006. 8297-82308. 17 kuMatshi 2008.
"I-Mastectomy yokukhusela: Imibuzo neempendulo." Iifayile zeSizwe zeCancer Institute . 26 uJulayi 2006. iNational Cancer Institute. 17 kuMatshi 2008.