Ese ni DCIS? Ibimenyetso, Impamvu, n'Ubuvuzi

DCIS, cyangwa ductal carcinoma in situ, ni ubwoko bwa kanseri y'amabere budatera, aho utwenge tudakomeye tuboneka mu myanya y'amata ariko ntibyakwirakwira mu tundi turemangingo tw'amabere. Tekereza ko ari utwenge twa kanseri “twafunzwe” muri iyo myanya, nk'amazi ari mu muyoboro utaravuza.

Nubwo ijambo “carcinoma” rishobora gutera ubwoba, DCIS ifatwa nk'igiciro cya kanseri y'amabere cya 0 kuko itaratera mu tundi turemangingo. Abaganga benshi bayita “uburwayi bwa kanseri” kandi, iyo ivuwe neza, ibyiringiro byiza biri ku bantu benshi.

Ni ibihe bimenyetso bya DCIS?

Abantu benshi bafite DCIS nta bimenyetso bigaragara bagira. Iyi ndwara isanzwe iboneka mu isuzuma rya mamografiya rusanzwe, atari uko umuntu yumvise ikintu kitari gisanzwe.

Iyo ibimenyetso bibayeho, akenshi biba bito kandi byoroshye kubirengagiza. Dore ibimenyetso bishobora kugaragara:

• Igisebe gito, kitababaje, ushobora kumva ubwo wikorera isuzuma
• Ibinyabutabire bitari bisanzwe by'umusemburo, bishobora kuba byera, byahumye, cyangwa by'amaraso
• Impinduka mu buryo umusemburo ugaragara, nko gukururwa imbere cyangwa imiterere idasanzwe
• Kubabara cyangwa kubabara mu gice kimwe cy'amabere
• Impinduka z'uruhu ku mabere, nko guhindagura cyangwa gucika

Ni ngombwa kwibuka ko ibi bimenyetso bishobora kandi kugaragaza uburwayi bw'amabere budatera. Ikintu nyamukuru ni ukutatera ubwoba ahubwo kujya kubigenzura hakiri kare kwa muganga.

Ni iki gatera DCIS?

DCIS itera iyo utwenge tw'imbere mu myanya y'amata dutangiye gukura mu buryo budasanzwe kandi tugakwirakwira mu buryo budakozwe. Nubwo tutazi neza icyo gitera uyu muhanda, abashakashatsi bamenye ibintu byinshi bishobora gutera.

Impamvu nyamukuru isa n'aho ari ukwangirika kwa ADN mu turemangingo tw'imbere mu myanya y'amata. Iyo mpanuka ishobora kuba mu gihe kirekire kubera gusaza bisanzwe, ibintu by'imisemburo, cyangwa ibintu byo mu kirere. Umubiri wawe usanzwe ukosora ubwo bwangirika, ariko rimwe na rimwe uburyo bwo gukosora ntibukora neza.

Ibintu byinshi bishobora kongera ibyago byo kurwara DCIS:

• Imyaka - ingero nyinshi ziba ku bagore barengeje 50
• Amateka y'umuryango wa kanseri y'amabere cyangwa ya ovaire
• Isuzuma ry'amabere ryabanje ryerekana utwenge tudakomeye
• Ubuvuzi bw'imisemburo bw'igihe kirekire
• Kugira imihango hakiri kare cyangwa guhagarika imihango nyuma y'igihe
• Kutera abana cyangwa guterwa umwana wa mbere nyuma y'imyaka 30
• Umuhindo w'imiterere ya gene, cyane cyane BRCA1 na BRCA2

Kugira ibi bintu bitera ibyago ntibivuze ko uzahita urwara DCIS. Abantu benshi bafite ibintu byinshi bitera ibyago ntibarwara iyo ndwara, mu gihe abandi badafite ibintu byo kumenya bitera ibyago barayirwara.

Ni ibihe bwoko bya DCIS?

DCIS igabanyijemo ubwoko butandukanye bushingiye ku buryo utwenge tudakomeye tugera ku ishusho ya mikoroskopi n'uburyo bwihuse bishobora gukura. Gusobanukirwa ubwoko bwawe bw'umwihariko bifasha muganga wawe gutegura uburyo bwiza bwo kuvura.

Uburyo nyamukuru bwo kubona ubwoko ni ukureba urwego rw'utwenge:

• DCIS y'urwego ruto - utwenge tumera nk'utwenge dusanzwe tw'amabere kandi gukura gahoro
• DCIS y'urwego rwo hagati - utwenge ni udakomeye mu buryo buciriritse hamwe n'umuvuduko wo gukura uciriritse
• DCIS y'urwego rwo hejuru - utwenge tumera bitandukanye cyane n'utwenge dusanzwe kandi gukura kwihuta

Umuhanga mu by'indwara azareba kandi imisemburo (estrogen na progesterone) na poroteyine yitwa HER2. Ibi bintu bifasha kumenya niba imiti imwe, nka terapi ya hormone, ishobora kukugirira akamaro.

Ubundi buryo abaganga basobanura DCIS ni uburyo bwo gukura mu myanya y'amata. Amwe ubwoko bukura mu buryo buhamye, mu gihe ayandi afite ishusho y'amaduka menshi, cribriform (isa na foromaje ya Swiss). Aya makuru afasha kuvuga uko iyo ndwara ishobora kwitwara.

Ni ryari ukwiye kujya kwa muganga kubera DCIS?

Wagomba kuvugana na muganga wawe niba ubona impinduka zidasanzwe mu mabere yawe, nubwo zasa nkeya. Kumenya hakiri kare no gusuzuma bihora byiza kuruta gutegereza no guhangayika.

Tegura gahunda mu minsi mike niba ufite:

• Igisebe gishya cyangwa gikomeye mu mabere yawe cyangwa munsi y'uruhande
• Ibinyabutabire by'umusemburo bigaragara utabanje gukanda
• Impinduka mu bunini cyangwa ishusho y'amabere
• Impinduka z'uruhu nko guhindagura, gucika, cyangwa gutukura
• Impinduka z'umusemburo, harimo no guhinduka cyangwa imiterere idasanzwe

Niba ufite imyaka irengeje 40 cyangwa ufite amateka y'umuryango wa kanseri y'amabere, ntukarengagize isuzuma ryawe rya mamografiya rusanzwe. Ingero nyinshi za DCIS ziboneka mu isuzuma rusanzwe mbere y'uko ibimenyetso bigaragara.

Wibuke ko impinduka nyinshi z'amabere atari kanseri, ariko bihora ari byiza kugira isuzuma ry'umwuga kugira ngo umutima utuje kandi ubone ubufasha bukwiye.

Ni ibihe bintu bitera ibyago bya DCIS?

Ibintu byinshi bishobora kongera amahirwe yawe yo kurwara DCIS, nubwo kugira ibintu bitera ibyago ntibivuze ko uzahita urwara iyo ndwara. Gusobanukirwa ibi bintu bishobora kugufasha gufata ibyemezo byuzuye ku bijyanye n'isuzuma n'imibereho.

Ibintu bitera ibyago by'ingenzi birimo:

• Imyaka - ibyago byiyongera cyane nyuma yo guhagarika imihango, ingero nyinshi ziba ku bagore barengeje 50
• Amateka y'umuryango - kugira abavandimwe ba hafi bafite kanseri y'amabere cyangwa ya ovaire byongera ibyago kabiri
• Ibibazo by'amabere byabanje - amateka ya atypical hyperplasia cyangwa lobular carcinoma in situ
• Umuhindo w'imiterere ya gene - BRCA1, BRCA2, n'ibindi bihinduka by'imiterere ya gene byarazwe
• Uruhu rw'amabere rukomeye - bituma kubona bigorana kandi byongera gato ibyago
• Imiterere y'imisemburo - igihe kirekire cyo kwibasirwa na estrogen binyuze mu mihango ya hakiri kare, guhagarika imihango nyuma y'igihe, cyangwa terapi ya hormone

Bimwe mu bintu bitera ibyago bitari byinshi abashakashatsi bamenye birimo kutakora ibere, kugira umubyibuho ukabije nyuma yo guhagarika imihango, no kugira imyitozo ngororamubiri mike. Ariko, ibi bintu bigira ingaruka nke cyane ku byago byawe rusange.

Bikwiye kuzirikana ko abagore bagera kuri 75% bafite DCIS nta bintu byo kumenya bitera ibyago uretse imyaka no kuba umugore. Niyo mpamvu isuzuma rya buri gihe ari ingenzi cyane kugira ngo hamenyekane hakiri kare.

Ni ibihe bibazo bishoboka bya DCIS?

Ikibazo nyamukuru cya DCIS ni uko gishobora gutera kanseri y'amabere itera ibindi bice niba kitavuwe. Ariko, iyo mpinduka si yo ihoraho, kandi ingero nyinshi za DCIS ntizigera ziba kanseri itera ibindi bice.

Ubushakashatsi bwerekana ko hatavuwe, ingero zigera kuri 30-50% za DCIS zishobora guhinduka kanseri itera ibindi bice mu myaka myinshi. Ibyago biterwa n'ibintu nko ku rwego rwa DCIS yawe n'imiterere yawe bwite.

Ibibazo bishoboka birimo:

• Guhinduka kanseri itera ibindi bice - ikibazo nyamukuru gitera ibyemezo byo kuvura
• Gusubira - DCIS ishobora gusubira mu gice kimwe cyangwa itera mu bindi bice by'amabere
• Ingaruka ziterwa no kuvura - ingaruka z'ubuganga, imirasire, cyangwa imiti
• Ingaruka zo mu mutwe - guhangayika kubera kanseri n'ibyemezo byo kuvura

Inkuru nziza ni uko, iyo havuwe neza, abantu benshi bafite DCIS bakomeza kubaho ubuzima busanzwe, bwiza. Igipimo cy'abakira DCIS mu myaka itanu ni hafi 100% iyo ivuwe neza.

Itsinda ryawe ry'ubuvuzi rizakorana nawe kugira ngo bahuze inyungu zo kuvura n'ibyago n'ingaruka, hakurikijwe uko uri n'ibyo ukunda.

DCIS imenyekanwa gute?

DCIS isanzwe imenyekanwa binyuze mu isuzuma ry'amashusho n'igipimo cy'uturemangingo. Uyu muhanda ubusanzwe utangira iyo hari ikintu kitari gisanzwe kigaragara kuri mamografiya mu isuzuma rusanzwe.

Muganga wawe ashobora gutangira asuzuma amashusho kugira ngo abone ishusho isobanutse y'ibiri kuba mu turemangingo tw'amabere yawe. Ibyo bishobora kuba mamografiya isobanura neza hamwe n'ibindi bice byinshi, ultrasound y'amabere, cyangwa rimwe na rimwe MRI y'amabere kugira ngo hasuzumwe neza.

Kumenya neza bisaba igipimo cy'uturemangingo, aho igice gito cy'uturemangingo tw'amabere gikurwaho kandi kigenzurwa kuri mikoroskopi. Uyu muhanda ubusanzwe ukorwa n'igipimo cy'umusemburo, kidatera uburwayi kurusha ubuganga kandi gishobora gukorwa hanze.

Mu gihe cy'isuzuma, muganga wawe azakoresha ubuyobozi bw'amashusho kugira ngo abemeze ko arimo gufata igice gikwiye. Uzabona imiti igabanya ububabare kugira ngo ugabanye ububabare, kandi uyu muhanda ubusanzwe umara iminota 30.

Igice cy'uturemangingo kijya ku muhanga mu by'indwara uzamenya niba utwenge tudakomeye buhari, kandi niba ari byo, ubwoko bwa DCIS ufite. Aya makuru afasha itsinda ryawe ry'ubuvuzi gutegura gahunda yo kuvura ikwiye ku mimerere yawe bwite.

Ni iki kivura DCIS?

Ubuvuzi bwa DCIS bugamije gukuraho utwenge tudakomeye no kugabanya ibyago byo guhinduka kanseri itera ibindi bice. Gahunda yawe yo kuvura izaterwa n'ibintu byinshi, birimo ubunini n'urwego rwa DCIS yawe, imyaka yawe, n'ibyo ukunda.

Ubuganga ubusanzwe ni bwo bwa mbere, kandi hari uburyo bubiri nyamukuru:

• Lumpectomy - ikuraho DCIS n'igice gito cy'uturemangingo dusanzwe hafi yacyo, ikagumana amabere yawe menshi
• Mastectomy - ikuraho ibere ryose, ubusanzwe ibyo bigirwa ku mabere manini cyangwa menshi ya DCIS

Nyuma ya lumpectomy, muganga wawe ashobora kugutegurira kuvurwa kw'imirasire mu turemangingo tw'amabere dushigaje. Ubu buvuzi bufasha kugabanya ibyago byo gusubira kwa DCIS mu ibere rimwe kandi ubusanzwe butangwa iminsi itanu mu cyumweru ibyumweru byinshi.

Ku bantu bafite DCIS ifite imisemburo, muganga wawe ashobora kugutegurira terapi ya hormone hamwe n'imiti nka tamoxifen. Ubu buvuzi bushobora kugabanya ibyago byo kurwara kanseri nshya y'amabere mu mabere yombi.

Bamwe mu bantu bafite DCIS yo hasi cyane bashobora kuba abakandida bo gukurikiranwa gukomeye aho kuvurwa vuba. Uyu muhanda ugaragaza gukurikirana neza hamwe n'amashusho rusanzwe n'isuzuma ry'abaganga, kuvura gusa niba hari impinduka zibaho.

Uko wakwitwara muri DCIS iwawe

Nubwo ubuvuzi ari ingenzi kuri DCIS, hari ibintu byinshi ushobora gukora iwawe kugira ngo ushyigikire ubuzima bwawe rusange n'imibereho yawe mu gihe cyo kuvurwa no nyuma yacyo.

Fata umwanya wo kugira imibereho myiza ishyigikira uburyo bw'umubiri wawe bwo gukira. Ibyo birimo kurya indyo yuzuye irimo imbuto, imboga, n'ibinyampeke byuzuye mu gihe ugabanya ibiryo bitegurwa n'inzoga nyinshi.

Imikino ngororamubiri ya buri gihe ishobora gufasha kongera imbaraga zawe z'umubiri no kunoza imibereho yawe rusange. Tangira imikino myoroheje nko kugenda cyangwa koga, hanyuma wiyongere uko wishimye kandi muganga akemereye.

Gucunga umunaniro ni ingenzi cyane mu gukira kwawe no mu buzima bwawe buhoraho. Tekereza uburyo bwo gutekereza, imyitozo yo guhumeka cyangwa yoga. Abantu benshi basanga kwinjira mu matsinda y'abafite ibibazo nk'ibyo cyangwa kuvugana n'abandi bafite ibibazo nk'ibyo bishobora gufasha cyane.

Komeza ukore impinduka mu mabere yawe kandi witabire gahunda zose zo gukurikirana n'itsinda ryawe ry'ubuvuzi. Ntuzuzagira ikibazo cyo kuvugana na muganga wawe niba ubona ikintu kitari gisanzwe cyangwa ufite impungenge ku bijyanye no gukira.

Uko wakwitegura gahunda yawe ya muganga

Kwitunganya mbere yo kujya kwa muganga bishobora kugufasha kugira ngo ubone igihe cyiza cyo kuvugana na muganga wawe kandi ubashe kubona ibisubizo byose by'ibibazo byawe.

Tangira wandike ibimenyetso byawe byose, harimo igihe byatangiye n'uko byahindutse mu gihe. Bandika ibintu byose bisa n'ibyagabanya cyangwa bikongera ibimenyetso, nubwo bisa ntibihuye n'impungenge z'amabere yawe.

Kora urutonde rwuzuye rw'imiti yawe, harimo imiti y'abaganga, imiti yo kwivura, amavitamini, n'ibindi bintu byongera. Nanone, kora amakuru ku mateka y'umuryango wawe, cyane cyane amateka ya kanseri y'amabere, ya ovaire, cyangwa izindi kanseri.

Tegura urutonde rw'ibibazo ushaka kubabaza muganga wawe. Bimwe mu bibazo by'ingenzi bishobora kuba:

• Ni ubwoko n'urwego rwa DCIS mfite?
• Ni ibihe bintu byo kuvura, kandi ni iki ugereranya?
• Ni izihe ngaruka z'uburyo bwo kuvura?
• Ubuvuzi buzagira ikihe kintu ku mirimo yanjye ya buri munsi?
• Ni ikihe kivuriro nzakenera?
• Hari impinduka mu mibereho nakwiye gutekereza?

Tegereza kuzana inshuti cyangwa umuryango wawe wizewe mu gahunda yawe. Bashobora kugufasha kwibuka amakuru y'ingenzi no gutanga inkunga mu gihe cy'ikiganiro gishobora kuba kigoye.

Ni iki gikuru wakura muri DCIS?

DCIS ni indwara ivurwa cyane ifite ibyiringiro byiza iyo imenyekanye hakiri kare kandi ivuwe neza. Nubwo kubona kanseri bishobora gutera ubwoba, wibuke ko DCIS ifatwa nk'igiciro cya kanseri cya 0 kuko itaratera mu myanya y'amata.

Ikintu cy'ingenzi cyo gusobanukirwa ni uko ufite igihe cyo gufata ibyemezo byuzuye ku bijyanye no kuvura. DCIS ubusanzwe ikura gahoro, kugira ngo utagomba kwihuta mu gufata ibyemezo byo kuvura. Fata umwanya wo gusobanukirwa amahitamo yawe, ubone undi muganga niba ubishaka, kandi uhitamo uburyo bukubereye.

Iyo havuwe neza, abantu benshi bafite DCIS bakomeza kubaho ubuzima buzuye, bwiza hataraba impinduka ya kanseri itera ibindi bice. Gukurikirana buri gihe no kugira imibereho myiza bishobora kongera gushyigikira ubuzima bwawe bwiza igihe kirekire.

Wibuke ko itsinda ryawe ry'ubuvuzi riri aho kugira ngo rigushyigikire muri buri ntambwe y'uru rugendo. Ntuzuzagira ikibazo cyo kubabaza ibibazo, gutanga impungenge zawe, cyangwa gushaka ubufasha bundi igihe ubikeneye.

Ibibazo byakunda kubazwa kuri DCIS

Ese DCIS ni kanseri koko?

DCIS mu buryo bw'amategeko ifatwa nk'igiciro cya kanseri y'amabere cya 0, ariko abaganga benshi bakunda kuyita “kanseri” kuko utwenge tudakomeye tudatera mu myanya y'amata. Nubwo ifite ubushobozi bwo guhinduka kanseri itera ibindi bice niba kitavuwe, ntabwo itera urupfu mu buryo bwayo kandi ifite ibyiringiro byiza iyo ivuwe.

Nzakenera chemotherapy kuri DCIS?

Chemotherapy ubusanzwe ntiterwa kuri DCIS kuko utwenge tudakomeye tudatera mu myanya y'amata. Ubuvuzi ubusanzwe burimo ubuganga kandi rimwe na rimwe kuvurwa kw'imirasire cyangwa terapi ya hormone. Gahunda yawe yo kuvura izaterwa n'imiterere ya DCIS yawe n'imimerere yawe bwite.

Ese DCIS ishobora gusubira nyuma yo kuvurwa?

Hari amahirwe make yo gusubira kwa DCIS, cyangwa nk'iya DCIS cyangwa nk'iya kanseri itera ibindi bice. Ibyago ubusanzwe biba bike, cyane cyane iyo havuwe neza harimo ubuganga n'imirasire iyo byasabwe. Gukurikirana buri gihe hamwe na mamografiya n'isuzuma ry'abaganga bifasha kubona impinduka zose hakiri kare.

Ese ubuvuzi bwa DCIS buramara igihe kingana iki?

Igihe kirahinduka bitewe na gahunda yawe yo kuvura. Ubuganga ubusanzwe bukeneye ibyumweru bike kugira ngo ukire, mu gihe kuvurwa kw'imirasire, iyo byasabwe, ubusanzwe bikubiyemo kuvurwa buri munsi ibyumweru 3-6. Terapi ya hormone, iyo yatanzwe, ubusanzwe ifatwa imyaka 5. Muganga wawe azatanga igihe runaka gishingiye ku gahunda yawe yo kuvura.

Ese nakwiye gukora isuzuma rya gene kuri DCIS?

Isuzuma rya gene rishobora kugutegurira niba ufite amateka y'umuryango akomeye ya kanseri y'amabere cyangwa ya ovaire, wamenyekanye ufite imyaka mike, cyangwa ufite ibindi bintu bitera ibyago bigaragaza indwara za kanseri zarazwe. Muganga wawe cyangwa umujyanama mu bya gene ashobora kugufasha kumenya niba isuzuma ryaba rifite akamaro mu mimerere yawe.