Ukuthi yini i-DCIS? Izimpawu, Izimbangela, Nokwelapha

I-DCIS, noma i-ductal carcinoma in situ, uhlobo lwe-kansa yebhubesi olungenahluphi lapho amaseli angajwayelekile atholakala khona ezindlebeni zobisi kodwa awakaqhambukelanga ezihlangeni zebhubesi eziseduze. Cabanga ngayo njengamaseli ekansa "afakwe" ngaphakathi kwezindlebeni, njengamanzi emphampeni angakaqothuli.

Nakuba igama elithi "carcinoma" lingase lizwakale liyesabekayo, i-DCIS ibhekwa njenge-kansa yebhubesi yesigaba 0 ngoba ayikagxili ezinhlakeni ezizungezile. Odokotela abaningi bayibiza ngokuthi "i-pre-cancer," futhi ngokwelashwa okuqondile, ithemba lihle kakhulu kubantu abaningi.

Ziyini izimpawu ze-DCIS?

Abantu abaningi abane-DCIS abanawo noma yimiphi impawu ebonakalayo. Lokhu kuqondana kuvame ukutholakala ngesikhathi sokuhlolwa okujwayelekile kwe-mammography, hhayi ngoba umuntu uzizwe into engavamile.

Uma izimpawu zivele, zivame ukuba zimbi futhi kulula ukuzigwema. Nazi izibonakaliso ezingase zivele:

• I-lump encane, engahluphi ongayizwa ngesikhathi sokuhlola ngokwakho
• Ukuqothula okungavamile kwe-nipple, okungase kube sobala, oluhlaza okwesundu, noma olune-bloody
• Ukushintsha kokubonakala kwe-nipple, njengokudonsa ngaphakathi noma ukwakheka okungavamile
• Ubuhlungu be-bhubesi noma ubuhlungu endaweni ethile
• Ukushintsha kwesikhumba ebhubesini, njengoku-dimpling noma uku-puckering

Kubalulekile ukukhumbula ukuthi lezi zimpawu zingase futhi zibonise izimo zebhubesi ezingalutho. Okubalulekile ukungathukutheli kodwa ukwenza noma yikuphi ukushintsha kuhlolwe ngumhlinzeki wakho wezempilo ngokushesha.

Yini ebangela i-DCIS?

I-DCIS ithuthukiswa lapho amaseli ezindlebeni zobisi eqala ukukhula ngokungavamile futhi ahlukaniswe ngokungapheli. Nakuba singazi kahle ukuthi yini ebangela le nqubo, abacwaningi baye bathola izinto eziningi ezingase zinikeze.

Imbangela eyinhloko ibonakala iyona ukulimala kwe-DNA ngaphakathi kwamaseli endlebeni zobisi. Lokhu kulimala kungenzeka ngokuhamba kwesikhathi ngenxa yokuguga okujwayelekile, imiphumela ye-hormonal, noma izinto ezingaphandle. Umzimba wakho ngokuvamile ulungisa lolo hlobo lokulimala, kodwa ngezinye izikhathi inqubo yokulungisa ayisebenzi kahle.

Izinto eziningi zingandisa amathuba okuthuthukisa i-DCIS:

• Ubudala - izimo eziningi zenzeka kwabesifazane abangaphezu kweminyaka engama-50
• Umlando womndeni we-kansa yebhubesi noma ye-ovarian
• I-biopsies yebhubesi yangaphambili ebonisa amaseli angavamile
• I-hormone replacement therapy yesikhathi eside
• Ukuqala kwesikhathi sokuqala noma i-menopause elide
• Ukungabi nabantwana noma ukuba nomntwana wakho wokuqala ngemva kweminyaka engama-30
• Ukuguqulwa kwe-genetic ethile, ikakhulukazi i-BRCA1 ne-BRCA2

Ukuba nalezi zinto ezingozi akusho ukuthi uzokuthuthukisa ngokuqinisekile i-DCIS. Abantu abaningi abanazo izinto eziningi ezingozi abazithuthukisi le meko, kanti abanye abangenazo izinto ezingozi ezaziwayo bayenza.

Ziyini izinhlobo ze-DCIS?

I-DCIS ihlelwa ngezinhlobo ezahlukene ngokusekelwe ekutheni amaseli angavamile abonakala kanjani ngaphansi komkhiqizo kanye nokuthi azokhula ngokushesha kangakanani. Ukuqonda uhlobo lwakho oluthile kusiza udokotela wakho ukuhlela indlela yokwelapha engcono kakhulu.

Uhlelo oluyinhloko lokuhlukanisa lubheka izinga lamaseli:

• I-DCIS ephansi - amaseli abonakala efana nawo amaseli ebhubesi ajwayelekile futhi akhula kancane
• I-DCIS ephakathi - amaseli angavamile ngokulinganayo ngesilinganiso sokukhula esiphakathi
• I-DCIS ephakeme - amaseli abonakala ehlukile kakhulu kumaseli ajwayelekile futhi akhula ngokushesha

I-pathologist yakho izophinde ihlole izamukeli ze-hormone (i-estrogen ne-progesterone) kanye ne-protein ebizwa nge-HER2. Le mininingwane ikusiza ukuthola ukuthi ukwelashwa okuthile, njenge-hormone therapy, kungase kube usizo kuwe.

Enye indlela odokotela abachaza ngayo i-DCIS iwumkhuba wokukhula wayo ngaphakathi kwezindlebeni. Ezinye izinhlobo zikhula ngendlela eqinile, kanti ezinye zinezimo ezisasazwe kakhulu, i-cribriform (efana ne-Swiss cheese). Lolu lwazi lusiza ukubikezela ukuthi le meko ingase iziphathe kanjani.

Nini okumele ubona udokotela nge-DCIS?

Kufanele uxhumane nomhlinzeki wakho wezempilo uma uqaphela noma yikuphi ukushintsha okungavamile ebhubesini lakho, ngisho noma kubonakala kuncane. Ukutholwa kwangaphambi kwesikhathi nokuhlolwa kuhlale kungcono kunokulinda nokukhathazeka.

Hlela i-aphoyintimenti phakathi nezinsuku ezimbalwa uma uhlangabezana nalokhu:

• Noma iyiphi i-lump entsha noma ukuqina ebhubesini lakho noma endaweni yebhubesi
• Ukuqothula kwe-nipple okuvela ngaphandle kokucindezela
• Ukushintsha usayizi noma isisindo sebhubesi
• Ukushintsha kwesikhumba njengoku-dimpling, uku-puckering, noma ukubomvu
• Ukushintsha kwe-nipple, kufaka phakathi ukuphenduka noma ukwakheka okungavamile

Uma ungaphezu kweminyaka engama-40 noma unemlando womndeni we-kansa yebhubesi, ungayeki i-mammograms yakho ejwayelekile. Izimo eziningi ze-DCIS zitholakala ngesikhathi sokuhlolwa okujwayelekile ngaphambi kokuba kube khona izimpawu.

Khumbula ukuthi ukushintsha okuningi kwe-bhubesi akuyona i-kansa, kodwa kuhlale kufanele kuhlolwe ngumuntu ochwepheshe ukuze uthole ukuthula kwengqondo nokunakekelwa okuqondile.

Ziyini izinto ezingozi ze-DCIS?

Izinto eziningi zingandisa amathuba akho okuthuthukisa i-DCIS, nakuba ukuba nezinto ezingozi akusho ukuthi uzokuthuthukisa le meko. Ukuqonda lezi zinto ezingozi kungakusiza wenze izinqumo ezinolwazi mayelana nokuhlola nokukhetha indlela yokuphila.

Izinto ezingozi ezibaluleke kakhulu zihlanganisa:

• Ubudala - ingozi iyanda kakhulu ngemva kwe-menopause, ngezimo eziningi ezenzeka kwabesifazane abangaphezu kweminyaka engama-50
• Umlando womndeni - ukuba nohlobo oluseduze olune-kansa yebhubesi noma ye-ovarian kuphinda ingozi yakho kabili
• Izinkinga zebhubesi zangaphambili - umlando we-atypical hyperplasia noma i-lobular carcinoma in situ
• Ukuguqulwa kwe-genetic - i-BRCA1, i-BRCA2, kanye nokuguqulwa kwe-gene elidluliselwe
• I-tissue yebhubesi e-dense - kwenza ukutholwa kube nzima futhi kancane kancane kwandise ingozi
• Ukuvezwa kwe-hormone - izikhathi ezide zokuvuleleka kwe-estrogen ngezikhathi zokuqala, i-menopause elide, noma i-hormone therapy

Ezinye izinto ezingozi ezingavamile abacwaningi abazitholile zihlanganisa ukungalimi, ukukhuluphala ngemva kwe-menopause, kanye nomsebenzi womzimba omncane. Noma kunjalo, lezi zinto zinomthelela omncane kakhulu engonzini yakho iyonke.

Kufanele kuqaphele ukuthi cishe u-75% wabesifazane abaxilongwe nge-DCIS abanazo izinto ezingozi ezaziwayo ngaphandle kobudala nokuthi ngowesifazane. Kungakho ukuhlolwa okujwayelekile kubaluleke kakhulu ekutholeni kwangaphambi kwesikhathi.

Ziyini izinhlupheko ezingase zenzeke nge-DCIS?

Ukukhathazeka okukhulu nge-DCIS ukuthi ingase ithuthuke ibe yi-kansa yebhubesi ehluphekayo uma ingalashwa. Noma kunjalo, lo mkhuba awuqedwa, futhi izimo eziningi ze-DCIS azikaze zibe yizinto ezihluphekayo.

Ucwaningo lubonisa ukuthi ngaphandle kokwelashwa, cishe u-30-50% wezimo ze-DCIS zingase zigcine zibe yi-kansa ehluphekayo eminyakeni eminingi. Amathuba axhomeke ezintweni njengengqondo ye-DCIS yakho kanye nezici zakho zomuntu siqu.

Izinhlupheko ezingase zenzeke zihlanganisa:

• Ukuthuthuka kube yi-kansa ehluphekayo - ukukhathazeka okukhulu okuphefumulela izinqumo zokwelapha
• Ukuphinda kuvela - i-DCIS ingabuya endaweni efanayo noma ithuthukise ezinye izingxenye zebhubesi
• Imiphumela ehlobene nokwelashwa - ukuhlinzwa, i-radiation, noma imiphumela emibi yemithi
• Umphumela ongokwenhliziyo - ukukhathazeka ngokuxilongwa kwe-kansa kanye nezinqumo zokwelapha

Izindaba ezinhle ukuthi ngokwelashwa okuqondile, iningi labantu abane-DCIS liqhubeka nokuphila impilo evamile, enempilo. Izinga lokuphila iminyaka emihlanu le-DCIS cishe liyi-100% uma liqondwa kahle.

Iqembu lakho lezempilo lizoqondana nawe ukuze lilinganise izinzuzo zokwelapha ngokumelene nezingozi nemiphumela emibi, ucabange ngesimo sakho nesifiso sakho.

I-DCIS ixilongwa kanjani?

I-DCIS ngokuvamile ixilongwa ngokuhlanganiswa kokuhlola kwe-imaging kanye nokuqoqwa kwe-tissue. Inqubo ngokuvamile iqala lapho into engavamile ivela ku-mammogram ngesikhathi sokuhlolwa okujwayelekile.

Udokotela wakho uzokuqala ngokuhlola kwe-imaging ukuze uthole isithombe esicacile sokuthi kwenzekani ezinhlakeni zakho zebhubesi. Lokhu kungase kuhlanganise i-mammogram yokuxilonga ngemibono eminingi, i-breast ultrasound, noma ngezinye izikhathi i-breast MRI yokuhlola okuphelele.

Ukutholwa okuqinisekile kudinga i-tissue biopsy, lapho isampula encane ye-tissue yebhubesi isuswa futhi ihlolwe ngaphansi komkhiqizo. Le nqubo ngokuvamile yenziwa nge-needle biopsy, engathinti kakhulu kunokuhlolwa kwe-surgical biopsy futhi ingenziwa endaweni yokwelashwa kwabantu.

Ngesikhathi se-biopsy, udokotela wakho uzosebenzisa isiqondiso se-imaging ukuqinisekisa ukuthi uqoqa indawo efanele. Uzothola i-anesthesia yendawo ukuze unciphise ubuhlungu, futhi le nqubo ngokuvamile ithatha cishe imizuzu engama-30.

Isampula ye-tissue iya ku-pathologist ozokunquma ukuthi amaseli angavamile akhona yini, futhi uma kunjalo, uhlobo luni lwe-DCIS onalo. Lolu lwazi lusiza iqembu lakho lezempilo ukuthuthukisa uhlelo lokwelapha olufanele kakhulu esimweni sakho.

Ukwelashwa kwe-DCIS yini?

Ukwelashwa kwe-DCIS kugqamele ekususeni amaseli angavamile nokunciphisa ingozi yale meko ukuya ekansini ehluphekayo. Uhlelo lwakho lokwelapha luzoxhomeka ezintweni eziningi, kufaka phakathi usayizi nengqondo ye-DCIS yakho, ubudala bakho, kanye nezifiso zakho zomuntu siqu.

Ukuhlinzwa ngokuvamile iyindlela yokuqala yokwelapha, futhi kunezindlela ezimbili eziyinhloko:

• I-Lumpectomy - isusa i-DCIS kanye nomda omncane we-tissue evamile ezungezile, igcina iningi lebhubesi lakho
• I-Mastectomy - isusa ibhubesi lonke, ngokuvamile kunconywa izindawo ezinkulu noma eziningi ze-DCIS

Ngemva kwe-lumpectomy, udokotela wakho angase ancome i-radiation therapy ezinhlakeni zebhubesi ezisele. Lokhu kwelashwa kusiza ukunciphisa ingozi ye-DCIS ebuya ebhubesini elifanayo futhi ngokuvamile kunikezwa izinsuku ezinhlanu ngesonto amasonto amaningana.

Nge-hormone receptor-positive DCIS, udokotela wakho angase ancome i-hormone therapy ngemithi efana ne-tamoxifen. Lokhu kwelashwa kungasiza ukunciphisa ingozi yokuthuthukisa i-kansa entsha yebhubesi kunoma yiliphi ibhubesi.

Abanye abantu abane-DCIS engozi ephansi kakhulu bangase babe abakhethi be-active surveillance esikhundleni sokwelashwa ngokushesha. Le ndlela ihlanganisa ukuqapha ngokucophelela ngokuhlola okujwayelekile kwe-imaging kanye nokuhlola okungokwelapha, ukwelapha kuphela uma kwenzeka ukushintsha.

Indlela yokuphatha i-DCIS ekhaya?

Nakuba ukwelashwa kwezokwelapha kubalulekile nge-DCIS, kunezinto eziningi ongenza zona ekhaya ukuze usekele impilo yakho yonke nokuphulukiswa ngesikhathi nokuphela kokwelashwa.

Gxila ekuqondeni indlela yokuphila enempilo esekela izinqubo zokwelapha zemvelo zomzimba wakho. Lokhu kuhlanganisa ukudla ukudla okuqondile okunama-fruits, imifino, nama-grains aphelele ngenkathi ugcina ukudla okuqediwe nokusetshenziswa okukhulu kwe-alcohol.

Ukuzivocavoca okujwayelekile kungasiza ekuqinisweni kwesistimu yakho yokuziphepha futhi kuqine impilo yakho yonke. Qala ngemisebenzi emnene njengokuhamba noma ukubhukuda, bese uqala ukwanda ngokuqina njengoba uzizwa ukhululekile futhi udokotela wakho avume.

Ukuphatha ukucindezeleka kubalulekile ngokulinganayo ekuphulukiseni kwakho nasempilweni yakho eqhubekayo. Cabanga ngezindlela njengokucamngca, ukuzivocavoca kokuphefumula okujulile, noma i-yoga. Abantu abaningi bathola ukuthi ukujoyina amaqembu wokusekela noma ukukhuluma nabanye abake baba nezimo ezifanayo kungaba usizo kakhulu.

Gcina ulandelela noma yikuphi ukushintsha ebhubesini lakho futhi uhambe kuwo wonke ama-aphoyintimenti okulandelela neqembu lakho lezempilo. Ungangabazi ukuxhumana nodokotela wakho uma uqaphela noma yini engavamile noma unezinkinga ngokuphulukiswa kwakho.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela i-aphoyintimenti yakho kungasiza ukuqinisekisa ukuthi uthola okuningi ngesikhathi sakho nomhlinzeki wakho wezempilo futhi uthola yonke imibuzo yakho iphendulwe ngokuphelele.

Qala ngokubhala zonke izimpawu zakho, kufaka phakathi ukuthi zaqala nini nokuthi zishintshile kanjani ngokuhamba kwesikhathi. Qaphela noma yiziphi izinto ezibukeka zenza izimpawu zibe ngcono noma zibe zimbi, ngisho noma zibonakala zingena-relation nezinkinga zakho zebhubesi.

Hlanganisa uhlu oluphelele lwemithi yakho, kufaka phakathi imithi yokwelapha, imithi yokuthengwa ngaphandle kokubhalwa komtholampilo, amavithamini, kanye nezinhlanganisela. Buye uqoqe ulwazi mayelana nomlando womndeni wakho wezokwelapha, ikakhulukazi noma yimuphi umlando we-kansa yebhubesi, ye-ovarian, noma ezinye i-kansa.

Lungiselela uhlu lwemibuzo ofuna ukuyibuza udokotela wakho. Eminye imibuzo ebalulekile ingase ihlanganise:

• Yiluphi uhlobo nengqondo ye-DCIS enayo?
• Ziyini izinketho zami zokwelapha, futhi yini ongayincoma?
• Ziyini imiphumela emibi engase ibe khona yanoma yiluphi ukwelashwa?
• Ukwelashwa kuzothinta kanjani imisebenzi yami yansuku zonke?
• Yikuphi ukunakekelwa okulandelayo engizokudinga?
• Ingabe kunezinguquko zendlela yokuphila engizidinga ukuzicabangela?

Cabanga ngokuletha umngani othembekile noma ilungu lomndeni ku-aphoyintimenti yakho. Bangakusiza ukuba ukhumbule ulwazi olubalulekile futhi banikeze ukwesekwa ngokomzwelo ngesikhathi esingase sizwakale sengathi ingxoxo enkulu.

Iyini into ebalulekile mayelana ne-DCIS?

I-DCIS iyimo elashwa kakhulu eline-prognosis enhle uma itholakala kwangaphambi kwesikhathi futhi ilawulwa kahle. Nakuba ukuthola ukuxilongwa kwe-kansa kungase kuzwakale kukhulu, khumbula ukuthi i-DCIS ibhekwa njenge-kansa yesigaba 0 ngoba ayikaze isakaze ngaphandle kwezindlebeni zobisi.

Into ebaluleke kakhulu okumele uyiqonde ukuthi unesikhathi sokuthatha izinqumo ezinolwazi mayelana nokwelashwa kwakho. I-DCIS ngokuvamile ikhula kancane, ngakho awudingi ukuphuthuma ezinqumweni zokwelapha. Thatha isikhathi sokuqonda izinketho zakho, thola umbono wesibili uma ufuna, bese ukhetha indlela ezizwa ifanele kuwe.

Ngokwelashwa okuqondile, iningi labantu abane-DCIS liqhubeka nokuphila impilo egcwele, enempilo ngaphandle kwale meko eya ekansini ehluphekayo. Ukunakekelwa okulandelayo okujwayelekile nokuqondisa indlela yokuphila enempilo kungasekele kakhulu impilo yakho yesikhathi eside.

Khumbula ukuthi iqembu lakho lezempilo lilapho ukuze likusize kuzo zonke izinyathelo zale ndlela. Ungangabazi ukubuza imibuzo, ubonise ukukhathazeka kwakho, noma ucele usizo olwengeziwe uma ulikudinga.

Imibuzo evamile ebuzwa mayelana ne-DCIS

Ingabe i-DCIS iyikansa ngempela?

I-DCIS ngokwezobuchwepheshe ihlelwa njenge-kansa yebhubesi yesigaba 0, kodwa odokotela abaningi bakhetha ukuyibiza ngokuthi "i-pre-cancer" ngoba amaseli angavamile awakaqhambukelanga ngaphandle kwezindlebeni zobisi. Nakuba inamandla okuthuthuka ibe yi-kansa ehluphekayo uma ingalashwa, ayiyona into eyingozi ekuphileni kwakho ngesimo sayo samanje futhi ine-prognosis enhle ngokwelashwa.

Ingabe ngizodinga i-chemotherapy nge-DCIS?

I-Chemotherapy ngokuvamile ayinconywa nge-DCIS ngoba amaseli angavamile awakaqhambukelanga ngaphandle kwezindlebeni. Ukwelashwa ngokuvamile kuhlanganisa ukuhlinzwa futhi mhlawumbe i-radiation therapy noma i-hormone therapy. Uhlelo lwakho oluthile lokwelapha luzoxhomeka ezintweni ze-DCIS yakho kanye nezimo zakho zomuntu siqu.

Ingabe i-DCIS ingabuya ngemva kokwelashwa?

Kukhona ithuba elincane lokuthi i-DCIS ingabuya, noma njenge-DCIS futhi noma njenge-kansa yebhubesi ehluphekayo. Ingozi ngokuvamile iphansi, ikakhulukazi ngokwelashwa okuphelele kufaka phakathi ukuhlinzwa ne-radiation uma kunconywa. Ukunakekelwa okulandelayo okujwayelekile nge-mammograms kanye nokuhlola okungokwelapha kusiza ekutholeni noma yikuphi ukushintsha kwangaphambi kwesikhathi.

Ukwelashwa kwe-DCIS kuthatha isikhathi esingakanani?

Isikhathi sokuqeda sihluka kuye ngohlelo lwakho lokwelapha. Ukuhlinzwa ngokuvamile kudinga amasonto ambalwa ukuze kuphulukiswe, kanti i-radiation therapy, uma kunconywa, ngokuvamile ihlanganisa ukwelashwa kwansuku zonke amasonto angu-3-6. I-hormone therapy, uma ilotshwe, ngokuvamile ithathiwe iminyaka emi-5. Udokotela wakho uzokunikeza isikhathi esithile esisekelwe kuhlelo lwakho lokwelapha.

Ingabe kufanele ngithole ukuhlolwa kwe-genetic nge-DCIS?

Ukuhlolwa kwe-genetic kungase kunconywe uma unemlando womndeni onamandla we-kansa yebhubesi noma ye-ovarian, uxilongwe eneminyaka emincane, noma unezinye izinto ezingozi eziphakamisa izifo ze-hereditary cancer. Udokotela wakho noma umxhumanisi we-genetic angakusiza ukuthola ukuthi ukuhlolwa kungaba usizo yini esimweni sakho.