Kupewa Khansa ya M'mawere

Zambiri Zokhudza Khansa ya M'mawere

Khansara ya m'mawere ndi matenda omwe maselo owopsa (khansa) amapanga mu minyewa ya bere.

Mabere amapangidwa ndi lobes ndi ducts.Bere lililonse lili ndi magawo 15 mpaka 20 otchedwa lobes, omwe ali ndi tizigawo ting'onoting'ono tambirimbiri totchedwa lobules.Tizilombo timene timatulutsa timabala tating'onoting'ono tomwe timatha kupanga mkaka.Ma lobes, lobules, ndi mababu amalumikizidwa ndi machubu oonda otchedwa ducts.

Bere lililonse limakhalanso ndi mitsempha ya magazi ndi mitsempha ya mitsempha.Mitsempha ya m'magazi imanyamula timadzi timene timakhala tambiri tomwe timakhala tamadzi tomwe timatchedwa lymph.Mitsempha ya mitsempha imanyamula ma lymph pakati pa ma lymph nodes.Ma lymph node ndi tinthu tating'ono tomwe timapanga ngati nyemba, timasefa maselo am'magazi ndikusunga maselo oyera omwe amathandiza kulimbana ndi matenda ndi matenda.Magulu a lymph nodes amapezeka pafupi ndi bere mu axilla (pansi pa mkono), pamwamba pa kolala, ndi pachifuwa.

Khansara ya m'mawere ndi khansa yachiwiri yofala kwambiri mwa amayi aku America.

Azimayi ku United States amadwala khansa ya m'mawere kuposa khansa yamtundu uliwonse kupatulapo khansa yapakhungu.Khansara ya m'mawere ndi yachiwiri kwa khansa ya m'mapapo monga chifukwa cha imfa ya khansa mwa amayi aku America.Komabe, imfa za khansa ya m'mawere zachepa pang'ono chaka chilichonse pakati pa 2007 ndi 2016. Khansara ya m'mawere imapezekanso mwa amuna, koma chiwerengero cha matenda atsopano ndi ochepa.

Kupewa Khansa ya M'mawere

Kupewa zinthu zoopsa komanso kuwonjezera zinthu zodzitetezera kungathandize kupewa khansa.

Kupewa zinthu zomwe zingayambitse khansa kungathandize kupewa khansa zina.Zomwe zimayambitsa ngozi ndi monga kusuta, kunenepa kwambiri, komanso kusachita masewera olimbitsa thupi mokwanira.Kuonjezera zinthu zodzitetezera monga kusiya kusuta ndi kuchita masewera olimbitsa thupi kungathandizenso kupewa khansa zina.Lankhulani ndi dokotala wanu kapena katswiri wina wa zaumoyo za momwe mungachepetsere chiopsezo cha khansa.

Zotsatirazi ndizomwe zimayambitsa khansa ya m'mawere:

1. Ukalamba

Ukalamba ndiye chinthu chachikulu chomwe chimayambitsa khansa zambiri.Mwayi wokhala ndi khansa umachuluka pamene mukukalamba.

2. Mbiri yaumwini ya khansa ya m'mawere kapena matenda osadziwika bwino (opanda khansa).

Amayi omwe ali ndi izi ali ndi chiopsezo chowonjezeka cha khansa ya m'mawere:

• Mbiri yamunthu ya khansa ya m'mawere, ductal carcinoma in situ (DCIS), kapena lobular carcinoma in situ (LCIS).
• Mbiri yaumwini ya matenda a bere (opanda khansa).

3. Chiwopsezo chobadwa nacho cha khansa ya m'mawere

Azimayi omwe ali ndi mbiri ya banja la khansa ya m'mawere mwa wachibale woyamba (mayi, mlongo, kapena mwana wamkazi) ali ndi chiopsezo chowonjezeka cha khansa ya m'mawere.

Azimayi omwe atengera kusintha kwa majini kapena majini ena ali ndi chiopsezo chachikulu cha khansa ya m'mawere.Kuopsa kwa khansa ya m'mawere chifukwa cha kusintha kwa majini kumadalira mtundu wa masinthidwe a majini, mbiri ya banja la khansa, ndi zina.

4. Mabere owonda

Kukhala ndi minofu ya m'mawere yomwe imakhala yochuluka pa mammogram ndizomwe zimayambitsa chiopsezo cha khansa ya m'mawere.Kuopsa kwa chiwopsezo kumadalira momwe minofu ya m'mawere iliri.Azimayi omwe ali ndi mawere owundana kwambiri ali ndi chiopsezo chachikulu cha khansa ya m'mawere kusiyana ndi amayi omwe ali ndi chifuwa chochepa.

Kuchulukirachulukira kwa mabere nthawi zambiri kumakhala chikhalidwe chobadwa nacho, koma kumatha kuchitikanso mwa amayi omwe sanaberekepo, omwe ali ndi pakati mochedwa kwambiri, amamwa mahomoni a postmenopausal, kapena kumwa mowa.

5. Kuwonekera kwa minofu ya m'mawere ku estrogen yopangidwa m'thupi

Estrogen ndi mahomoni opangidwa ndi thupi.Zimathandizira kuti thupi likhale ndi machitidwe ogonana ndi akazi.Kupezeka kwa estrogen kwa nthawi yayitali kungapangitse chiopsezo cha khansa ya m'mawere.Miyezo ya Estrogen imakhala yokwera kwambiri pazaka zomwe mkazi ali msambo.

Kumwa kwa estrogen kwa amayi kumawonjezeka m'njira izi:

• Kusamba msanga: Kuyamba kusamba ali ndi zaka 11 kapena kucheperapo kumawonjezera chiwerengero cha zaka zomwe minofu ya m'mawere imakhala ndi estrogen.
• Kuyambira paukalamba: Mkazi akamasamba kwa zaka zambiri, m’pamenenso minofu yake ya m’mawere imayamba kudwala estrogen.
• Ukalamba pa kubadwa koyamba kapena kusabalapo: Chifukwa chakuti mlingo wa estrogen umachepa panthaŵi ya mimba, minofu ya m’mawere imakhala ndi estrogen yowonjezereka mwa amayi amene amatenga mimba kwanthaŵi yoyamba atatha zaka 35 kapena amene satenga mimba.

6. Kumwa mankhwala a mahomoni pazizindikiro za kusintha kwa thupi

Mahomoni, monga estrogen ndi progesterone, akhoza kupangidwa kukhala mawonekedwe a mapiritsi mu labotale.Estrogen, progestin, kapena zonse ziŵiri zingaperekedwe m’malo mwa estrojeni yosapangidwanso ndi thumba losunga mazira mwa akazi otha msinkhu kapena akazi amene achotsedwa dzira lawo.Izi zimatchedwa hormone replacement therapy (HRT) kapena hormone therapy (HT).Kuphatikiza HRT/HT ndi estrogen yophatikizidwa ndi progestin.Mtundu uwu wa HRT/HT umawonjezera chiopsezo cha khansa ya m'mawere.Kafukufuku akusonyeza kuti akazi akasiya kumwa estrogen pamodzi ndi progestin, ngozi ya khansa ya m’mawere imachepa.

7. Chithandizo cha radiation ku bere kapena pachifuwa

Chithandizo cha radiation pachifuwa chochizira khansa kumawonjezera chiopsezo cha khansa ya m'mawere, kuyambira zaka 10 mutalandira chithandizo.Kuopsa kwa khansa ya m'mawere kumadalira mlingo wa radiation ndi zaka zomwe zimaperekedwa.Chiwopsezo chimakhala chachikulu ngati chithandizo cha radiation chidagwiritsidwa ntchito pakutha msinkhu, pamene mawere akupanga.

Chithandizo cha radiation chochiza khansa m'mawere amodzi sichikuwoneka kuti chikuwonjezera chiopsezo cha khansa mu bere lina.

Kwa amayi omwe atengera kusintha kwa majini a BRCA1 ndi BRCA2, kukhudzidwa ndi ma radiation, monga a pachifuwa cha x-ray, kungapangitse chiopsezo cha khansa ya m'mawere, makamaka kwa amayi omwe anajambulidwa asanakwanitse zaka 20.

8. Kunenepa kwambiri

Kunenepa kwambiri kumawonjezera chiopsezo cha khansa ya m'mawere, makamaka kwa amayi omwe ali ndi vuto losiya kusamba omwe sanagwiritse ntchito mankhwala obwezeretsa mahomoni.

9. Kumwa mowa

Kumwa mowa kumawonjezera chiopsezo cha khansa ya m'mawere.Mlingo wa chiopsezo umakwera pamene kuchuluka kwa mowa kumakwera.

Zotsatirazi ndizomwe zimateteza khansa ya m'mawere:

1. Kuchepa kwa minofu ya m'mawere ku estrogen yopangidwa ndi thupi

Kuchepetsa utali wa nthawi yomwe minofu ya m'mawere ya mkazi ikukumana ndi estrogen kungathandize kupewa khansa ya m'mawere.Kuwonetsedwa kwa estrogen kumachepetsedwa m'njira zotsatirazi:

• Mimba yoyambirira: Miyezo ya Estrogen imakhala yochepa pa nthawi ya mimba.Azimayi omwe ali ndi mimba nthawi zonse asanakwanitse zaka 20 amakhala ndi chiopsezo chochepa cha khansa ya m'mawere kusiyana ndi amayi omwe alibe ana kapena obereka mwana woyamba atatha zaka 35.
• Kuyamwitsa: Mlingo wa Estrogen ukhoza kukhala wotsika pamene mayi akuyamwitsa.Amayi omwe amayamwitsa ali ndi chiopsezo chochepa cha khansa ya m'mawere kusiyana ndi amayi omwe ali ndi ana koma osayamwitsa.

2. Kumwa mankhwala a mahomoni otchedwa estrogen-only hormone pambuyo pa hysterectomy, selective estrogen receptor modulators, kapena aromatase inhibitors ndi inactivators

Estrogen-only hormone therapy pambuyo pa hysterectomy

Thandizo la mahomoni ndi estrogen kokha lingaperekedwe kwa amayi omwe ali ndi hysterectomy.Kwa amayiwa, chithandizo cha estrogen chokha pambuyo posiya kusamba chingachepetse chiopsezo cha khansa ya m'mawere.Pali chiopsezo chowonjezeka cha sitiroko ndi matenda a mtima ndi mitsempha ya magazi mwa amayi omwe ali ndi vuto losiya kusamba omwe amatenga estrogen pambuyo pa hysterectomy.

Zosankha za estrogen receptor modulators

Tamoxifen ndi raloxifene ali m'gulu la mankhwala omwe amatchedwa selective estrogen receptor modulators (SERMs).Ma SERM amachita ngati estrogen pamagulu ena amthupi, koma amaletsa mphamvu ya estrogen pamagulu ena.

Chithandizo cha tamoxifen chimachepetsa chiopsezo cha khansa ya m'mawere ya estrogen receptor-positive (ER-positive) ndi ductal carcinoma in situ mu amayi omwe ali ndi premenopausal ndi postmenopausal omwe ali pachiopsezo chachikulu.Kuchiza ndi raloxifene kumachepetsanso chiopsezo cha khansa ya m'mawere mwa amayi omwe ali ndi vuto la postmenopausal.Ndi mankhwala aliwonse, chiwopsezo chochepa chimakhala kwa zaka zingapo kapena kupitilira apo chithandizo chasiya.Kutsika kwa mafupa osweka kwadziwika mwa odwala omwe amatenga raloxifene.

Kutenga tamoxifen kumawonjezera chiopsezo cha kutentha, khansa ya endometrial, sitiroko, ng'ala, ndi magazi (makamaka m'mapapo ndi miyendo).Chiwopsezo chokhala ndi mavutowa chimawonjezeka kwambiri mwa amayi opitilira zaka 50 poyerekeza ndi azimayi achichepere.Azimayi ochepera zaka 50 omwe ali ndi chiopsezo chachikulu chokhala ndi khansa ya m'mawere akhoza kupindula kwambiri pomwa tamoxifen.Chiwopsezo chokhala ndi mavutowa chimachepa tamoxifen itayimitsidwa.Lankhulani ndi dokotala wanu za kuopsa ndi ubwino wa kumwa mankhwalawa.

Kutenga raloxifene kumawonjezera chiopsezo cha magazi m'mapapo ndi miyendo, koma sizikuwoneka kuti zikuwonjezera chiopsezo cha khansa ya endometrial.Kwa amayi omwe ali ndi vuto la osteoporosis (kuchepa kwa mafupa), raloxifene amachepetsa chiopsezo cha khansa ya m'mawere kwa amayi omwe ali ndi chiopsezo chachikulu kapena chochepa cha khansa ya m'mawere.Sizikudziwika ngati raloxifene ingakhale ndi zotsatira zofanana ndi amayi omwe alibe osteoporosis.Lankhulani ndi dokotala wanu za kuopsa ndi ubwino wa kumwa mankhwalawa.

Ma SERM ena akuphunziridwa m'mayesero azachipatala.

Aromatase inhibitors ndi inactivators

Aromatase inhibitors (anastrozole, letrozole) ndi inactivators (exemestane) amachepetsa chiopsezo choyambiranso komanso cha khansa ya m'mawere yatsopano mwa amayi omwe ali ndi mbiri ya khansa ya m'mawere.Aromatase inhibitors amachepetsanso chiopsezo cha khansa ya m'mawere mwa amayi omwe ali ndi zotsatirazi:

• Azimayi otha msinkhu omwe ali ndi mbiri yakale ya khansa ya m'mawere.
• Azimayi omwe alibe mbiri ya khansa ya m'mawere omwe ali ndi zaka 60 kapena kuposerapo, ali ndi mbiri ya ductal carcinoma in situ ndi mastectomy, kapena ali ndi chiopsezo chachikulu chokhala ndi khansa ya m'mawere potengera chida cha Gail (chida chomwe chimagwiritsidwa ntchito poyerekezera kuopsa kwa mabere). khansa).

Kwa amayi omwe ali ndi chiopsezo chowonjezeka cha khansa ya m'mawere, kutenga aromatase inhibitors kumachepetsa kuchuluka kwa estrogen yopangidwa ndi thupi.Asanasiye kusamba, estrogen imapangidwa ndi dzira ndi minyewa ina ya m’thupi la mkazi, kuphatikizapo ubongo, minofu yamafuta, ndi khungu.Pambuyo pa kusamba, mazira amasiya kupanga estrogen, koma minyewa ina imasiya.Aromatase inhibitors amalepheretsa puloteni yotchedwa aromatase, yomwe imagwiritsidwa ntchito kupanga estrogen yonse ya thupi.Aromatase inactivators amaletsa enzyme kuti isagwire ntchito.

Zowopsa zomwe zingatheke potenga aromatase inhibitors ndi monga kupweteka kwa minofu ndi mafupa, osteoporosis, kutentha kwambiri, komanso kutopa kwambiri.

3. Kuchepetsa chiopsezo cha mastectomy

Azimayi ena omwe ali ndi chiopsezo chachikulu cha khansa ya m'mawere angasankhe kukhala ndi mastectomy yochepetsera chiopsezo (kuchotsa mawere onse ngati palibe zizindikiro za khansa).Chiwopsezo cha khansa ya m'mawere ndi chochepa kwambiri mwa amayiwa ndipo ambiri sada nkhawa kwambiri ndi chiopsezo cha khansa ya m'mawere.Komabe, ndikofunikira kwambiri kuwunika kuopsa kwa khansa ndi upangiri wa njira zosiyanasiyana zopewera khansa ya m'mawere musanapange chisankho.

4. Kuchotsa mazira

Mazira amatulutsa estrogen yambiri yomwe imapangidwa ndi thupi.Mankhwala amene amaletsa kapena kutsitsa mlingo wa estrogen wopangidwa ndi thumba losunga mazira amaphatikizapo opaleshoni yochotsa dzira, chithandizo cha radiation, kapena kumwa mankhwala enaake.Izi zimatchedwa kuchotsa ovarian.

Azimayi apakati omwe ali ndi chiopsezo chachikulu cha khansa ya m'mawere chifukwa cha kusintha kwina kwa majini a BRCA1 ndi BRCA2 angasankhe kukhala ndi oophorectomy yochepetsera chiopsezo (kuchotsedwa kwa mazira onse awiri pamene palibe zizindikiro za khansa).Izi zimachepetsa kuchuluka kwa estrogen yopangidwa ndi thupi ndikuchepetsa chiopsezo cha khansa ya m'mawere.Oophorectomy yochepetsera chiopsezo imachepetsanso chiopsezo cha khansa ya m'mawere mwa amayi omwe ali ndi vuto lotha msinkhu komanso amayi omwe ali ndi chiopsezo chowonjezereka cha khansa ya m'mawere chifukwa cha kutentha kwa chifuwa.Komabe, ndikofunikira kwambiri kuwunika kuopsa kwa khansa ndi upangiri musanapange chisankho.Kutsika kwadzidzidzi kwa milingo ya estrogen kungayambitse zizindikiro za kusamba.Izi ndi monga kutentha thupi, kugona, nkhawa, ndi kuvutika maganizo.Zotsatira za nthawi yayitali zimaphatikizapo kuchepa kwa chilakolako chogonana, kuuma kwa ukazi, ndi kuchepa kwa mafupa.

5. Kuchita masewera olimbitsa thupi mokwanira

Azimayi amene amachita masewera olimbitsa thupi maola anayi kapena kupitirira pa sabata amakhala ndi chiopsezo chochepa cha khansa ya m'mawere.Zotsatira zakuchita masewera olimbitsa thupi pachiwopsezo cha khansa ya m'mawere zitha kukhala zazikulu mwa amayi omwe ali ndi vuto losiya kusamba omwe ali ndi thupi labwinobwino kapena lochepa.

Sizikudziwika ngati zotsatirazi zimakhudza chiopsezo cha khansa ya m'mawere:

1. Njira zakulera m'mahomoni

Mahomoni akulera amakhala ndi estrogen kapena estrogen ndi progestin.Kafukufuku wina wasonyeza kuti amayi omwe akugwiritsa ntchito njira zakulera za mahomoni panopa kapena posachedwapa akhoza kukhala ndi chiopsezo chochepa cha khansa ya m'mawere.Kafukufuku wina sanawonetse chiopsezo chowonjezeka cha khansa ya m'mawere mwa amayi omwe amagwiritsa ntchito njira zolerera za mahomoni.

Mu kafukufuku wina, chiopsezo cha khansa ya m'mawere chinawonjezeka pang'ono pamene mkazi amagwiritsa ntchito njira zolerera za mahomoni.Kafukufuku wina anasonyeza kuti kuwonjezeka pang'ono kwa chiopsezo cha khansa ya m'mawere kunachepa pakapita nthawi pamene amayi anasiya kugwiritsa ntchito njira zolerera za mahomoni.

Kafukufuku wochulukirapo akufunika kuti adziwe ngati njira zolerera za mahomoni zimakhudza chiopsezo cha mayi kudwala khansa ya m'mawere.

2. Chilengedwe

Kafukufuku sanatsimikizire kuti kukumana ndi zinthu zina m'chilengedwe, monga mankhwala, kumawonjezera chiopsezo cha khansa ya m'mawere.

Kafukufuku wasonyeza kuti zinthu zina zimakhala ndi zotsatira zochepa kapena zilibe kanthu pa chiopsezo cha khansa ya m'mawere.

Zotsatirazi zili ndi mphamvu zochepa kapena zilibe kanthu pa chiopsezo cha khansa ya m'mawere:

• Kuchotsa mimba.
• Kupanga kusintha kwa zakudya monga kudya mafuta ochepa kapena zipatso zambiri ndi ndiwo zamasamba.
• Kutenga mavitamini, kuphatikizapo fenretinide (mtundu wa vitamini A).
• Kusuta fodya, kuchitapo kanthu komanso kungokhala chete (kupuma utsi wa fodya).
• Gwiritsani ntchito deodorant kapena antiperspirant.
• Kutenga ma statins (mankhwala ochepetsa cholesterol).
• Kutenga ma bisphosphonates (mankhwala ochizira osteoporosis ndi hypercalcemia) pakamwa kapena kudzera m'mitsempha.
• Kusintha kwa kayimbidwe kanu ka circadian (kusintha kwa thupi, maganizo, ndi khalidwe komwe kumakhudzidwa makamaka ndi mdima ndi kuwala kwa maola a 24), zomwe zingakhudzidwe ndi ntchito usiku kapena kuchuluka kwa kuwala m'chipinda chanu usiku.

Gwero:http://www.chinancpcn.org.cn/cancerMedicineClassic/guideDetail?sId=CDR257994&type=1