Ka hoʻomaopopo ʻana i ke kahua no ka maʻi ʻaʻai

Anter

• Pehea e hoʻokumu ʻia ai ka maʻi ʻaʻai umauma?
• He aha nā pae o ka maʻi ʻaʻai umauma?
• Kahua 0
• Kahua 1
• Kahua 2
• Kahua 3
• Kahua 4
• Kanesa maʻi ʻaʻai hou
• Hoʻopilikia ka pae maʻi ʻaʻai i nā ʻōuli?
• ʻO ke ola ke ola ma ke kahua
• Nā koho lapaʻau e ka pae
• Kahua 0
• Nā pae 1, 2, a me 3
• Kahua 4
• Ke kala a me ka pilikia o ka hoʻi hou ʻana
• ʻO ka lawe lawe ʻana

ʻO ka maʻi ʻaʻai umauma ka maʻi ʻaʻai e hoʻomaka i nā lobule, nā aʻa, a i ʻole nā ​​mea hoʻopili o ka umauma.

Hoʻokomo ʻia ka maʻi ʻaʻai umauma mai 0 a 4. Hōʻike ka pae i ka nui o ka tumo, ke komo ʻana o ka lymph node, a me ka mamao o ka palahalaha ʻana o ka maʻi ʻaʻai. ʻO nā mea ʻē aʻe, e like me ke kūlana receptor hormone a me ka papa tumo, hoʻopili pū ʻia i loko o ke kahua.

He mea koʻikoʻi kēia ʻike i ka hoʻoholo ʻana i nā lāʻau lapaʻau a me ka hoʻomaopopo ʻana i kāu kuʻuna maʻamau.

E hoʻomau i ka heluhelu ʻana e aʻo ai pehea e hoʻokumu ʻia ai ka maʻi ʻaʻai umauma, pehea e hoʻopili ai i ka mālama ʻana, a me nā mea āu e manaʻo ai.

Pehea e hoʻokumu ʻia ai ka maʻi ʻaʻai umauma?

Kuhi paha ke kauka i ka maʻi ʻaʻai umauma ma hope o ka hoʻokolohua kino, mammogram, a i ʻole nā ​​hōʻike kiʻi ʻē aʻe. Noi paha lākou i kahi biopsy, ʻo ia wale nō ke ala e hōʻoia ai i kahi kuhi o ka maʻi ʻaʻai umauma.

E hoʻohana ke kauka i nā hopena mai kāu biopsy e hāʻawi i kahi pae "clinical".

Ma hope o ke kaha ʻana e wehe i kahi tumo, hiki i kāu kauka ke kaʻana like aku i ka ʻike me ʻoe e pili ana i ke komo ʻana o ka lymph node, me nā hōʻike pathology hou aʻe.

I kēlā manawa, e hāʻawi kāu kauka i kahi pae "pathologic" ʻoi aku ka pololei me ka hoʻohana ʻana i ka pālākiō TNM. Eia kahi haki o ke ʻano o ka T, N, a me M:

T pili i ka nui o ka tumo.

• HI ʻAʻole hiki ke loiloi i ka Tumor.
• T0. ʻAʻohe hōʻike o ka tumo mua.
• ʻO Tis. ʻAʻole i ulu ka Tumor i loko o kaʻiʻo olakino olakino (in situ).
• T1, T2, T3, T4. ʻO ke kiʻekiʻena o ka helu, ʻo ka nui o ka tumo a i ʻole ka nui o ka hoʻouka kaua ʻana i kaʻiʻo umauma.

N pili i ke komo pū ʻana o ka lymph node.

• NX. ʻAʻole hiki ke loiloi i nā lymph node kokoke.
• AʻOLE. ʻAʻohe pili o ka lymph node i pili.
• N1, N2, N3. ʻO ke kiʻekiʻena o ka helu, ʻo ka nui o ke komo ʻana o ke aho lymph.

M pili i ka metastasis ma waho o ka umauma.

• MX. ʻAʻole hiki ke loiloi.
• M0. ʻAʻohe hōʻike o ka metastasis mamao.
• M1. Ua pālahalaha ka maʻi ʻaʻai i kahi ʻaoʻao mamao o ke kino.

Hoʻohui ʻia nā ʻāpana e kiʻi i ke kahua, akā hiki i kēia mau mea ke hoʻopili i ke kahua.

• estrogen receptor kūlana
• kūlana receptor progesterone
• Kūlana HER2 / neu

Pēlā nō hoʻi, kau ʻia nā puʻupuʻu ma ka pālākiō o 1 a 3 e pili ana i ke ʻano o ka ʻike ʻole ʻia o nā hunaola maʻi ʻaʻai. ʻO ke kiʻekiʻena o ka papa, e ulu ana a ākea paha.

He aha nā pae o ka maʻi ʻaʻai umauma?

Kahua 0

ʻO ka maʻi kanulau ʻole noninvasive me ka carcinoma ductal in situ (DCIS). ʻAʻole i hōʻea nā pūnaewele maʻamau i nā mea kokoke.

Kahua 1

Māhele ʻia ka pae 1 i nā pae 1A a me 1B.

I ke kahua maʻi ʻaʻai umauma 1A, ana ke tumo a i 2 kenimika, akā ʻaʻohe pili o ka lymph node.

Me ka maʻi ʻaʻai umauma 1B umauma, ʻoi aku ka liʻiliʻi o ka tumo ma mua o 2 centimita, akā aia kekahi mau pūʻulu liʻiliʻi o nā hunaola maʻi maʻi ma nā pūnana lymph kokoke.

Hoʻonohonoho ʻia hoʻi ka maʻi ʻaʻai umauma pae 1B inā ʻaʻohe puʻupuʻu, akā aia nā pūʻulu liʻiliʻi o nā hunaola maʻi maʻi i nā lymph node.

Kaha: Inā he estrogen receptor- a i ʻole progesterone receptor-positive, hiki ke hoʻokau ʻia e like me 1A.

Kahua 2

Māhele ʻia ka pae 2 i nā pae 2A a me 2B.

Hāʻawi ʻia ke kahua 2A no kekahi o kēia mau mea:

• ʻaʻohe puʻupuʻu, akā hoʻokahi i ʻekolu mau puʻupuʻu lymph ma lalo o ka lima a i ʻole ma kahi o ka umauma i loaʻa ai nā pūnaʻi maʻi maʻi
• tumo a i 2 kenimika, a me ka maʻi ʻaʻai i nā lymph nodes ma lalo o ka lima
• tumo ma waena o 2 a me 5 mau kenimika, akā ʻaʻohe pili lymph i hoʻopili ʻia

Kaha: Inā he HER2-maikaʻi ka tumo a ʻo ka receptor estrogen- a me ka receptor-positive progesterone, hiki ke hoʻokaʻawale ʻia ma ke ʻano he pae 1A.

Hāʻawi ʻia ke kahua 2B no kekahi o kēia mau mea:

• tumo ma waena o 2 a me 5 mau kenimika, a me nā hui liʻiliʻi o ka maʻi ʻaʻai i hoʻokahi a ʻekolu paha mau lymph node
• ʻoi aku ka nui o ka tumo ma mua o 5 kenimika, akā ʻaʻohe pili o ka lymph i hoʻopili ʻia

Kaha: Inā he HER2-maikaʻi a me ka receptor estrogen- a me ka receptor-positive progesterone, hiki ke hoʻokaʻawale ʻia ma ke ʻano he pae 1.

Kahua 3

Māhele ʻia ka pae 3 i nā pae 3A, 3B, a me 3C.

Hāʻawi ʻia ke kahua 3A no kekahi o kēia mau mea:

• maʻi ʻaʻai i ʻehā a ʻeiwa mau lymph node kokoke, me ka ʻole a he tumo ʻole
• ʻoi aku ka nui o ka tumo ma mua o 5 kenimika, a me nā pūʻulu liʻiliʻi o nā hunaola maʻi ʻaʻai i nā pūnana lymph

Kaha: Inā ʻoi aku ka nui o kahi tumo ma mua o 5 kenimika ka papa 2, estrogen receptor-, progesterone receptor-, a me HER2-positive, me ka maʻi ʻaʻai e loaʻa ʻia i ʻehā a ʻeiwa mau lymph node, e hoʻohālikelike ʻia ia me 1B.

I ke kahua 3B, ua hiki kahi tumo i ka paia o ka pahu, a ʻo ka maʻi ʻaʻai paha:

• hohola a haki ma o ka ʻili
• hohola a ʻeiwa mau pona lymph ma lalo o ka lima a i ʻole ma kahi o ka umauma

Kaha: Inā he estrogen receptor-positive a me ka progesterone receptor-positive ka tumo, a laila e hoʻohālikelike ʻia ia ma ke ʻano he 1 a i ʻole 2 e pili ana i ka pae tumo. ʻO ka maʻi ʻaʻai umauma inflammatory ka mea ma ka liʻiliʻi ma ke kahua 3B.

I ke kahua 3C, ʻaʻohe paha he tumo i ka umauma. Akā inā aia, ua hiki paha i ka paia o ka umauma a i ʻole ʻili umauma, a me:

• 10 a ʻoi paha nā lymph node underarm
• lymph nodes kokoke i ka iwi iwi
• lymph nodes ma lalo o ka lima a kokoke i ka umauma

Kahua 4

Manaʻo ʻia ka pae 4 i ka maʻi ʻaʻai umauma holomua, ai ʻole ka maʻi ʻaʻai umauma metastatic. ʻO kēia ke kumu ua hoʻolaha ia i nā wahi mamao o ke kino.Aia paha ka maʻi ʻaʻai i loko o nā akemāmā, lolo, ate, a i ʻole nā ​​iwi.

Kanesa maʻi ʻaʻai hou

ʻO ka maʻi ʻaʻai e hoʻi mai ma hope o ke kūleʻa maikaʻi ʻana he kanesa umauma hou.

Hoʻopilikia ka pae maʻi ʻaʻai i nā ʻōuli?

ʻAʻole paha ʻoe e loaʻa ana i nā ʻōuli a hiki i ka nui ʻana o ka tumo e ʻike ai. Hiki i nā ʻōuli ʻekahi ke komo i nā hoʻololi i ka nui a i ʻole ke ʻano o ka umauma a i ʻole ka piko, ka hoʻokuʻu ʻia ʻana mai ka nipple, a i ʻole kahi puʻupuʻu ma lalo o ka lima.

Ma hope o nā ʻōuli ke hilinaʻi nei ma kahi o ka maʻi ʻaʻai i laha aku ai a e komo pū paha me:

• nalo ʻai ʻole
• Kaumaha emi
• pokole o ka hanu
• ʻūhā
• ʻeha poʻo
• hihio pālua
• ʻeha iwi
• nāwaliwali o nā mākala
• ʻōmaʻomaʻo ʻōiwi

ʻO ke ola ke ola ma ke kahua

ʻOiai ke hoʻokaʻawale ʻia e ka pae, paʻakikī e hoʻoholo i ke ola no kekahi me ka maʻi ʻaʻai umauma ma muli o kēia mau mea:

• Nui a hewahewa nā ʻano maʻi ʻaʻai o ka umauma, a ʻokoʻa lākou i kā lākou pae o ka hoʻokūkū. Hoʻolālā kekahi i ka lāʻau hoʻomalu, ʻo kekahi ʻaʻole.
• Ma muli o ka makahiki, nā pilikia olakino ʻē aʻe, a me nā mālama ʻana āu e koho ai.
• ʻO nā helu ola ke kuhi ʻia e pili ana i ka poʻe i ʻike ʻia i nā makahiki i hala. Ke holo nei i mua me ka wikiwiki, no laila hiki iā ʻoe ke kali i ke ola ʻoi aku ka maikaʻi ma mua o ka poʻe i ʻike ʻia he ʻelima mau makahiki i hala.

ʻO ia ke kumu e lawe ʻole ai i nā helu helu maʻamau i ka puʻuwai. Hiki i kāu kauka ke hāʻawi iā ʻoe i kahi manaʻo ʻoi aku o ka mea e kali ai ma muli o kāu pilikino pilikino.

ʻAʻole nānā ka Surveillance, Epidemiology, a me ka hopena hopena hopena (SEER) i nā helu o ke ola ʻana o ka maʻi ʻaʻai umauma ma o ke ʻano a i ʻole nā ​​pae 0 a 4. Hoʻohālikelike kahi ola e pili ana i ka poʻe me ka maʻi ʻaʻai umauma i ka poʻe i ka lehulehu.

Ma hope o SEER ʻelima mau makahiki o ke ola e pili ana i nā wahine i ʻike ʻia ma waena o 2009 a me 2015:

Nā koho lapaʻau e ka pae

He mea nui ka pae i ka hoʻoholo ʻana i ka lāʻau, akā aia kekahi mau mea, e like me:

• ʻano maʻi ʻaʻai umauma
• pae tumano
• estrogen receptor a me ke kūlana receptor progesterone
• Kūlana HER2
• makahiki a inā ua hōʻea ʻoe i ka menopause
• olakino holoʻokoʻa

E noʻonoʻo kāu kauka i kēia mau mea āpau ke koi ʻana i ka lāʻau. Pono ka hapa nui o ka poʻe i kahi hui o nā therapies.

Kahua 0

• ʻOki-mālama mālama ʻoki (lumpectomy). E kāpae kāu kauka i nā kiko kīnā ʻole a me kahi palena iki o kaʻiʻo olakino.
• Mastectomy. Lawe kāu kauka i ka umauma holoʻokoʻa a, i kekahi mau hihia, nānā i nā lymph node kokoke no ka maʻi ʻaʻai.
• Lapaʻau hoʻomākala. Koi ʻia kēia lapaʻau inā he lumpectomy kāu.
• ʻOki kino hana hou. Hiki iā ʻoe ke hoʻonohonoho koke i kēia kaʻina hana a i ʻole i kahi lā ma hope.
• Hoʻoikaika Hormone (tamoxifen a i ʻole kahi mea kāohi aromatase). Hiki i kāu kauka ke koi aku i kēia ʻano lapaʻau ke DCIS he estrogen receptor- a progesterone receptor-positive.

Nā pae 1, 2, a me 3

• lumpectomy a i ʻole mastectomy a me ka hemo ʻana o nā lymph node kokoke e nānā no ka maʻi ʻaʻai
• kūkulu hou i ka umauma i ka manawa a i ʻole i kahi lā ma hope
• radiation therapy, ʻoi loa inā koho ʻoe i ka lumpectomy ma mua o ka mastectomy
• chemotherapy
• hormone therapy for estrogen receptor-positive and progesterone receptor-positive umauma maʻi maʻi maʻi
• nā lāʻau i hoʻomākaukau ʻia e like me trastuzumab (Herceptin) a i ʻole pertuzumab (Perjeta) no nā kanesa HER2-maikaʻi

Kahua 4

• chemotherapy e hoʻoliʻiliʻi i nā tumors a i ʻole ka lohi o ka ulu ʻana o ka tumo
• ʻoki kino e hemo i nā hikoko a i ʻole mālama i nā hōʻailona
• radiation therapy e hōʻoluʻolu i nā ʻōuli
• nā lāʻau i hoʻomākaukau ʻia no ka estrogen receptor-, progesterone receptor-, a i ʻole ʻo HER2-maikaʻi maʻi maʻi maʻi umauma
• nā lāʻau e hōʻoluʻolu ai i ka ʻeha

I kēlā me kēia pae, hiki paha iā ʻoe ke komo i nā hoʻokolohua hoʻokolohua. Hiki i kēia mau noiʻi noiʻi ke hāʻawi iā ʻoe i ke komo i nā therapies e hoʻomau nei i ka hoʻomohala. E noi i kāu kauka e pili ana i nā hoʻokolohua hoʻokolohua e kūpono paha iā ʻoe.

Ke kala a me ka pilikia o ka hoʻi hou ʻana

ʻO ke kala piha loa ua pau nā hōʻailona o ka maʻi ʻaʻai.

I kekahi manawa, waiho ʻia nā hunaola maʻi ʻaʻai ma hope o ka hoʻomaʻamaʻa hope ʻana i nā tumors hou. Hiki i ke kanesa ke hoʻi hou i kahi, ka ʻāina, a i ʻole nā ​​wahi mamao. ʻOiai hiki ke hana i kēia i kēlā me kēia manawa, aia i loko o nā makahiki ʻelima mua.

Ma hope o kou hoʻopau ʻana i ka lāʻau, pono i nā mākaʻikaʻi mau e kipa i nā kipa kauka, nā hōʻike kiʻi, a me nā hoʻāʻo ʻana i ke koko e nānā i nā hōʻailona o ka maʻi ʻaʻai.

ʻO ka lawe lawe ʻana

Hoʻokumu ʻia ka maʻi ʻaʻai umauma mai 0 a 4. Ke ʻike koke ʻoe i ke ʻano a me ke kahua, e hana pū ana kāu pūʻulu olakino me ʻoe e koho i kahi hoʻolālā maikaʻi loa.