Ukuthi yini i-Lobular Carcinoma in Situ? Izimpawu, Izimbangela, kanye Nokwelashwa

I-Lobular carcinoma in situ (LCIS) akuyona i-kansa, noma ngabe igama layo lithi kanjani. Kuyisimo lapho amaseli angajwayelekile ekhula khona ngaphakathi kwezinsimbi zokukhiqiza ubisi (ama-lobules) ebele lakho, kodwa la maseli awakahlanganisi ezinye izicubu eziseduze.

Cabanga nge-LCIS njengophawu olusikhombisa ukuthi izicubu zebele lakho zinethuba elikhulu lokuthuthukisa i-kansa kamuva. Abesifazane abaningi abane-LCIS abathuthuki i-kansa yebhubu, kodwa ukuqonda lesi simo kuzokusiza wena nodokotela wakho ukuba nizenze izinqumo ezifanele mayelana nokulandelela impilo yakho.

Ukuthi yini i-Lobular Carcinoma in Situ?

I-LCIS yisimo esinobukhulu lapho amaseli angajwayelekile ehlangana khona ema-lobules ebele lakho. La ma-lobules yiingxande ezincane, ezizungezile ezikhiqiza ubisi ngesikhathi sokuncelisa.

Igama elithi "carcinoma" egazini lingadida futhi lesabe, kodwa i-LCIS ayikho i-kansa ehlukanisayo. Amaseli angajwayelekile ahlala evaliwe ngaphakathi kwama-lobules futhi awaphuluki ukuze ahlasele izicubu zebele ezizungezile.

Ochwepheshe bezokwelapha manje bakhetha ukubiza lokhu ngokuthi "i-lobular neoplasia" ngoba leli gama libonisa kangcono ukuthi luphawu lokukhula komngcipheko kunokuba yi-kansa yangempela. Ukuba ne-LCIS kusho ukuthi unethuba eliphakathi kuka-1-2% ngonyaka lokukhula kwe-kansa ehlukanisayo, uma kuqhathaniswa nethuba lika-0.1-0.2% ngonyaka labantu abavamile.

Ziyini izimpawu ze-Lobular Carcinoma in Situ?

I-LCIS ngokuvamile ayibangeli zimpawu ongazibona noma uzizwe. Abesifazane abaningi bathola ukuthi bane-LCIS kuphela ngemuva kokuhlolwa kwebele okwenziwe ngenye injongo.

Awusoze wabona ibhala, ubuhlungu bebele, ukukhishwa kwesifuba, noma ukushintsha kwesikhumba nge-LCIS. Lokhu kungenxa yokuthi amaseli angajwayelekile ahlala encane futhi evaliwe ngaphakathi kwama-lobules.

Njengoba i-LCIS ingabangeli zimpawu ezibonakalayo, ngokuvamile itholakala ngengozi lapho odokotela behlola izicubu zebele ngaphansi komkhiqizo ngemuva kokuhlolwa kwe-biopsy ye-calcifications noma ukushintsha kwebele okubonwayo kuma-mammograms.

Yini ebangela i-Lobular Carcinoma in Situ?

Imbangela eqondile ye-LCIS ayiqondakali ngokuphelele, kodwa kubonakala sengathi ithuthuka lapho amaseli ema-lobules ebele lakho eqala ukukhula ngokungajwayelekile. Lokhu kwenzeka ezingeni le-genetic ngaphakathi kwamaseli.

Izici eziningi zingase zifake isandla ekukhuleni kwe-LCIS:

• Ithonya lama-hormone, ikakhulukazi ukukhishwa kwe-estrogen ngokuhamba kwesikhathi
• Ukukhethwa kwe-genetic, yize ama-gene athile angakaqondakali
• Ukushintsha kwamaseli okuhlobene nobudala okwenzeka ngokwemvelo
• Umbhalo wokuzala, kufaka phakathi lapho uqale khona ukuqala ukuba nesikhathi sakho nokuqala kwe-menopause

Kubalulekile ukuqonda ukuthi i-LCIS ayibangelwa yilutho olukwenzile noma awukwenzanga. Ukushintsha kwamaseli kwenzeka ngokungalindelekile futhi akuhlobene nezindlela zokuphila njengokudla, ukuzivocavoca, noma amazinga engcindezi.

Nini okufanele ubona udokotela nge-Lobular Carcinoma in Situ?

Uma usuqondiswe yi-LCIS, kufanele uqale ukunakekelwa okuqhubekayo nodokotela webele noma i-oncologist. Lokhu akuyona ngoba une-kansa, kodwa ngoba udinga ukulandelela okukhethekile.

Hlela ukuvakashela okuqhubekayo njengoba kunconywe udokotela wakho, ngokuvamile izinyanga ezingu-6-12 ekuqaleni. Lezi zivivinyo zisiza ekuqapheleni noma yikuphi ukushintsha ezicubeni zebele lakho futhi kuqinisekisa ukuthi ulandela uhlelo olufanele lokuqapha.

Xhumana nodokotela wakho uma ubona noma yikuphi ukushintsha okusha ebeleni lakho phakathi kokuhlangana okulungisiwe, njengezibala, ukushintsha kwesikhumba, noma ukukhishwa kwesifuba. Nakuba lezi zimpawu ngokuvamile zingahlobene ne-LCIS, zidinga ukuhlolwa ngenxa yesimo sakho esikhulu somngcipheko.

Ziyini izici zomngcipheko we-Lobular Carcinoma in Situ?

Ukuqonda izici zakho zomngcipheko kuzokusiza uqonde i-LCIS futhi kuqondise izinqumo zakho zezempilo. Lezi zici zingandisa amathuba akho okukhula kwe-LCIS:

• Ubudala, ngokuxilonga okuningi kwenzeka kubesifazane abaneminyaka engama-40-50
• Ukusetshenziswa kwe-hormone replacement therapy, ikakhulukazi i-estrogen ne-progesterone ehlanganisiwe
• Ukuba awukaze ukhule noma ukukhulela kwakho kokuqala kwakungemuva kweminyaka engama-30
• Ukuqala ukuba nesikhathi sakho ngaphambi kweminyaka engu-12 noma i-menopause ngemuva kweminyaka engama-55
• Umbhalo womndeni we-kansa yebhubu noma i-ovarian
• I-biopsies yebele yangaphambili ebonisa ukushintsha okukhulu komngcipheko

Ukuba nalezi zici zomngcipheko akusho ukuthi uzokhula ngokuqinisekile i-LCIS noma i-kansa yebhubu. Abesifazane abaningi abanezici eziningi zomngcipheko abakhulumi noma yikuphi okuqukethwe, kuyilapho abanye abesifazane abanezici ezimbalwa zomngcipheko bekhula.

Ziyini izinhlanganisela ezingaba khona ze-Lobular Carcinoma in Situ?

Ukukhathazeka okukhulu nge-LCIS ukuxhumana kwayo nokukhula komngcipheko we-kansa yebhubu. Abesifazane abane-LCIS banethuba eliphakathi kuka-20-25% lokukhula kwe-kansa ehlukanisayo, uma kuqhathaniswa no-12-13% lwabantu abavamile.

Lo mngcipheko owandiswe uthinta amabele womabili, hhayi nje lowo lapho i-LCIS itholakele khona. I-kansa ekhula ngokuvamile yi-invasive ductal carcinoma kunokuba yi-invasive lobular carcinoma, futhi ingaba kuphi lapho ebeleni.

Umphumela wokuzwa ngokwengqondo wokuxilongwa kwe-LCIS naye ungaba mkhulu. Abesifazane abaningi baye baba nokukhathazeka ngomngcipheko wabo we-kansa, okungathinta ikhwalithi yokuphila nokwenza izinqumo mayelana nezinyathelo zokuvimbela.

Ngokungavamile, i-LCIS ingahlotshaniswa nezinye izimo zebele ezingumngcipheko ophezulu, njenge-atypical ductal hyperplasia, engase ikhulise umngcipheko we-kansa. I-pathologist yakho izohlola i-biopsy yakho ngalezi zitholakala ezengeziwe.

I-Lobular Carcinoma in Situ ixilongwa kanjani?

I-LCIS ixilongwa nge-biopsy yebele, ngokuvamile yenziwa ngenxa yokuqaphela okungathandeki kuma-mammogram noma i-breast MRI. Isampula yesicubu ihlolwa ngaphansi komkhiqizo yi-pathologist.

Inqubo yokuxilonga ngokuvamile iqala lapho isithombe sibonisa i-calcifications, indawo yokuguqulwa, noma ukushintsha okudingayo ukuhlolwa. Udokotela wakho uzokuncoma i-core needle biopsy ukuthola izampula zezicubu.

Uma i-LCIS isiqondiwe, i-pathologist yakho izohlola isicubu ngezici ezengeziwe ezingumngcipheko ophezulu noma i-kansa ehambisanayo. Ngezinye izikhathi, i-biopsy yokuhlinzwa ingase ibe yilona isikhuthazo uma isampula yokuqala ibonisa i-LCIS kanye nezinye izici ezinkulu.

Umbiko wakho we-pathology uzochaza uhlobo nobukhulu be-LCIS, ukusiza udokotela wakho ukuba anqume uhlelo olufanele lokuqhubeka. Lolu lwazi luqondise izinqumo mayelana nokuqapha njalo nezinyathelo zokuvimbela ezingaba khona.

Ukwelashwa kwe-Lobular Carcinoma in Situ kuyini?

I-LCIS ngokwayo ayidingi ukwelashwa ngoba ayikho i-kansa. Esikhundleni salokho, ukunakekelwa kwakho kugxile ekuqapheleni nasekwehliseni umngcipheko wakho we-kansa yesikhathi esizayo.

Udokotela wakho uzokuncoma ukuqapha okwandisiwe, okuhlanganisa ngokuvamile ukuhlolwa kwebele njalo izinyanga ezingu-6-12 nama-mammograms minyaka yonke. Abesifazane abanye bangase bazuze ekuhlolweni kwe-breast MRI minyaka yonke ngaphezu kwe-mammography.

Imithi yokunciphisa umngcipheko ebizwa ngokuthi yi-selective estrogen receptor modulators (SERMs) ingase inikwe. Le mithi, njenge-tamoxifen noma i-raloxifene, inganciphisa umngcipheko we-kansa yebhubu ngamaphesenti angu-50 kodwa inezingozi nezinzuzo zayo okufanele uzixoxe nodokotela wakho.

Kubabesifazane abanesongo esikhulu, i-mastectomy yokuvimbela ingase icatshangelwe, yize lokhu kuyisinqumo esikhulu esidinga ukwelulekwa ngokucophelela. Abesifazane abaningi abane-LCIS bakhetha ukuqapha okwandisiwe kunokuvimbela kokuhinzwa.

Indlela yokuphatha i-Lobular Carcinoma in Situ ekhaya?

Gxilisa ekuqapheleni impilo yebele ngokujwayelekile ngokuzwa kwakho siqu kanye nokukhetha impilo enempilo. Nakuba ungakwazi ukushintsha ukuxilongwa kwe-LCIS, ungathuthukisa impilo yakho jikelele.

Hlala uqaphele ukuthi amabele akho abukeka futhi azizwa kanjani, ubhale noma yikuphi ukushintsha kudolotela wakho ngokushesha. Lokhu akuyona ngokwenza ukuhlolwa kwakho siqu, kodwa kunokuba uqaphele umzimba wakho.

Cabanga ngokushintsha kwesitayela sokuphila okungase kusekele impilo yebele, njengokugcina isisindo esinempilo, ukulinganisela ukusetshenziswa kotshwala, ukuhlala usebenza ngokomzimba, nokudla ukudla okuhlanzekile okugcwele izithelo nemifino.

Phatha ukucindezeleka nokukhathazeka ngokuxilongwa kwakho ngamaqembu wokusekela, ukwelulekwa, noma amasu okuphumula. Ama-centre amaningi e-kansa anikeza ukusekela ngokukhethekile kubesifazane abanezimo zebele ezingumngcipheko ophezulu.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Letha uhlu oluphelele lwemithi yakho, kufaka phakathi izithasiselo ezingaphezu kokuthengwa ngaphandle ne-hormone. Udokotela wakho udinga ukwazi nge-hormone replacement therapy noma amaphilisi okuvimbela ukukhulelwa owawo.

Lungiselela umbhalo womndeni wakho we-kansa yebhubu, i-ovarian, nezinye i-kansa kokubili eceleni lomndeni wakho. Faka iminyaka yokuxilongwa nohlobo lwe-kansa, njengoba lolu lwazi luthinta ukulinganiswa komngcipheko wakho.

Bhala phansi imibuzo mayelana nokuxilongwa kwakho, ukunakekelwa okuqhubekayo, nezinketho zokunciphisa umngcipheko. Cabanga ukubuza mayelana namahlelo okuqapha, izinketho zemithi, ukudluliselwa kokwelulekwa kwe-genetic, kanye nokushintsha kwesitayela sokuphila.

Letha umbiko wakho we-pathology nanoma yimiphi imiphumela yangaphambili yokuhlola ibele. Ukuba nalezi zincwadi kuzokusiza udokotela wakho ukuba anikeze izincomo eziqondene nomuntu siqu ngokunakekelwa kwakho.

Iyini into ebalulekile mayelana ne-Lobular Carcinoma in Situ?

I-LCIS luphawu olukhulu lomngcipheko, akuyona i-kansa ngokwayo, olukhombisa ukuthi udinga ukuqapha okuseduze kwempilo yebele. Abesifazane abaningi abane-LCIS abakhulumi i-kansa yebhubu, kodwa ukuqapha okufanele kubalulekile.

Sebenza neqembu lakho lezokunakekelwa ukwakha uhlelo oluqondene nomuntu siqu lokuqapha nokunciphisa umngcipheko. Le ndlela yokubambisana ikusiza ukuba wenze izinqumo ezifanele ngokunakekelwa kwakho ngenkathi uphatha ukukhathazeka ngokuxilongwa kwakho.

Khumbula ukuthi ukuba ne-LCIS kusho ukuthi manje usekhona ukuthola noma yikuphi ukushintsha kwebele kwesikhathi esizayo, lapho ukwelashwa kuphumelela kakhulu. Ukuqaphela kwakho okwandisiwe nokuqapha kwezokwelapha kuyizixhobo ezinamandla zokugcina impilo yakho.

Imibuzo evamile ebuzwayo mayelana ne-Lobular Carcinoma in Situ

Ingabe i-LCIS ifana ne-invasive lobular carcinoma?

Cha, i-LCIS ne-invasive lobular carcinoma ziyizimo ezihlukile ngokuphelele. I-LCIS iqukethe amaseli angajwayelekile ahlanganisiwe ngaphakathi kwama-lobules ebele, kuyilapho i-invasive lobular carcinoma iyi-kansa yangempela esakazeke ngaphandle kwama-lobules eya ezicubeni ezizungezile. Ukuba ne-LCIS akusho ukuthi une-kansa noma uzokhula ngokuqinisekile.

Kufanele ngitshele amalungu omndeni wami ngokuxilongwa kwami kwe-LCIS?

Cabanga ngokwabelana ngokuxilongwa kwakho nabantu abaseduze bomndeni wesifazane, njengoba kungase kuthonye izinqumo zabo zempilo yebele. Nakuba i-LCIS ngokwayo ayidluliselwa ngqo, umlando womndeni wezimo zebele ungabalulekile kudolotela wabo ukuba bawazi. Abantu bomndeni wakho bangase bazuze ekuhlolweni kwe-kansa yebhubu kwangaphambili noma okuvamile.

Ngingasaphuza yini i-hormone replacement therapy uma ngine-LCIS?

Lesi sinqumo sidinga ingxoxo enhle nodokotela wakho ngezingozi nezinzuzo zakho siqu. I-hormone replacement therapy ingakhuphula umngcipheko we-kansa yebhubu, okungase kube ukukhathazeka ngokukhethekile ngenxa yokuxilongwa kwakho kwe-LCIS. Udokotela wakho uzokusiza ukulinganisa izinzuzo ze-hormone therapy ngokumelene nomngcipheko wakho owandiswe we-kansa yebhubu.

Ingabe ukuba ne-LCIS kuzothinta ikhono lami lokuncelisa esikhathini esizayo?

I-LCIS ngokwayo akufanele ithonye ikhono lakho lokuncelisa, njengoba ngokuvamile ayidingi ukwelashwa kokuhinzwa okungalimaza izicubu zebele. Kodwa-ke, uma uthatha imithi yokunciphisa umngcipheko njenge-tamoxifen, kuzodingeka uxoxe ngokuhlela umndeni nodokotela wakho, njengoba le mithi ayikaphephile ngesikhathi sokukhulelwa noma sokuncelisa.

Ngaziqopha kangaki izikhathi zokulandelela nokuhlolwa?

Ekuqaleni, cishe uzoba nokuhlolwa kwebele njalo izinyanga ezingu-6-12 nama-mammograms minyaka yonke. Abanye abesifazane bathola nokuhlolwa kwe-breast MRI minyaka yonke. Uhlelo lwakho lokuqhubeka lungashintshwa ngokuhamba kwesikhathi ngokuya ngezici zakho siqu zomngcipheko, ubudala, nanoma yikuphi ukushintsha ezicubeni zebele lakho. Iqembu lakho lezokunakekelwa lizodala uhlelo oluqondene nomuntu siqu lokuqapha ngawe.