Iyini i-Invasive Lobular Carcinoma? Izimpawu, Izimbangela, & Ukwelashwa

I-Invasive lobular carcinoma (ILC) uhlobo lwesibili oluvamile kakhulu lomdlavuza webele, olukwakha amaphesenti angu-10-15 wabo bonke ubuhlungu bomdlavuza webele. Ngokungafani nezinye izinhlobo zomdlavuza webele ezakha ama-lumps acacile, i-ILC ikhula ngendlela yeqhwa elilodwa ngendwangu yebhubu, okwenza kube nzima ukuyithola ekuhlolweni komzimba nakwivivinyo zokufanekisa.

Lolu hlobo lomdlavuza luqala ezindlebeni zokukhiqiza ubisi (ama-lobules) ebeleni lakho bese lusakazeka endwangu yebhubu eseduze. Nakuba igama elithi "invasive" lingase lizwakale liyesabekayo, lisho nje ukuthi amangqamuzana omdlavuza ahambile lapho aqale khona. Abantu abaningi abane-ILC bayaphendula kahle ekwelapheni, ikakhulukazi uma kubanjwe ngokushesha.

Ziyini izimpawu ze-invasive lobular carcinoma?

I-ILC ngokuvamile ayenzi i-lump eqinile evamile abantu abaningi abayihlobisa nomdlavuza webele. Kunalokho, ithambekele ekukhuleni ngendlela engayenza izwakale njengokuqina noma ukugcwalisa endwangu yebhubu lakho.

Nazi izibonakaliso ongaziqaphela, ukhumbula ukuthi i-ILC yokuqala ingase ingabangeli zimpawu nhlobo:

• Ukuqina noma ukuqina okuncane engxenyeni yebhubu lakho kunokuba yi-lump ehlukile
• Ukushintsha kokubukeka noma ukuzwa kwendwangu yebhubu lakho
• Ukukhula noma ukwanda kwebhubu ngakolunye uhlangothi
• Ukubhoboka noma ukubhoboka kwesikhumba okubukeka njengobaqhekeza lawo-orenji
• Ukukhishwa kwebele akuyona ubisi
• I-nipple eguqula ngaphakathi lapho ingazange ikwenze ngaphambili
• Ukushintsha kokubukeka noma usayizi webele
• Ubuhlungu noma ubuhlungu obuqhubekayo bebele endaweni ethile

Ngenxa yokuthi i-ILC ingase ibe buthakathaka, izimo eziningi zitholakala ngesikhathi se-mammograms ejwayelekile ngaphambi kokuba kube khona izimpawu. Lokhu empeleni kuyizindaba ezinhle ngoba kusho ukuthi umdlavuza ngokuvamile ubanjwa esigabeni sokuqala, esilula ukwelashwa.

Ziyini izinhlobo ze-invasive lobular carcinoma?

Iningi le-invasive lobular carcinomas liwela ohlotsheni oluvamile, kepha kunezinguquko ezimbalwa ezingavamile odokotela bakho bangazibona. Ukuqonda lezi zinhlobo kusiza ukuqondisa uhlelo lwakho lokwelapha.

Uhlobo oluvamile luqukethe cishe amaphesenti angu-80 wazo zonke izimo ze-ILC. Lamangqamuzana omdlavuza akhula ngendlela evamile yeqhwa elilodwa futhi athambekele ekubeni yi-hormone receptor-positive, okusho ukuthi aphendula kahle ekwelapheni kwe-hormone.

Izinhlobo ezingavamile zihlanganisa i-pleomorphic lobular carcinoma, ethambekele ekubeni inamandla futhi ingase ingaphenduli ekwelapheni kwe-hormone. Kukhona futhi i-solid lobular carcinoma ne-alveolar lobular carcinoma, kepha lezi zimbalwa kakhulu. I-pathologist yakho izobona ukuthi yiluphi uhlobo olukhona ngokuhlola amasampula e-tissue ngaphansi komkhiqizo.

Yini ebangela i-invasive lobular carcinoma?

Njengomdlavuza webele, i-ILC ikhula lapho amangqamuzana ebele ajwayelekile enza ukushintsha kwi-DNA yawo okubangela ukukhula nokwahlukaniswa okungenakulawuleka. Noma kunjalo, asiqondi ngokugcwele ukuthi kungani lezi zinguquko ezithile zenzeka kumangqamuzana e-lobular.

Izici eziningi zingase zifake isandla ekukhuleni kwe-ILC, yize ukuba nalezi zici akusho ukuthi uzokhula umdlavuza ngokuqinisekile:

• Ubudala - izimo eziningi zenzeka kwabesifazane abangaphezu kweminyaka engu-50
• Umlando womndeni womdlavuza webele noma womdlavuza we-ovarian
• Ukushintsha kwe-gene okuzuzwe njenge-BRCA1 noma i-BRCA2
• Umlando siqu womdlavuza webele noma izimo ezithile zebele ezinhle
• Ukusetshenziswa kwe-hormone replacement therapy isikhathi eside
• Indwangu yebhubu eqinile
• Ukukhishwa kweradieysheni endaweni yesifuba
• Izici zokuphila njengokusetshenziswa kotshwala nokuntuleka kokuzivocavoca

Kubalulekile ukukhumbula ukuthi abantu abaningi abanezi zici zingozi abakhulumi umdlavuza webele, kanti abanye abangenazo izici zingozi ezaziwayo bayenza. Ukukhula komdlavuza kuyinkimbinkimbi futhi ngokuvamile kuhilela izici eziningi ezisebenza ndawonye isikhathi eside.

Nini kufanele ubone udokotela nge-invasive lobular carcinoma?

Kufanele uxhumane nodokotela wakho uma uqaphela noma yikuphi ukushintsha okuqhubekayo ebeleni lakho, ngisho noma kubukeka kuncane. Njengoba i-ILC ingase ibe buthakathaka, kungcono ukuba noma yikuphi ukukhathazeka kuhlolwe kunokulinda ukubona uma kuyahamba.

Hlela i-aphoyintimenti ngokushesha uma uhlangabezana nanoma yikuphi ukushintsha kwebhubu okuqhubeka isikhathi eside kunesikhathi esisodwa sokuya esikhathini. Lokhu kuhlanganisa izindawo ezintsha zokuqina, ukushintsha kokubukeka noma usayizi webele, ukushintsha kwesikhumba, noma ukukhishwa kwebele. Ngisho noma usanda kuba ne-mammogram evamile, izimpawu ezintsha kufanele zihlolwe.

Uma unomlando womndeni womdlavuza webele noma we-ovarian, cabanga ukuxoxa nge-genetic counseling nodokotela wakho. Bangakusiza ukuqonda ingozi yakho nokunquma ukuthi ukuhlolwa kwe-genetic kungase kufanelekele yini kuwe.

Ziyini izici zingozi ze-invasive lobular carcinoma?

Ukuqonda izici zakho zingozi kungakusiza wena nodokotela wakho ukwenza izinqumo ezinolwazi mayelana nezindlela zokuhlola nokuvimbela. Ezinye izici zingozi ongaziqondisa, kanti ezinye awukwazi.

Izici ongenakuzishintsha zihlanganisa ubudala bakho, umlando womndeni, nokwenziwa kwe-genetic. I-ILC ivame kakhulu kwabesifazane abangaphezu kweminyaka engu-50, futhi ukuba nezihlobo eziseduze ezinomdlavuza webele noma we-ovarian kukwandisa ingozi yakho. Ukushintsha kwe-gene okuzuzwe, ikakhulukazi i-BRCA2, kungase kukhulise kancane ingozi ye-ILC uma kuqhathaniswa nezinye izinhlobo zomdlavuza webele.

Izici ezingase zibe ngaphansi kokulawulwa kwakho zihlanganisa ukugcina isisindo esinempilo, ukulinganisela ukusetshenziswa kotshwala, ukuhlala usebenza ngokomzimba, nokuxoxa ngezingozi nezinzuzo ze-hormone replacement therapy nodokotela wakho. Nakuba lezi zinguquko zokuphila zingasiza ekuqedeni ingozi, azinaqinisekisi ukuvimbela.

Ziyini izinhlanganisela ezingase zenzeke ze-invasive lobular carcinoma?

Uma kutholakala ngokushesha futhi kuphathwe ngokufanele, abantu abaningi abane-ILC banemiphumela emihle. Noma kunjalo, njenganoma yiluphi uhlobo lomdlavuza, kunezinkinga ezingase zenzeke okufanele uzazi ukuze ukwazi ukusebenza neqembu lakho lokukhathalela impilo ukuze uqaphele futhi uqaphele.

Ukukhathazeka okukhulu nanoma yiluphi uhlobo lomdlavuza webele oluhlala luyi-possibility yokusakazeka kuma-lymph nodes aseduze noma kwezinye izingxenye zomzimba. I-ILC inenkambo encane enkulu kunamanye ama-cancers ebele ukuba khona ebeleni zombili, noma ngesikhathi esifanayo noma eminyakeni eminingi kamuva. Kungakho udokotela wakho angase akukhuthaze ukulandelela njalo amabele womabili.

Izinhlanganisela ezihlobene nokwelashwa zingase zihlanganise imiphumela emibi yokucutshungulwa, njengokushintsha kokuzwa kwebhubu noma ukunyakaza kwesandla ngemuva kokususa i-lymph node. I-chemotherapy ne-radiation therapy, uma kudingeka, zingase zibangele imiphumela emibi yesikhashana njengokukhathala, ukugula, noma ukushintsha kwesikhumba. I-hormone therapy yesikhathi eside, nakuba isebenza kakhulu, ingase ikhulise ingozi ye-blood clots noma ukulahleka kwamathambo kwabanye abantu.

Izinhlanganisela ezingavamile zingase zihlanganise ukukhula kolunye uhlobo lomdlavuza kamuva ekuphileni, yize le ngozi ngokuvamile incane. Iqembu lakho lokukhathalela impilo lizokuxoxela ngesimo sakho esithile futhi likusize ukuqonda ukuthi yiziphi izinhlanganisela ezifanele kakhulu icala lakho.

I-invasive lobular carcinoma ingavimbeka kanjani?

Nakuba kungekho ndlela eqinisekisiwe yokuvimbela i-ILC, ungathatha izinyathelo zokunciphisa ingozi yakho yonke yomdlavuza webele nokuthola noma yiziphi izinkinga ngokushesha lapho zilula ukwelashwa.

Ukushintsha kokuphila okungasiza kuhlanganisa ukugcina isisindo esinempilo, ukuzivocavoca njalo, ukulinganisela ukusetshenziswa kotshwala, nokugwema i-hormone therapy engafaneleki. Uma ucabanga nge-hormone replacement therapy ngezimpawu ze-menopause, xoxa ngezingozi nezinzuzo ngokugcwele nodokotela wakho.

Ukuhlola okujwayelekile yindlela yakho engcono kakhulu yokulwa ne-ILC. Landela imiyalelo ye-mammography yeqembu lakho lobudala, futhi ungawashiyi ama-aphoyintimenti. Uma unendwangu yebhubu eqinile noma ezinye izici zingozi, udokotela wakho angase akukhuthaze ukuhlolwa kwezithombe ezengeziwe njenge-breast MRI noma i-ultrasound.

Kwabantu abasezingozini eziphezulu ngenxa yomlando womndeni noma izici ze-genetic, izinyathelo zokuvimbela zingase zihlanganise ukuhlolwa okuvamile, i-genetic counseling, noma ezimweni ezingavamile, ukuhlinzwa kokuvimbela. Lezi zinqumo ziyimfihlo kakhulu futhi kufanele zenziwe ngokufaka isandla kubachwepheshe abaqonda isimo sakho esiyingqayizivele.

I-invasive lobular carcinoma ihlonishwa kanjani?

Ukuhlonishwa kwe-ILC ngokuvamile kudinga izinyathelo eziningi ngoba lolu hlobo lomdlavuza lungase lube nzima ukubonakala ekuhlolweni kwezithombe okujwayelekile. Udokotela wakho cishe uzoqala ngokuhlola komzimba futhi ahlole izimpawu zakho nomlando wakho wezokwelapha.

Ukuhlolwa kwezithombe ngokuvamile kuhlanganisa i-mammogram, yize i-ILC ingase ingabonakali kahle kuleli viyivo. Udokotela wakho angase futhi a-ode i-breast ultrasound noma i-MRI, engase ibe yiphumelela kakhulu ekutholeni ama-cancers e-lobular. I-MRI isebenza kakhulu kwi-ILC ngoba ingabonisa ubukhulu bomdlavuza nokuhlola umdlavuza ebeleni elihlukile.

Ukuhlonishwa okuqinisekile kudinga i-tissue biopsy, lapho isampula encane yendwangu engathandeki isuswa futhi ihlolwe ngaphansi komkhiqizo. Lokhu kungenziwa nge-core needle biopsy, evame ukwenziwa ehhovisi lodokotela nge-anesthesia yendawo. I-pathologist izobona ukuthi umdlavuza ukhona yini, kanye nezici ezibalulekile njengesimo se-hormone receptor nesivinini sokukhula.

Ukuhlolwa okuqhubekayo kungase kuhlanganise umsebenzi wegazi ukuhlola impilo yakho yonke nokuhlolwa kwezithombe ukubona ukuthi umdlavuza usakazeke yini kwezinye izingxenye zomzimba wakho. Iqembu lakho lokukhathalela impilo lizokuchazela ngakunye ukuhlolwa nokuthi imiphumela isho ukuthini ohlelweni lwakho lokwelapha.

Ukuphathwa kwe-invasive lobular carcinoma kunjani?

Ukuphathwa kwe-ILC ekhaya kuhilela ukunakekela impilo yakho yomzimba nengqondo ngenkathi ulandela uhlelo lwakho lokwelapha. Izinyathelo ezincane, eziqhubekayo zingenza umehluko omkhulu endleleni ozizwa ngayo ngesikhathi sokwelashwa nokubuyiselwa.

Gxila ekudleni ukudla okunomsoco okukunika amandla futhi kusize umzimba wakho ukuba uphilisiwe. Lokhu akusho ukulandela ukudla okunqunyiwe, kodwa kunokuba ukukhetha izithelo eziningi, imifino, amaprotheni ahlanzekile, nama-grains aphelele uma kungenzeka. Hlala uthambile futhi ungakhathazeki uma ukudla kwakho kuguquka ngesikhathi sokwelashwa - lokhu kuyinto evamile.

Ukuzivocavoca okuthambile, njengoba kuvunywe udokotela wakho, kungasiza ekuqedeni ukukhathala nokwenza isimo sakho sengqondo sibe ngcono. Lokhu kungase kube lula njengokuhamba imizuzu embalwa noma ukwenza ukwelula okuthambile. Phumula uma kudingeka, futhi ungazizwa unecala ngokuthatha isikhathi sokuphulukana.

Ukuphathwa kwemiphumela emibi kubalulekile ngenxa yokududuzeka kwakho nokuphumelela kokwelashwa. Gcina umbhalo wanoma yiziphi izimpawu futhi uxhumane njalo neqembu lakho lokukhathalela impilo. Bangakunikeza imithi noma amasu okusiza ngezinkinga njengokugula, ukukhathala, noma ubuhlungu. Unganqikazi ukuxhumana phakathi kwama-aphoyintimenti uma unemikhathazo.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela i-aphoyintimenti yakho kungakusiza ukwenza kakhulu isikhathi sakho neqembu lakho lokukhathalela impilo futhi kuqinisekise ukuthi uthola lonke ulwazi olukudingayo. Qala ngokubhala phansi imibuzo yakho ngaphambi kokufika.

Letha uhlu lwayo yonke imithi oyithathayo, kuhlanganise nemithi yokuthengwa ngaphandle komthetho kanye nezinhlanganisela. Buye uqoqe noma yimaphi amarekhodi ezokwelapha afanele, ikakhulukazi ama-mammograms angaphambili noma izifundo zokufanekisa ibele. Uma kungenzeka, letha umngani othembekile noma ilungu lomndeni ukuze likusize ukukhumbula ulwazi oluqakathekile oluxoxwe ngesikhathi sokuvakasha.

Cabanga ngezimpawu zakho nokuthi zaqala nini. Lungela ukuchaza noma yikuphi ukushintsha oqaphele ebeleni lakho, ngisho noma kubukeka kuncane. Udokotela wakho uzofuna futhi ukwazi ngomlando womndeni wakho womdlavuza nanoma yiziphi izinkinga zebele okade unazo.

Bhala phansi imibuzo yakho ebaluleke kakhulu kuqala, uma isikhathi singanele. Ungesabi ukucela incazelo uma ungaqondi lutho - iqembu lakho lokukhathalela impilo lifuna ukuqinisekisa ukuthi ulwazi oluphelele ngesimo sakho nezinketho zokwelapha.

Yini eyinhloko mayelana ne-invasive lobular carcinoma?

Into ebaluleke kakhulu okumele uyiqonde nge-ILC ukuthi iyilona uhlobo lomdlavuza webele oluphulukiswayo, ikakhulukazi uma kubanjwe ngokushesha. Nakuba kungase kube nzima ukuyithola kunamanye ama-cancers ebele, ukuthuthuka ekufanekiseni nasekwelapheni kuye kwathuthukisa kakhulu imiphumela kwabantu abanesimo.

Ukutholakala ngokushesha ngokuhlola okujwayelekile nokukhathalela ukushintsha kwebhubu kusala yindlela yakho engcono kakhulu yokuba nemiphumela emihle. Ungavumeli ukuba buthakathaka kwezimpawu ze-ILC kukwenze ulibale ukufuna ukunakekelwa kwezokwelapha uma uqaphela noma yikuphi ukushintsha ebeleni lakho.

Khumbula ukuthi ukuba ne-ILC akuchazi, futhi ngokwelashwa okufanele nokusekelwa, abantu abaningi baqhubeka bephila impilo egcwele, enempilo. Iqembu lakho lokukhathalela impilo lilapho ukukukhokhela kuzo zonke izinyathelo zenqubo, futhi kunezinto eziningi ezitholakalayo zokusiza wena nabathandekayo bakho ukuhamba kule ndlela.

Imibuzo evamile ebuzwayo mayelana ne-invasive lobular carcinoma

Q1: Ingabe i-invasive lobular carcinoma inamandla kakhulu kunamanye ama-cancers ebele?

I-ILC ngokuvamile ayinamandla kakhulu kunohlobo oluvamile lomdlavuza webele (i-invasive ductal carcinoma). Eqinisweni, i-ILC ngokuvamile ikhula kancane futhi ngokuvamile yi-hormone receptor-positive, okusho ukuthi iphendula kahle ekwelapheni kwe-hormone. Noma kunjalo, kungase kube nzima ukuyithola futhi ingase ibe nethuba elikhulu lokuba khona ebeleni zombili ngokuhamba kwesikhathi.

Q2: Kungani i-mammogram yami ingabonisi i-invasive lobular carcinoma?

I-ILC ikhula ngendlela yeqhwa elilodwa ngendwangu yebhubu kunokuba yenze i-mass ehlukile, okwenza kube nzima ukuyibona kuma-mammograms. Kungakho udokotela wakho angase akukhuthaze ukuhlolwa kwezithombe ezengeziwe njenge-ultrasound noma i-MRI, ikakhulukazi uma unezimpawu noma izici zingozi. I-MRI isebenza kakhulu ekutholeni i-ILC nokubona ubukhulu bayo.

Q3: Ingabe ngizodinga i-mastectomy uma ngine-invasive lobular carcinoma?

Akuyona njalo. Abantu abaningi abane-ILC bangaba nokuhlinzwa kokulondoloza ibele (i-lumpectomy) okulandelelwa yi-radiation therapy. Ukukhetha phakathi kwe-lumpectomy ne-mastectomy kuncike ezintweni njengobusayizi nendawo yomdlavuza wakho, ukuthi usezindaweni eziningi yini, kanye nezifiso zakho siqu. Udokotela wakho wezokwelapha uzoxoxa ngezinketho ezinhle kakhulu zesimo sakho esithile.

Q4: Ingabe ukuba ne-invasive lobular carcinoma kukhuphula ingozi yomdlavuza ebeleni elinye?

Yebo, i-ILC inenkambo encane enkulu yokukhula komdlavuza ebeleni elihlukile uma kuqhathaniswa nezinye izinhlobo zomdlavuza webele. Kungakho udokotela wakho cishe azokukhuthaza ukulandelela njalo amabele womabili ngokuhlolwa kwezithombe. Abanye abantu bakhetha ukuhlinzwa kokuvimbela ebeleni elingathintekile, kodwa lokhu kuyisinqumo somuntu siqu okufanele senziwe ngokucabangela ngokucophelela nokuqondiswa kwabachwepheshe.

Q5: Ngingakuthatha isikhathi esingakanani ukwelashwa kwe-hormone nge-invasive lobular carcinoma?

Abantu abaningi abane-hormone receptor-positive ILC bathatha i-hormone therapy iminyaka engu-5-10 ngemuva kokwelashwa kwabo kokuqala. Isikhathi esiqondile kuncike ezintweni zakho siqu zingozi nokuthi uyithwala kangcono kanjani imithi. Udokotela wakho we-oncologist uzosebenza nawe ukuze unqume ubude obuhle bokwelashwa, uqondanise izinzuzo zokwelashwa okuqhubekayo nanoma yimiphi imiphumela emibi ongayithola.