Chii chinonzi Lumpectomy? Chinangwa, Maitiro & Kupora

Lumpectomy ndiko kuvhiyiwa kunochengetedza zamu kunobvisa bundu rine kenza pamwe chete nehuwandu hudiki hwezvinyama zvakakomberedza zvine hutano. Maitiro aya anokubvumira kuti uchengetedze chikamu chikuru chezamu rako uchibata kenza yezamu zvinobudirira. Inowanzozivikanwa se "kuvhiyiwa kunochengetedza zamu" nekuti inochengetedza chimiro chose uye chitarisiko chezamu rako.

Vakadzi vazhinji vanonzwa vachinetseka pavanoziva nezvekuda kuvhiyiwa zamu. Kunzwisisa zvinobatanidzwa mu lumpectomy kunogona kubatsira kuderedza izvo zvinonetsa uye kukugonesa kuti uite sarudzo dzine ruzivo nezvekuchengetwa kwako.

Chii chinonzi lumpectomy?

Lumpectomy maitiro ekuvhiya anobvisa kenza yezamu uchichengetedza zvakawanda zvezvinyama zvako zvezamu sezvinobvira. Munguva yekuvhiya uku, chiremba anobvisa bundu pamwe chete nemuganhu wezvinyama zvine hutano zvakapoteredza kuti ave nechokwadi chekuti maseru ese ekenza abviswa.

Funga nezvazvo sekurapa kwakanyatsojeka kunotarisa chete dambudziko racho. Chinangwa ndechekuita kubviswa kwakakwana kwekenza uchichengetedza chitarisiko chakasikwa uye basa rezamu rako. Iyi nzira yakaratidzwa kuti inoshanda sezvakaita mastectomy yekenza yezamu padanho rekutanga kana yakabatanidzwa ne radiation therapy.

Maitiro acho anowanzo tora 1-2 maawa uye anoitwa pasi pe general anesthesia. Varwere vazhinji vanogona kuenda kumba zuva rimwechete kana mushure mehusiku humwe, zvichienderana nemamiriro emunhu uye kurudziro yechiremba.

Nei lumpectomy ichiitwa?

Lumpectomy inoitwa kurapa kenza yezamu uchichengetedza zamu rako. Ndiyo nzira yekurapa inosarudzwa kana kenza yawanikwa kare uye yakavharirwa kunzvimbo diki yezvinyama zvezamu.

Chiremba wako anogona kukurudzira lumpectomy kana uine gomarara remazamu rinopinda kana ductal carcinoma in situ (DCIS), iyo isiri-invasive fomu yegomarara remazamu. Saizi nenzvimbo yegomarara rako, pamwe chete neutano hwako hwese, zvinosarudza kana uri munhu akakodzera nzira iyi.

Kuvhiyiwa uku kunopa zvakanakira zvakawanda pamusoro penzira dzakawanda. Unochengeta chitarisiko chemazamu ako echisikigo, unowana nguva pfupi yekupora, uye kazhinji unonzwa wakasununguka nemuviri wako mushure mekurapa. Zvidzidzo zvinoratidza kuti lumpectomy inoteverwa ne radiation therapy inopa mazinga ekurarama akaenzana ne mastectomy yegomarara remazamu rechikamu chekutanga.

Ndeipi nzira ye lumpectomy?

Nzira ye lumpectomy inotevera nzira yakarongwa zvakanyanya kuti ive nechokwadi chekubviswa kwegomarara kwakakwana uku uchichengetedza tishu ine hutano. Chikwata chako chekuvhiya chichange chakanyatsoongorora nyaya yako uye zvidzidzo zvekuongorora zvisati zvaitika kuvhiyiwa.

Hezvino zvinoitika panguva yekuvhiya kwako lumpectomy:

1. Uchagamuchira general anesthesia kuti uve nechokwadi chekuti unonzwa wakasununguka zvachose panguva yacho
2. Chiremba wako anogadzira incision diki pamusoro penzvimbo yegomarara, kazhinji achitevera contour yechisikigo yechipfuwo chako
3. Gomarara rinobviswa zvakanyatsonaka pamwe chete nemugumo wetishu ine hutano yakatenderedza
4. Tishu yakabviswa inotumirwa ku pathology kuti iongororwe nekukasira kuti ive nechokwadi chekuti miganhu yakajeka
5. Kana miganhu isina kujeka, imwe tishu inogona kubviswa panguva imwecheteyo
6. Chiremba wako anovhara incision nemasutures kana surgical clips
7. Tube yekudhonza inogona kuiswa kwenguva pfupi kana zvichidikanwa

Nzira yese inowanzo tora 1-2 maawa, zvichienderana nesaizi yegomarara nenzvimbo. Chiremba wako anogona zvakare kuita sentinel lymph node biopsy panguva imwecheteyo kuti aone kana gomarara raenda kune dzimwe lymph nodes dziri pedyo.

Mune dzimwe nguva, chiremba wako anovhiya angashandisa wire localization kana dzimwe nzira dzekuona kuti awane chaizvo tumor diki dzisinganzwisisike panguva yekuongorora. Izvi zvinovimbisa kubviswa kwakaringana uku uchichengetedza nyama yakawanda ine hutano sezvinobvira.

Maitiro ekugadzirira lumpectomy yako?

Kugadzirira lumpectomy kunosanganisira kugadzirira kwemuviri nekwekunzwa kuti uve nechokwadi chekuwana mhedzisiro yakanaka. Chikwata chako chekuchengetedza hutano chichapa mirairo yakatarwa yakagadzirirwa mamiriro ako ega.

Matanho akati wandei achakubatsira kugadzirira kuvhiyiwa kunobudirira nekupora:

• Regedza kutora mishonga inoderedza ropa sezvinotaurwa nachiremba wako, kazhinji mazuva 7-10 vasati vavhiyiwa
• Gadzirisa kuti mumwe munhu akutyairire kumba uye agare newe kwemaawa makumi maviri nemana ekutanga
• Tsanya kwemaawa 8-12 usati wavhiyiwa sezvinorairwa nechikwata chako chekuvhiya
• Pfeka mbatya dzakasununguka, dzakasununguka dzinobata mabhatani kana zipi kumberi
• Bvisa zvishongo zvese, makeup, uye nail polish usati wasvika kuchipatara
• Geza nesipo inorwisa mabhakitiriya husiku hwamboenda kuvhiyiwa nemangwanani
• Uya nechinyorwa chemishonga yese uye zvinowedzera zvauri kutora

Chiremba wako anovhiya achasangana newe usati waita maitiro ekupindura chero mibvunzo yekupedzisira uye kuona kuti unonzwa wakasununguka kuenderera mberi. Iyi inguva yakanaka yekukurukura chero zvinokunetsa nezvekuvhiyiwa kana maitiro ekupora.

Funga kugadzirira imba yako kuti upore nekugadzira nzvimbo yekuzorora yakasununguka ine mukana wekuwana zvinhu zvinodiwa. Kuva nemapaki echando, mapiro akasununguka, uye sarudzo dzekunakidzwa dziripo zvinogona kuita kuti kupora kwako kuve kunofadza.

Maitiro ekuverenga mhedzisiro yako ye lumpectomy?

Kunzwisisa mushumo wako we lumpectomy pathology kunokubatsira kunzwisisa zvakaitwa nevhiyiwa uye matanho anotevera muronga wako wekurapa. Mushumo we pathology unopa ruzivo rwakakosha nezvekenza yako uye kana kuvhiyiwa kwakabvisa zvese zvinyama zvine kenza.

Mushumo wako we pathology uchabatanidza zvinhu zvakakosha zvinokutungamirira mukutarisirwa kwako kuri kuenderera mberi. Chinhu chakanyanya kukosha ndechokuti chiremba wako akawana "clear margins," zvinoreva kuti hapana masero ekenza akawanikwa pamativi etishu yakabviswa.

Hezvino zvikamu zvikuru zvichataurwa nemushumo wako we pathology:

• Margin status - kana masero ekenza akasvika kumativi etishu yakabviswa
• Saizi yetumor nerudzi - maitiro chaiwo ekenza yako
• Hormone receptor status - kana kenza yako ichipindura kumahomoni
• HER2 status - protein inokanganisa kukura kwekenza uye sarudzo dzekurapa
• Grade - kuti masero ako ekenza anoita sei ane hasha pasi pekuongorora microscopic
• Lymph node involvement - kana kenza yakapararira kune lymph nodes dzepedyo

Clear margins zvinoreva kuti chiremba wako akabvisa zvinobudirira kenza yese inooneka netishu ine hutano ichiipoteredza. Kana margins dzisina kujeka, unogona kuda kuvhiyiwa kwakawedzerwa kuti ubvise imwe tishu uye uve nechokwadi chekubviswa kwakakwana kwekenza.

Oncologist wako achatarisa mhedzisiro iyi newe uye achatsanangura kuti inokanganisa sei chirongwa chako chekurapa. Ruzivo urwu runobatsira kuona kana uchida mamwe marapirwo senge chemotherapy, hormone therapy, kana targeted therapies.

Nzira yekupora mushure me lumpectomy yako?

Kupora kubva ku lumpectomy kazhinji kwakananga, nevakawanda vanodzoka kune zvakajairika zviitiko mukati me1-2 vhiki. Muviri wako unoda nguva yekupora, uye kutevera mirairo yachiremba wako zvakanyatsonaka kunokurudzira kupora kwakanaka.

Mumazuva mashoma ekutanga mushure mekuvhiyiwa, iwe ungangodaro uchinzwa kusagadzikana, kuzvimba, uye kupwanya pedyo nenzvimbo yekuvhiya. Zviratidzo izvi zvakajairika zvachose uye zvinovandudzika zvishoma nezvishoma sezvo muviri wako uchipora.

Chirongwa chako chekupora chinofanira kusanganisira aya matungamirirwo akakosha:

• Tora mishonga yekurwadziwa yakarairwa sezvakarairwa kuti urambe wakasununguka
• Chengeta nzvimbo yekuvhiya yakachena uye yakaoma, uchitevera mirairo chaiyo yekuchengeta ronda
• Dzivisa kusimudza zvinhu zvinorema (kupfuura mapaundi gumi) kwemavhiki 1-2
• Dzokera zvishoma nezvishoma kuzviitwa zvako zvenguva dzose sezvaunonzwa wagadzirira
• Pinda misangano yese yekutevera nechikwata chako chekuvhiya
• Tarisa zviratidzo zveutachiona senge kuwedzera kutsvuka, kudziya, kana kubuda
• Ita maekisesa emaoko zvinyoro sezvinokurudzirwa kudzivirira kuoma

Vanhu vazhinji vanogona kudzokera kubasa mukati mevhiki, zvichienderana nezvinodiwa nebasa ravo. Zviitwa zvinosanganisira kusimudza zvinhu zvinorema kana kufamba kwemaoko kunofanirwa kudzivirirwa kusvikira chiremba wako avhiya apa mvumo, kazhinji 2-4 mavhiki mushure mekuvhiya.

Kupora kwako kwepfungwa kwakakosha sekupora kwemuviri. Zvakajairika kunzwa kushushikana, kusuruvara, kana kunetseka mushure mekuvhiya kenza. Usazeza kusvika kuchikwata chako chehutano, mapoka ekutsigira, kana vapi vemazano kana uchida rutsigiro rwepfungwa panguva ino.

Ndezvipi zvinhu zvine njodzi zvekuda lumpectomy?

Zvikonzero zvekuda lumpectomy zvakafanana nezvikonzero zvekukudziridza kenza yemazamu. Kunzwisisa izvi zvinhu zvinokubatsira kuita sarudzo dzine ruzivo nezve nzira dzekuongorora nekudzivirira.

Zvimwe zvinhu zvine njodzi zvekenza yemazamu zvinogona kutungamira ku lumpectomy hazvisi pasi pekudzora kwako, nepo vamwe vachibatanidzwa nesarudzo dzehupenyu hwaunogona kukanganisa. Zera rinoramba riri chinhu chakakosha chenjodzi, nekuti mazhinji ekenza yemazamu anoitika muvakadzi vane makore anopfuura makumi mashanu.

Heano zvinhu zvakakosha zvinowedzera mukana wekenza yemazamu:

• Kuva mukadzi uye kukwegura, kunyanya mushure mekuenda kumwedzi
• Nhoroondo yemhuri yegomarara rezamu kana remazai
• Kuchinja kwemajini kwakagara nhaka senge BRCA1 kana BRCA2
• Gomarara rezamu raimbovepo kana mamwe mamiriro ezvinhu ezamu asina njodzi
• Nyama yezamu yakakora inoita kuti kuongorora gomarara kuve kwakaoma
• Kusangana neestrogen kwenguva refu
• Kusangana nemwaranzi kunzvimbo yechipfuwa panguva yehudiki kana kuyaruka

Zvikonzero zvemararamiro zvinogona kuwedzera njodzi zvinosanganisira kunwa doro, kuva nemafuta akawandisa mushure mekuenda kumwedzi, uye kushaya basa remuviri. Zvisinei, kuva nezvikonzero zvenjodzi hazvirevi kuti zvechokwadi uchava negomarara rezamu.

Kuongororwa nguva dzose kuburikidza nemammograms uye kuongororwa kwezamu kunobatsira kuona gomarara kare apo lumpectomy inogona kubudirira. Kuonekwa kare kunovandudza zvakanyanya mhedzisiro yekurapa uye mitengo yekupona.

Ndezvipi zvinetso zvinogona kuitika zve lumpectomy?

Lumpectomy inowanzoita nzira yakachengeteka ine njodzi shoma yezvinetso zvakakomba. Zvisinei, semamwe maoparesheni, inotakura njodzi dzimwe dzinogona kuitika dzichakurukurwa nechikwata chako chekuvhiya newe usati waita oparesheni.

Zvizhinji zvezvinetso zvishoma uye zvinogadziriswa nekutarisirwa kwakakodzera nenguva. Chikwata chako chekuvhiya chinotora matanho akawanda kuderedza njodzi uye kuona mhedzisiro yakachengeteka inogoneka yemamiriro ako chaiwo.

Zvinetso zvakajairika zvinogona kuitika zvinosanganisira:

• Kutapukirwa panzvimbo yekuita oparesheni, iyo inowanzoita zvakanaka kumishonga inorwisa mabhakitiriya
• Kubuda ropa kana kuumbwa kwehematoma kunoda kumwe kurapwa
• Kuchinja kwekunzwa kwezamu, izvo zvinogona kuva zvenguva pfupi kana zvachose
• Seroma formation (kuunganidzwa kwemvura) iyo inogona kuda kuburitswa
• Kuvadzwa kunogona kukanganisa chitarisiko chezamu
• Miganhu yakanaka inoda kumwe kuvhiyiwa
• Lymphedema kana ma lymph nodes akabviswa

Zvisingawanzoitika asi zvakakomba zvinosanganisira maitiro akakomba ekurwara neanesthesia, magwamba eropa, kana kubuda ropa kwakanyanya kunoda kurapwa nekukurumidza. Chikwata chako chekuvhiya chinokutarisa zvakanyatso panguva uye mushure mekuvhiya kuti ugadzirise nekukurumidza chero matambudziko.

Vanhu vazhinji vanongonzwa kusagadzikana kudiki uye vanopora zvakakwana mukati mevhiki 4-6. Njodzi yako yematambudziko inoenderana nezvinhu zvakaita sehutano hwako hwese, saizi nenzvimbo yetumor yako, uye kuti unotevedza sei mirairo yekuvhiya.

Ndingatarisira riini chiremba mushure mekuvhiya?

Unofanira kubata chikwata chako chehutano nekukurumidza kana ukaona chero zviratidzo zvinonetsa mushure mekuvhiya. Nepo kusagadzikana uye kuzvimba zvakajairika, zviratidzo zvakati wandei zvinoda kutariswa kwekurapa nekukurumidza.

Chikwata chako chekuvhiya chichagadzirisa nguva dzekutevera nguva dzose kuti chitarise kupora kwako uye kukurukura matanho anotevera muhurongwa hwako hwekurapa. Nguva idzi dzakakosha pakuona kupora kwakakwana uye kuenderera mberi nekuchengetwa kwekenza.

Bata chiremba wako nekukurumidza kana ukaona:

• Zviratidzo zveutachiona zvakaita sefivha, kuwedzera kutsvuka, kudziya, kana pus kubva pakuvhiwa
• Kurwadziwa kwakanyanya kusingavandudzike nemishonga yakarairwa
• Kubuda ropa kwakanyanya kana kuwedzera kamwe kamwe mukudonha
• Zviratidzo zvemagwamba eropa zvakaita sekuzvimba kwegumbo, kurwadziwa muchipfuva, kana kufema
• Kusvotwa kwakanyanya kana kurutsa kunokutadzisa kugara wakanyoroveswa
• Kuzvimba kusingaite muruoko rwako kana ruoko rwakavhiyiwa
• Chero mapundu matsva kana shanduko muzamu rako kana nzvimbo dzakapoteredza

Musangano wako wekutanga wekutevera unowanzoitika mukati mevhiki 1-2 mushure mekuvhiya kuti utarise kufambira mberi kwako uye kubvisa chero sutures kana zvichidikanwa. Misangano yekuwedzera inobatsira kuronga radiation therapy kana mamwe marapirwo anokurudzirwa ne oncologist yako.

Kutarisirwa nguva refu nguva dzose kunosanganisira mammograms, bvunzo dzemazamu ekiriniki, uye kuenderera mberi kwekuongorora kudzoka kwekenza. Chikwata chako chekuchengetedza hutano chichagadzira chirongwa chekutarisa chakagadzirirwa zvinoenderana nemamiriro ako chaiwo uye zvinhu zvine njodzi.

Mibvunzo inowanzo bvunzwa nezve lumpectomy

Q1. Lumpectomy inoshanda zvakanyanya semastectomy yegomarara remuzamu here?

Hongu, lumpectomy inoteverwa ne radiation therapy inoshanda zvakanyanya semastectomy yegomarara remuzamu rematangi ekutanga. Zvidzidzo zvakawanda zvikuru zvakaratidza kuti mitengo yekupona yakaenzana pakati peiyi nzira mbiri kana gomarara racho rabatwa kare.

Musiyano mukuru uri mukukura kwebviswa kwetishu uye kudiwa kwe radiation therapy mushure me lumpectomy. Nepo mastectomy ichibvisa mazamu ese, lumpectomy inochengetedza yakawanda yetishu yako yemazamu ichiita zvakafanana zvinobuda mukudzora gomarara.

Q2. Ndichada radiation therapy mushure me lumpectomy here?

Vanhu vazhinji vane lumpectomy vachada radiation therapy kuderedza njodzi yekuti gomarara ridzoke muzamu. Radiation therapy inowanzo kutanga 4-6 mavhiki mushure mekuvhiyiwa kana kucheka kwako kwapora zvakanaka.

Oncologist wako achasarudza kana radiation therapy ichidikanwa zvichienderana nemaitiro ako chaiwo egomarara, zera, uye hutano hwese. Muzviitiko zvisingawanzoitiki, varwere vakuru vane gomarara diki, rine njodzi shoma vangasada radiation therapy.

Q3. Mazamu angu achataridzika sei mushure me lumpectomy?

Vanhu vazhinji vanofadzwa nekuti mazamu avo anotaridzika sei mushure me lumpectomy, kunyanya kana achienzaniswa nezvimwe zvingasarudzwa zvekuvhiya. Chinangwa ndechekubvisa gomarara uku uchichengetedza chitarisiko chako chemazamu uye chimiro.

Zvimwe zvachinja muchitarisiko chemazamu zvakajairika uye zvinogona kusanganisira chironda chidiki, asymmetry shoma, kana shanduko diki muchimiro chemazamu. Shanduko idzi dzinowanzo kuve dzakapfava uye dzinovandudza nekufamba kwenguva sezvo kupora kuchifambira mberi uye kuzvimba kunoderera.

Q4. Ndingayamwisa mushure mekuva ne lumpectomy here?

Vakadzi vazhinji vanogona kubereka vachiyamwisa zvakabudirira mushure me lumpectomy, kunyangwe kugona kwako kungatsamira panzvimbo uye huwandu hwekuvhiyiwa. Kana machubhu emukaka asina kukanganiswa zvakanyanya, basa rekuyamwisa rinowanzoramba rakakwana.

Kurukurai zvirongwa zvenyu zvekuyamwisa ramangwana nachiremba wako wekuvhiya musati maitwa maitiro acho. Vanogona kuronga nzira yekuvhiya kuti vashoma kukanganisa machubhu emukaka uye kuchengetedza kugona kuyamwisa pazvinogoneka.

Q5. Ndingashanda riini mushure me lumpectomy?

Vanhu vazhinji vanogona kudzokera kubasa mukati mevhiki 1-2 mushure me lumpectomy, zvichienderana nezvinodiwa nebasa ravo uye kufambira mberi kwekupora. Vashandi vemuhofisi vanowanzo dzoka nekukurumidza kupfuura avo mabasa avo anosanganisira kusimudza zvinhu zvinorema kana basa remuviri.

Chiremba wako wekuvhiya achapa gwara rakatarisa nezvekuti unogona kudzokera riini kuzviitwa zvakasiyana zvichibva pakufambira mberi kwako kwekupora uye zvinodiwa nebasa. Teerera muviri wako uye usakurumidze kudzokera kuzviitwa zvakazara usati wagadzirira.