I-phyllodes tumor iyithumba elingajwayelekile lebele, elivame ukuvela ngaphambi komdlavuza webele. Imvamisa ayilungile, kepha kukhona izinhlobo ezinonya ezinolaka. Ukwelashwa okuncanyelwayo ukuhlinzwa, okunesibikezelo esihle ngokuvamile, ngisho noma ukuphindeka kwasendaweni kungeke kukhishwe.

Incazelo

I-Phyllodes tumor iyi-tumor engavamile yebele, eqala ezicutshini ezixhumeneyo. Kuyisimila esixubile, esibizwa ngokuthi i-fibroepithelial, esibonakala ngokwanda kwamaseli e-epithelial namaseli ezicubu ezixhumene, kuyilapho iningi lomdlavuza wamabele lithinta amangqamuzana ezindlala. 

Ama-Phyllodes tumors ahlukaniswa ngamaqembu amathathu:

• iningi (phakathi kuka-50% no-75% ngokusho kwababhali) yizimila ezinobungozi (ibanga loku-1)
• I-15-20% yizimila ezisemngceleni, noma umngcele (ibanga lesi-2)
• I-10 kuya ku-30% yizimila eziyingozi, okusho ukuthi ezinomdlavuza (ibanga lesi-3), ngezinye izikhathi ezibizwa ngokuthi ama-phyllodes sarcomas.

Izimila ze-phyllodes zeBanga loku-1 zikhula kancane kancane futhi zivame ukuba zincane (zohlelo lwesentimitha), zikhula ngokushesha futhi izimila ezinkulu ze-phyllodes (kufika ku-15 cm) zivame ukulimaza.

Izimila ze-phyllodes eziyingozi kuphela ezingadala i-metastase.

Izimbangela

Izimbangela zokwakheka kwalezi zimila azikacaci kahle.

kwesifo

Isimila, esakha inqwaba eguquguqukayo echazwe kahle, ivame ukutholakala ngesikhathi sokuzihlola noma ukuhlolwa komtholampilo lapho kuboniswana nodokotela besifazane.

Ukukhula okusheshayo kwenqwaba eyaziwayo ekhona ngaphambili kungase kuphakamise ukuxilongwa, okubuye kuqondiswe iminyaka yesiguli.

AMAPOSA

Izivivinyo ze-imaging ezikhethwayo i-mammography ne-ultrasound, kodwa i-MRI inganikeza ulwazi ezimeni ezithile. Kodwa-ke, lokhu kuhlola akukwenzi kube nokwenzeka ngaso sonke isikhathi ukuhlola izinga lesimila se-phyllodes, noma ukusehlukanisa ne-fibradenoma, isimila sesifuba esinobuntu esifana ncamashí.

i-biopsy

I-Percutaneous biopsy (ukuthatha izingcezu zezicubu usebenzisa inaliti efakwe esikhumbeni) yenziwa ngaphansi kokuqondiswa kwe-ultrasound. Ivumela ukuqinisekiswa kwe-histological: izicubu ezithathiwe zihlaziywa ngesibonakhulu ukuze kutholwe uhlobo lwesimila.

Abantu abathintekayo

Izimila ze-Phyllodes zingenzeka kunoma ibuphi ubudala kodwa ikakhulukazi zihlasela abesifazane abaphakathi kweminyaka engama-35 nengama-55 ubudala, ngenani eliphakeme kakhulu lenzeke phakathi kweminyaka engama-40 nengama-45 ubudala. Ngakho-ke zivela kamuva kune-fibradenoma, ehlasela abesifazane abasebasha kakhulu, kodwa ngaphambi komdlavuza webele.

Bamele ngaphansi kwe-0,5% yazo zonke izimila zamabele.

Izici zengozi

Abacwaningi basola ukungenelela kwezici ezihlukene zofuzo ekubukekeni nasekuthuthukeni kwalezi zimila.

Izimila eziningi ze-phyllodes azinabuhlungu futhi azihlotshaniswa ne-axillary lymphadenopathy (awekho ama-lymph nodes asolisayo, aqinile noma avuthayo ekhwapheni).

Lapho i-palpation i-nodule iqinile, iyahamba uma incane, inamathela ezicubu lapho ikhula.

Izimila ezinkulu zingahambisana nezilonda zesikhumba. Akuvamile, kube khona ukuphuma kwengono noma ukuhlehla kwengono.

ukuhlinzwa

Ukwelashwa kusekelwe kakhulu ekukhishweni kokuhlinzwa kwamathumba angewona ama-metastatic, kungakhathaliseki ukuthi ayingozi noma ayingozi, kuyilapho kugcinwa umkhawulo wokuphepha ongu-1 cm. Ukuhlinzwa kwe-Conservative kuya ngokuya kukhethwa kune-mastectomy. Lokhu kungase kudingeke kodwa uma kwenzeka kuphindelela okunonya.

I-Axillary lymph node dissection ayivamile ukusiza.

Radiotherapy

I-radiotherapy ingaba i-adjuvant yokwelapha izimila ezimbi ze-phyllodes, ikakhulukazi uma kwenzeka ziphindeka.

Ukwelashwa ngamakhemikhali

Ukusebenziseka kwe-chemotherapy njengokwelashwa kwe-adjuvant yezimila ezimbi ze-phyllodes kuxoxwa ngakho-ke icala ngalinye. Izimiso ezisetshenziswayo ziyefana nalezo ezisetshenziswa ekwelapheni ama-sarcoma ezicubu ezithambile.

Ukubikezelwa kwezimila zama-phyllodes ngokuvamile kuhle, akuphindeki eminyakeni eyi-10 kwabesifazane abayisi-8 kwabayishumi, kungakhathaliseki ukuthi iliphi ibanga lesimila. 

Ukuphindeka kwasendaweni, nokho, kusalokhu kuvame. Ngokuvamile zenzeka phakathi neminyaka emibili yokuhlinzwa, kodwa zingavela kamuva kakhulu, okudinga ukuqapha njalo. Izimila eziyingozi zivame ukuvela ngaphambi kwesikhathi.

Isimila se-phyllodes esiphindelelayo singase sibe nolaka ngokwemvelo kunethumba lokuqala. Kuyaqabukela, kunalokho, izoba nomlingiswa olungile. Ngakho-ke ezinye izimila ezinobungozi zingaphinde zivele ngesimo sezimila ezinomdlavuza, noma ngisho ne-metastatic evolution. Ingozi yokuba ne-metastasizing iphezulu lapho isimila esiyinhloko se-phyllodes sasiyingozi.

Esimeni sokuphindaphinda kwendawo, lokho okubizwa ngokuthi "i-catch-up" mastectomy inikeza izinga eliphezulu lokwelapha kodwa lihlala liyisenzo esilimazayo, ngokuvamile esitholwa kabi abesifazane abasebasha. Inzuzo ye-radiotherapy kanye / noma ukwelashwa ngamakhemikhali kuxoxwa ngakho ngakunye yithimba lezempilo.

I-prognosis ihlala imbi lapho ukuphindaphinda okunamandla kuholela ekubonakaleni kwama-metastases. Ukusabela ku-chemotherapy akuvamile ukuqina, nokufa kwenzeka phakathi nezinyanga ezi-4 kuya kwezi-6. Ngakho-ke ukuqapha kunendima ebalulekile okufanele kuyidlale.