سرطان الثدي

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سرطان الثدي

  1. 1. ‫انششائخ‬ ‫ػشض‬:٘‫انضذ‬ ٌ‫نغشغب‬ ٙ‫يشئ‬ ‫دنٛم‬ Slideshow: A Visual Guide to Breast Cancer Source from: WebMD Reviewed by Sujana Movva, MD on August 21, 2013 ‫بتصرف‬ ‫ترجمة‬ ‫الشريك‬ ‫يوسف‬ ‫دكتور‬ Dr. Yousef Elshrek
  2. 2. •‫أػشاض‬ٌ‫عشغب‬٘‫انضذ‬ •‫ؿبنجب‬‫نٛظ‬‫ُْبى‬‫أػشاض‬‫رذل‬ٗ‫ػه‬‫اإلصبثخ‬،ّ‫ث‬ٍ‫ٔنك‬ٙ‫ك‬ ‫ثؼط‬ٌ‫األدٛب‬‫هذ‬‫ٚزى‬‫انكشق‬ّٛ‫ػه‬ٍ‫ي‬‫هجم‬‫انًصبثخ‬ّ‫ث‬. •‫رشًم‬‫ػاليبد‬‫ٔأػشاض‬‫اإلصبثخ‬‫ثبنًشض‬ٗ‫ػه‬ٙ‫انزبن‬:- .1‫ظٕٓس‬‫َزٕءاد‬‫ؿٛش‬‫يؤنًخ‬ٙ‫ك‬٘‫انضذ‬ .2‫دذٔس‬‫رـٛش‬ٙ‫ك‬‫دجى‬٘‫انضذ‬ٔ‫أ‬‫رـٛش‬ٙ‫ك‬ّ‫شكه‬ .3‫رٕسو‬ٙ‫ك‬‫اإلثػ‬ •‫انزٕسو‬‫انًلبجئ‬٘‫نهضذ‬(‫ادًشاس‬٘‫انضذ‬‫ٔرذٕل‬ّ‫يهًغ‬ّ‫ٔشكه‬ ٗ‫إن‬‫يب‬ّ‫ٚشج‬‫هششح‬‫انجشروبل‬) •‫انزـٛٛشاد‬‫انذهًخ‬ٔ‫أ‬ٙ‫ك‬‫اإلكشاصاد‬(‫هذ‬‫ٚزغجت‬‫رشاكى‬‫انغٕائم‬ ٙ‫ك‬٘‫انضذ‬ٗ‫إن‬ِ‫ظٕٓس‬‫ثشكم‬‫يذجت‬ّ‫ٚشج‬‫شكم‬‫هششح‬‫انجشروبل‬. ٙ‫ك‬‫ثؼط‬ٌ‫األدٛب‬‫رشخص‬‫ثشكم‬‫خبغئ‬ٗ‫ػه‬َّ‫ا‬‫نذؿخ‬‫دششح‬ ٔ‫أ‬ٖٔ‫ػذ‬ٙ‫ك‬٘‫انضذ‬.ٙ‫ك‬ّ‫دبن‬ٌ‫عشغب‬٘‫انضذ‬ٙ‫االنزٓبث‬‫ال‬‫ٕٚجذ‬ ‫ٔسو‬ٙ‫ك‬‫انـبنت‬‫كًب‬ٙ‫ك‬‫ثوٛخ‬‫عشغبَبد‬٘‫انضذ‬.‫األػشاض‬‫هذ‬ ًٍ‫رزع‬: •‫انذكخ‬. •‫روهص‬‫ٔاَكًبػ‬‫انذهًخ‬. •‫رٕسو‬‫انـذد‬‫انهًلبٔٚخ‬‫رذذ‬‫انزساع‬ٙ‫ٔك‬‫انشهجخ‬. •‫دفء‬‫ؿٛش‬٘‫ػبد‬ٙ‫ك‬٘‫انضذ‬‫انًصبة‬. •‫ٚصجخ‬٘‫انضذ‬ٙ‫هبع‬‫ٔيزصهت‬. Breast Cancer Symptoms There are often no symptoms of breast cancer, but sometimes women may discover a breast problem on their own. Signs and symptoms to be aware of may include: A painless lump in the breast Changes in breast size or shape Swelling in the armpit Nipple changes or discharge Breast pain can also be a symptom of cancer, but this is not common.
  3. 3. •‫ػاليبد‬‫انزٓبة‬ٌ‫عشغب‬٘‫انضذ‬ •‫انزٓبثبد‬ٌ‫عشغب‬٘‫انضذ‬‫َبدسح‬،‫انذذٔس‬‫ٚزًٛض‬‫ثبنزطٕس‬ ‫انغشٚغ‬‫ٔظٕٓس‬‫انًُطوخ‬‫انًصبثخ‬ٌٕ‫ثه‬‫أدًش‬‫يزٕسو‬ ،‫ٔصهت‬‫ٔٚذذس‬ٌ‫انغشغب‬ٙ‫االنزٓبث‬‫ػُذيب‬‫رغذ‬‫انخالٚب‬ ‫انٕسيٛخ‬‫األٔػٛخ‬‫انهًلبٔٚخ‬ٙ‫ك‬٘‫انضذ‬،‫يًب‬‫ٚغجت‬ ‫ظٕٓس‬‫انشكم‬ٙ‫انٕصل‬‫انًًٛض‬٘‫نهضذ‬‫ٔٚزشاكن‬ٙ‫ك‬‫ثؼط‬ ٌ‫األدٛب‬‫يغ‬‫دذٔس‬‫رـٛشاد‬‫جهذٚخ‬(‫جهذ‬‫انجشروبل‬) ‫ٔاَكًبػ‬‫ٔروهص‬‫دجى‬‫انذهًخ‬. •ٍ‫ي‬‫اإلػشاض‬ٖ‫األخش‬ّ‫ن‬‫انضٚبدح‬‫انغشٚؼخ‬ٙ‫ك‬‫دجى‬ ،٘‫انضذ‬،‫االدًشاس‬‫انذكخ‬،‫انًغزًشح‬‫ٔعخَٕخ‬‫انجهذ‬‫ػُذ‬ ّ‫نًغ‬. •‫ٚخزهػ‬ّ‫رشخٛص‬‫ثشكم‬‫شبئغ‬‫يغ‬‫انزٓبة‬‫ؿذح‬‫ٔأَغجخ‬ ٘‫انضذ‬ Signs of Inflammatory Breast Cancer Inflammatory breast cancer is a rare, fast- growing type of cancer that often causes no distinct lump. Instead, breast skin may become thick, red, and may look pitted -- like an orange peel. The area may also feel warm or tender and have small bumps that look like a rash.
  4. 4. •ٌ‫عشغب‬٘‫انضذ‬‫ٔرصٕٚش‬٘‫انضذ‬ ‫ثبألشؼخ‬‫انغُٛٛخ‬ •‫انكشق‬‫انًجكش‬ٗ‫ػه‬ِ‫ٔجٕد‬‫ٔهجم‬ ِ‫رطٕس‬‫ٚغٓم‬ّ‫ػالج‬. •‫ٚزى‬‫رصٕٚش‬٘‫انضذ‬‫ثبألشؼخ‬،‫انغُٛٛخ‬ ٙ‫ٔانز‬‫ثٕاعطزٓب‬ٍ‫ًٚك‬‫انكشق‬ٍ‫ػ‬ ‫األٔساو‬‫هجم‬ٌ‫أ‬ٌٕ‫رك‬‫كجٛشح‬‫ثًب‬ٙ‫ٚكل‬. •ٙ‫رٕص‬‫جًؼٛخ‬ٌ‫انغشغب‬‫األيشٚكٛخ‬ ‫إجشاء‬‫ػًهٛخ‬‫يغخ‬٘‫انضذ‬‫ثبألشؼخ‬ ‫انغُٛٛخ‬‫عُٕٚب‬‫اثزذاء‬ٍ‫ي‬ٍ‫ع‬40 ‫نهُغبء‬(‫يزٕعػ‬‫يشادم‬‫​انًخبغش‬​). •ٙ‫رٕص‬‫كشهخ‬‫انؼًم‬ٙ‫انٕهبئ‬‫خذيبد‬ ‫كذص‬‫ثبألشؼخ‬‫انغُٛٛخ‬ٙ‫ك‬‫انٕالٚبد‬ ‫انًزذذح‬‫كم‬ٍٛ‫عُز‬‫نهُغبء‬ٍْ‫أػًبس‬ ‫يب‬ٍٛ‫ث‬50-74. •‫انًطهٕة‬ٍ‫ي‬‫كم‬‫عٛذح‬‫هجم‬ٌ‫أ‬‫رجهؾ‬ ٍ‫ع‬50‫عُخ‬،‫يشاجؼخ‬‫انطجٛت‬‫نًؼشكخ‬ ‫يب‬ْٕ‫جذٔل‬‫انلذص‬‫انًُبعت‬،‫نٓب‬ ‫نًؼشكخ‬‫ادزًبالد‬‫انلبئذح‬‫ٔانعشس‬ ٍٛ‫انًذزًه‬. Breast Cancer and Mammograms The earlier breast cancer is found, the easier it is to treat. And mammograms, X-rays of the breast, can detect tumors before they are large enough to feel. The American Cancer Society recommends yearly mammograms beginning at age 40 for women at average risk. The U.S. Preventive Services Task Force recommends a screening mammogram every two years from age 50 to 74. It also notes that before age 50, each woman should check with a doctor to find out what screening schedule is right for her, considering the potential benefits and harms.
  5. 5. •‫انكشق‬ٍ‫ػ‬ٌ‫عشغب‬٘‫انضذ‬ ‫ثبنًٕجبد‬‫كٕم‬‫انصٕرٛخ‬ ‫ٔرصٕٚش‬ٍَٛ‫ثبنش‬ٙ‫انًـُبغٛغ‬ ‫ثجبَت‬‫رصٕٚش‬٘‫انضذ‬‫ثبألشؼخ‬ ‫انغُٛٛخ‬ٍ‫ًٚك‬ٌ‫أ‬‫ٚطهت‬‫انطجٛت‬ ‫انكشق‬ٍ‫ػ‬٘‫انضذ‬‫ثبنًٕجبد‬ ‫كٕم‬‫انصٕرٛخ‬ٙ‫ٔانز‬‫ثٕاعطزٓب‬ ‫انكشق‬ٍ‫ػ‬‫ٔجٕد‬‫أكٛبط‬ ‫يًزهئخ‬‫ثبنغٕائم‬‫ٔنكُٓب‬‫ؿٛش‬ ‫عشغبَٛخ‬،‫ٔهذ‬‫ٚزطهت‬‫األيش‬ ‫انزصٕٚش‬ٍَٛ‫ثبنش‬ٙ‫انًـُبغٛغ‬ ‫يغ‬‫انزصٕٚش‬‫ثبألشؼخ‬‫انغُٛٛخ‬ ‫نهكشق‬ُٙٛ‫انشٔر‬‫نجؼط‬ ‫انغٛذاد‬ٙ‫انالر‬ٍٓٚ‫نذ‬‫ادزًبل‬ ‫خطش‬‫اإلصبثخ‬‫ثٓزا‬‫انًشض‬ Breast Ultrasound and MRI Besides a mammogram, your doctor may order additional imaging with breast ultrasound. An ultrasound can help determine the presence of cysts, fluid-filled sacs that are not cancer. An MRI may be recommended along with a mammogram for routine screening in certain women who have a higher risk of breast cancer.
  6. 6. •٘‫انضذ‬ ‫كشق‬ٙ‫انزار‬ ‫صذسْب‬ ٗ‫ػه‬ ‫انشٓش‬ ٙ‫ك‬ ‫ٔادذح‬ ‫يشح‬ ‫ايشأح‬ ‫كم‬ ‫ركشق‬ ٌ‫ثأ‬ ٗ‫ٕٚص‬. •‫انكشق‬ ٙ‫ك‬ ‫جذا‬ ‫صـٛشا‬ ‫دٔسا‬ ‫رهؼت‬ ٘‫نهضذ‬ ‫انزارٛخ‬ ‫انكشٕكبد‬ ِ‫ْز‬ ٌ‫أ‬ ٗ‫إن‬ ‫انذساعبد‬ ‫رشٛش‬ ٌ‫انغشغب‬ ٗ‫ػه‬. •‫انًشأح‬ ‫رؼشف‬ ٌ‫أ‬ ‫انًٓى‬ ٍ‫ي‬ َّ‫أ‬ ْٕ ٙ‫انذبن‬ ‫انزلكٛش‬ٍ‫ػ‬ ‫أكضش‬‫ٔٚجت‬ ، ‫صذٚٓب‬ ٍ‫ػ‬ ‫انزـٛشاد‬ ‫دٔسٚب‬ ‫كذصٓب‬ ٍ‫ي‬ ‫ثذال‬ ، ‫نصذسْب‬ ‫ٚذذس‬ ‫رـٛش‬ ٘‫ثأ‬ ‫يؼشكخ‬ •‫انطجٛخ‬ ‫ثبنكشٕكبد‬ ‫يصبدجب‬ ٌٕ‫ٚك‬ ٍ‫ٔنك‬ ، ٘‫نهضذ‬ ٙ‫انزار‬ ‫ثبنكشق‬ ‫روٕو‬ ‫انًشأح‬ ٗ‫ػه‬ ‫ٚجت‬ ‫انًخزص‬ ‫غجٛجٓب‬ ‫هجم‬ ٍ‫ي‬. Breast Self-Exams It was once widely recommended that women check their own breasts once a month. But studies suggest these breast self-exams play a very small role in finding cancer. The current thinking is that it’s more important to know your breasts and be aware of any changes, rather than checking them on a regular schedule. If you want to do breast self-exams, be sure to go over the technique with your doctor
  7. 7. •‫انضذ٘؟‬ ٙ‫ك‬ ‫ٔسو‬ ‫ٔجٕد‬ ‫ػُذ‬ ‫ٚذذس‬ ‫يبرا‬ ‫نهزػش‬ ٙ‫داػ‬ ‫ال‬ ،‫أٔال‬. •80%ٍ‫ي‬‫أٔساو‬٘‫انضذ‬‫نٛغذ‬‫عشغبَٛخ‬. •‫ظٕٓس‬‫يضم‬ِ‫ْز‬‫األٔساو‬‫ؿبنجب‬‫يب‬ٌٕ‫رك‬ ،‫دًٛذح‬‫ؿٛش‬،‫يزغشغُخ‬ٙٓ‫ك‬‫ؿبنجب‬‫ػجبسح‬ ٍ‫ػ‬‫أكٛبط‬‫ؿٛش‬‫ظبسح‬ٔ‫أ‬‫َزٛجخ‬‫دذٔس‬ ‫رـٛٛشاد‬ٙ‫ك‬‫األَغجخ‬‫أصُبء‬‫دٔسح‬‫انطًش‬. •ٍ‫ٔنك‬‫ٚجت‬ٗ‫ػه‬‫كم‬‫عٛذح‬ٌ‫أ‬‫رخجش‬‫غجٛجٓب‬ ‫كٕسا‬‫ثًجشد‬‫دذٔس‬٘‫أ‬‫رـٛش‬ٙ‫ك‬‫أَغجخ‬ ‫صذٚٓب‬. •ٍ‫ٔي‬‫أْى‬‫يًٛضاد‬‫انكشق‬،‫انًجكش‬َّ‫أ‬ ‫ٚشٚخ‬‫انجبل‬،‫ٔهذ‬‫ٕٚظخ‬‫ثٕجٕد‬‫خالٚب‬ ‫عشغبَٛخ‬ٙ‫ك‬‫يشادهٓب‬ٗ‫األٔن‬ٍ‫ي‬ًُٕ‫ان‬ ٙ‫ٔانز‬ٍ‫ًٚك‬‫يؼبنجزٓب‬‫ٔانغٛطشح‬‫ػهٛٓب‬ ‫ثُجبح‬. What If You Find a Lump? First, don't panic. Eighty percent of breast lumps are not cancerous. Lumps often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But you should let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier it's found the better. And if it's not, testing can give you peace of mind.
  8. 8. •‫أخذ‬‫خزعة‬‫من‬‫الثدي‬ •‫طرٌقة‬‫أخذ‬‫الخزعة‬ً‫ه‬‫الطرٌقة‬ ‫الوحٌدة‬‫لتحدٌد‬‫ما‬‫إذا‬‫كانت‬‫كثل‬ ‫المتكونة‬ً‫ف‬‫الثدي‬ً‫ه‬‫خالٌا‬ ‫سرطانٌة‬‫أو‬‫ال‬. •‫وهذا‬‫ٌنطوي‬‫على‬‫أخذ‬‫عٌنة‬ (‫وخزة‬)‫من‬‫أنسجة‬‫الثدي‬ً‫ف‬ ‫المختبر‬‫من‬‫خالل‬‫إبرة‬‫صغٌرة‬. •ً‫ف‬‫بعض‬‫األحٌان‬‫ٌتم‬‫أخذ‬‫جزء‬‫من‬ ‫الكتلة‬‫المتورمة‬‫أو‬‫الكتلة‬‫بكاملها‬ ‫عن‬‫طرٌق‬‫إجراء‬‫عملٌة‬‫جراحٌة‬. •‫وسوف‬‫تظهر‬‫النتائج‬‫ما‬‫إذا‬‫كانت‬ ‫الكتلة‬ً‫ه‬‫خالٌا‬‫سرطانٌة‬‫أو‬‫ال‬. •‫إذا‬‫دلت‬‫نتائج‬‫الكشف‬‫بأن‬‫هذه‬ ‫الكتلة‬‫عبارة‬‫عن‬‫خالٌا‬‫سرطانٌة‬، ً‫فف‬‫مثل‬‫هذه‬‫الحالة‬‫ٌجب‬‫معرفة‬ ‫نوع‬‫السرطان‬‫وتحدٌد‬‫الطرٌقة‬ ‫المناسبة‬‫لعالجه‬. Breast Biopsy The only sure way to determine whether a lump is cancer is to do a biopsy. This involves taking a tissue sample for further examination in the lab, sometimes through a small needle. Sometimes surgery is done to take part of or the entire lump for testing. The results will show whether the lump is cancer, and if so, what type. There are several forms of breast cancer, and treatments are carefully matched to the type of cancer.
  9. 9. •‫هرمون‬‫حساسٌة‬‫سرطان‬‫الثدي‬ •‫تغذى‬‫هرمونات‬‫االستروجٌن‬‫أو‬ ‫البروجسترون‬‫بعض‬‫أنواع‬‫سرطان‬‫الثدي‬ ‫وتشجعها‬‫على‬‫النمو‬. •‫الكشف‬‫عن‬‫طرٌق‬‫أخذ‬،‫الخزعة‬‫ٌمكن‬‫أن‬ ‫تكشف‬‫ما‬‫إذا‬‫كان‬‫الورم‬‫له‬‫مستقبالت‬ ‫هرمون‬‫االستروجٌن‬(+ERً‫إٌجاب‬)‫و‬ /‫أو‬‫البروجسترون‬(+PRً‫إٌجاب‬). •‫اثنٌن‬‫من‬‫أصل‬‫ثالثة‬‫سرطانات‬‫الثدي‬ً‫ه‬ ‫عبارة‬‫عن‬‫هرمون‬‫الحساسٌة‬‫لسرطان‬ ‫الثدي‬. •‫هناك‬‫العدٌد‬‫من‬‫األدوٌة‬ً‫الت‬‫تمنع‬‫تغذٌة‬ ‫الهرمونات‬‫للخالٌا‬‫السرطانٌة‬‫وتقلل‬ ‫نموها‬. •‫الصورة‬‫التالٌة‬‫توضح‬‫نموذجا‬‫جزٌئٌا‬‫من‬ ‫مستقبالت‬‫هرمون‬‫االستروجٌن‬. Hormone-Sensitive Breast Cancer Some types of breast cancer are fueled by the hormones estrogen or progesterone. A biopsy can reveal whether a tumor has receptors for estrogen (ER-positive) and/or progesterone (PR-positive). About two out of three breast cancers are hormone sensitive. There are several medications that keep the hormones from promoting further cancer growth. The image shows a molecular model of an estrogen receptor.
  10. 10. •‫يغزوجالد‬‫إٚجبثٛخ‬ٌ‫نغشغب‬٘‫انضذ‬ human epidermal growth factor receptor 2 (HER2) •‫رصم‬‫َغجخ‬‫ٔجٕد‬‫يغزوجالد‬‫اإلٚجبثٛخ‬‫انكضٛشح‬‫انًؼشٔكخ‬‫ثبعى‬ (HER2)ٙ‫دٕان‬20%ٙ‫ك‬‫انًصبثبد‬ٌ‫ثغشغب‬٘‫انضذ‬ •‫ٚؼشف‬َّ‫ثأ‬‫أعشع‬‫األَٕاع‬‫ًَٕا‬ٍ‫ي‬‫انغشغبَبد‬ٖ‫األخش‬. •ٍ‫ي‬‫انًٓى‬‫رذذٚذ‬‫يب‬‫إرا‬ٌ‫كب‬‫انٕسو‬ٙ‫إٚجبث‬HER2،ٙ‫كل‬‫يضم‬ِ‫ْز‬ ‫انذبنخ‬‫ٚذزبط‬ّ‫يؼبنجز‬‫ثًؼبنجخ‬‫خبصخ‬ّ‫ث‬. •‫انصٕسح‬‫رٕظخ‬‫خهٛخ‬ٌ‫عشغب‬٘‫انضذ‬HER2-‫اإلٚجبثٛخ‬‫ٕٔٚظخ‬ ٌٕ‫انه‬‫األخعش‬‫كٛٓب‬ًَٕ‫خالٚب‬‫ؿٛش‬‫انطجٛؼٛخ‬. HER2-Positive Breast Cancer In about 20% of patients, breast cancer cells have too many receptors for a protein called HER2. This type of cancer is known as HER2-positive, and it tends to spread faster than other forms of breast cancer. It's important to determine whether a tumor is HER2-positive, because there are special treatments for this form of cancer. A HER2-positive breast cancer cell is illustrated here, with abnormal growth signals shown in green.
  11. 11. •‫يشادم‬ٍٕٚ‫رك‬ٌ‫عشغب‬٘‫انضذ‬ •‫انخطٕح‬‫انزبنٛخ‬‫ثؼذ‬‫رشخٛص‬ٌ‫عشغب‬،٘‫انضذ‬ْٙ‫رذذٚذ‬‫دجى‬‫كجش‬‫انٕسو‬ ٖ‫ٔيذ‬ِ‫اَزشبس‬ •‫هغى‬‫األغجبء‬ٍٕٚ‫رك‬ٌ‫عشغب‬٘‫انضذ‬ٗ‫إن‬‫أسثؼخ‬‫يشادم‬ِْٙٔ‫ْز‬‫انخطٕح‬ ‫ثؼًهٛخ‬‫يب‬ًٗ‫ٚغ‬‫يشدهخ‬(0):-ٙ‫ك‬ِ‫ْز‬‫انًشدهخ‬ٌٕ‫ٚك‬ٌ‫انغشغب‬ٙ‫يٕظؼ‬ ٔ‫أ‬‫يذٕصم‬ٌْٕٔ‫عشغب‬‫ؿٛش‬ٙ‫اجزٛبد‬‫يجكش‬‫جذا‬ٙ‫ك‬٘‫انضذ‬‫ال‬ٔ‫ٚـض‬‫انخالٚب‬ ،‫انًجبٔسح‬ٍ‫ًٔٚك‬ّ‫اعزئصبن‬‫ٔاالدزلبظ‬٘‫ثبنضذ‬ٔ‫أ‬‫اعزئصبل‬٘‫انضذ‬ّ‫ثكبيه‬) .1‫انًشدهخ‬(1)ْٔٙ‫يشدهخ‬‫يجكشح‬ٍ‫ي‬ٌ‫عشغب‬٘‫انضذ‬‫ٔهذ‬‫ٚصٛت‬‫كٛٓب‬ ‫األَغجخ‬،‫انًجبٔسح‬ُٙ‫ٔرؼ‬‫انًشدهخ‬ٗ‫األٔن‬ٌ‫أ‬ٌ‫انغشغب‬‫نى‬‫ٚزجبٔص‬٘‫انضذ‬ .2‫انًشدهخ‬(2)ْٔٙ‫أٚعب‬‫يشدهخ‬‫يجكشح‬ٍ‫ي‬ٌ‫عشغب‬٘‫انضذ‬‫هذ‬‫ٚصٛت‬‫كٛٓب‬ ‫األَغجخ‬‫انًجبٔسح‬‫ٔهذ‬‫ُٚزشش‬ٌ‫انغشغب‬ٙ‫ك‬‫انؼوذ‬‫انهًٛلبٔٚخ‬‫رذذ‬‫اإلثػ‬. ْٙٔ‫هذ‬ٌٕ‫رك‬ٗ‫ػه‬ٍٛ‫دسجز‬Stage IIAٔ‫أ‬Stage IIB .3‫انًشدهخ‬(3)ًٔٗ‫رغ‬‫يشدهخ‬ٌ‫انغشغب‬ٙ‫انًٕظؼ‬،‫انًزوذو‬ٌٕ‫ٔٚك‬ِ‫اَزشبس‬ ‫أكضش‬ٙ‫ك‬‫انؼوذ‬‫انهًٛلبٔٚخ‬‫رذذ‬‫اإلثػ‬‫ٔسثًب‬ٙ‫ك‬‫األَغجخ‬ٖ‫األخش‬‫انًذبرٚخ‬ ٘‫نهضذ‬.ْٙٔ‫هذ‬ٌٕ‫رك‬ٗ‫ػه‬3‫دسجبد‬Stage IIIAٔ‫أ‬Stage IIIBٔ‫أ‬ Stage IIIC. .4‫انًشدهخ‬(4)ْٙٔ‫انًشدهخ‬‫االَجضبصٛخ‬‫ٔكٛٓب‬‫ُٚزوم‬ٌ‫انغشغب‬ٍ‫ي‬٘‫انضذ‬ ٙ‫نجبه‬‫أػعبء‬‫انجغى‬‫كبنؼظبو‬‫ٔانشئخ‬‫ٔانكجذ‬‫ٔانذيبؽ‬. Breast Cancer Stages Once breast cancer has been diagnosed, the next step is to determine how big the tumor is and how far the cancer has spread. This process is called staging. Doctors use Stages 0- 4 to describe whether cancer is localized to the breast, has invaded nearby lymph nodes, or has spread to other organs, such as the lungs. Knowing the stage and type of breast cancer will help your health care team formulate a treatment strategy.
  12. 12. •‫ٚالدع‬ٌ‫أ‬‫األٔساو‬،‫رزذسط‬ٍ‫ي‬ ‫انًشدهخ‬‫صلش‬(‫دٛش‬‫ُْبى‬‫ٔسو‬ ‫صـٛش‬‫ثذاخم‬‫انُزٕءاد‬‫ٔانـذد‬ ‫انهجُٛخ‬‫هذ‬ٌٕ‫ٚك‬‫ؿٛش‬‫يذغٕط‬ ‫ثبنٛذ‬‫ػُذ‬‫كذص‬،٘‫انضذ‬‫ٔؿذد‬ ‫نًٛلبٔٚخ‬‫ال‬‫رٕجذ‬‫ثٓب‬‫خالٚب‬ ‫عشغبَٛخ‬)ٗ‫دز‬‫انًشدهخ‬،‫انشاثؼخ‬ (‫دٛش‬‫انٕسو‬‫هذ‬‫اَزشش‬ٗ‫إن‬‫يُطوخ‬ ٔ‫أ‬‫يُبغن‬ٖ‫أخش‬‫خبسط‬‫يُطوخ‬ ٘‫انضذ‬‫سثًب‬ٗ‫إن‬‫انشئخ‬‫ٔانكجذ‬... ‫إنخ‬)،‫ٔثًُٛٓب‬‫دسجبد‬ٖ‫أخش‬ٙ‫ك‬ ‫انًشدهخ‬‫انضبَٛخ‬‫ٔانضبنضخ‬ •‫ٔرشجغ‬‫أًْٛخ‬‫روغٛى‬‫ٔرؼشٚق‬ ‫انًشادم‬ْٙ‫انزخطٛػ‬‫نهؼالط‬ ‫ٔإػطبء‬‫ككشح‬‫يجذئٛخ‬ٍ‫ػ‬ ‫يغزوجم‬‫انًصبثخ‬ّ‫ث‬.
  13. 13. •‫معدل‬‫بقاء‬‫على‬‫قٌد‬‫الحٌاة‬ ‫ترتبط‬‫احتماالت‬‫البقاء‬‫على‬‫قٌد‬‫الحٌاة‬ ‫بمراحل‬‫تكوٌن‬‫سرطان‬‫الثدي‬‫ومدى‬ ‫انتشاره‬ •‫وفقا‬‫لجمعٌة‬‫السرطان‬،‫األمٌركٌة‬‫أن‬ 88٪‫من‬‫النساء‬‫المصابات‬‫بسرطان‬ ‫الثدي‬‫المرحلة‬(1)‫ٌعٌشهن‬‫خمس‬ ‫سنوات‬‫على‬،‫األقل‬‫مقارنة‬‫مع‬‫النساء‬ ً‫اللوات‬‫لم‬‫ٌكن‬‫لدٌهن‬‫سرطان‬–‫وقد‬ ‫تكون‬‫الكثٌر‬‫منهن‬ً‫ف‬‫هذه‬‫المجموعة‬ ‫خالٌة‬‫من‬‫السرطان‬‫نهائٌا‬. •‫وتقل‬‫هذه‬‫المدة‬‫على‬‫حسب‬‫المرحلة‬ ‫تكوٌن‬‫السرطان‬،‫وبالطبع‬‫تكون‬‫المرحلة‬ (4)‫أقل‬‫بنسبة‬15%‫من‬‫المراحل‬ ‫السابقة‬‫الستمرار‬‫الحٌاة‬ •‫ولكن‬‫قد‬‫تطال‬‫مدة‬‫الحٌاة‬‫بالعالج‬ ‫المناسب‬‫ومدى‬‫استجابة‬‫المرض‬‫للعالج‬. Breast Cancer Survival Rates The odds of surviving breast cancer are strongly tied to how early it is found. According to the American Cancer Society, 88% of women with Stage 1 breast cancer live at least five years, compared with women who don't have cancer -- and many women in this group remain cancer-free for good. The more advanced the cancer, the lower this figure becomes. By Stage 4, the five-year relative survival rate declines to 15%. But these rates can improve as more effective treatments are found.
  14. 14. •‫سرطان‬‫الثدي‬-‫العالج‬‫باإلشعاع‬ ‫ٌمكن‬‫استخدام‬‫عالج‬‫باإلشعاع‬‫بعد‬‫إجراء‬‫عملٌة‬‫جراحة‬‫لثدي‬، ‫باإلضافة‬‫إلى‬‫العالج‬ً‫الكٌمٌائ‬‫للسرطان‬‫المنتشر‬. •‫ما‬‫هو‬‫العالج‬‫الشعاعً؟‬ •‫وهو‬‫استعمال‬‫أشعة‬‫ذات‬‫طاقة‬‫عالٌة‬‫للقضاء‬‫على‬‫الخالٌا‬ ‫السرطانٌة‬‫ومنعها‬‫من‬‫النمو‬.‫ٌكون‬‫اإلشعاع‬‫إما‬‫من‬‫الخارج‬ external radiation‫وٌصدر‬‫من‬‫جهاز‬‫خارج‬‫الجسم‬‫أو‬‫بوضع‬ ‫مواد‬‫إشعاعٌة‬ً‫ف‬‫أنابٌب‬‫بالستٌكٌة‬‫رقٌقة‬‫مباشرة‬‫داخل‬‫الثدي‬ ‫وٌسمى‬‫باإلشعاع‬‫المزروع‬implant radiation‫وأحٌانا‬‫تتلقى‬ ‫المرٌضة‬‫النوعٌن‬‫من‬‫العالج‬. •‫ومن‬‫عٌوبه‬‫بأنه‬‫ٌسبب‬‫أثار‬‫جانبٌة‬‫مثل‬‫التورم‬ً‫ف‬‫منطقة‬‫المعرة‬ ‫لإلشعاع‬،،‫والتعب‬‫أو‬‫اإلحساس‬‫بالحرق‬‫مثل‬‫حرقة‬‫الشمس‬ Breast Cancer - Radiation Therapy Radiation therapy can be used after breast cancer surgery, or it may be used in addition to chemotherapy for widespread cancer. The high-energy radiation kills cancer cells. This treatment does have side effects, which can include swelling of the area, tiredness, or a sunburn-like sensation
  15. 15. • Breast Cancer - Chemotherapy • Chemotherapy drugs are given to kill cancer cells that are located anywhere in the body. It can be administered by IV solution, by pill, or by an injection, depending upon the drug. Sometimes chemotherapy is given after surgery to help prevent the cancer from recurring. Side effects of chemotherapy can include risk of infection, nausea, fatigue, and hair loss. ‫سرطان‬‫الثدي‬-‫العالج‬ً‫الكٌمٌائ‬* ‫ما‬‫هو‬‫العالج‬ً‫الكٌمٌائ‬‫أو‬‫الكٌماوي؟‬ ‫هو‬‫استعمال‬‫األدوٌة‬‫والعقاقٌر‬‫للقضاء‬‫على‬‫الخالٌا‬ ‫السرطانٌة‬ً‫وف‬‫أغلب‬‫الحاالت‬‫ٌعالج‬‫سرطان‬‫الثدي‬ ‫بمجموعة‬‫من‬،‫األدوٌة‬‫وتعطى‬‫األدوٌة‬‫إما‬‫عن‬ ‫طرٌق‬‫الفم‬‫أو‬‫بالحقن‬ً‫ف‬‫الورٌد‬‫أو‬ً‫ف‬،‫العضل‬ ً‫وف‬‫كل‬‫الطرق‬‫ٌعتبر‬‫العالج‬ً‫الكٌمٌائ‬‫عالجا‬ ‫شامال‬‫ألن‬‫األدوٌة‬‫تصل‬‫إلى‬‫جمٌع‬‫أنحاء‬‫الجسم‬ ‫عن‬‫طرٌق‬‫مجرى‬‫الدم‬.ً‫بالتال‬‫فهو‬‫مفٌد‬ً‫ف‬‫حالة‬ ‫انتشار‬‫المرض‬. ‫تعطى‬‫األدوٌة‬‫إما‬‫عن‬‫طرٌق‬‫الفم‬‫أو‬‫بالحقن‬ً‫ف‬ ‫الورٌد‬‫أو‬ً‫ف‬‫العضل‬‫ولتسهٌل‬‫عملٌة‬‫الحقن‬ ‫بالورٌد‬‫والتقلٌل‬‫من‬‫إمكانٌة‬‫حدوث‬‫التهاب‬‫مكان‬ ‫وضع‬‫اإلبرة‬ً‫ف‬‫الورٌد‬‫فربما‬‫تطلبٌن‬‫أو‬‫ٌخبرك‬ ‫الطبٌب‬‫أنه‬‫باإلمكان‬‫زرع‬‫منفذ‬ً‫بالستٌك‬‫تحت‬ ‫الجلد‬‫ٌتم‬‫حقن‬‫األدوٌة‬‫من‬‫خالله‬‫وأٌضا‬‫أخذ‬‫عٌنات‬ ‫الدم‬. ‫ومن‬‫عٌوب‬‫هذا‬‫العالج‬‫تعرض‬‫المرٌض‬‫للتلوث‬ ً‫المٌكروب‬‫والدوخة‬‫والتعب‬‫وفقد‬‫الشعر‬. ‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ *‫المصدر‬:-sehha.com
  16. 16. Breast Cancer - Hormone Therapy ER- and PR-positive breast cancers grow in response to hormones, so hormone therapy that blocks the action of hormones can be given to women whose breast cancer is hormone receptor-positive. It is usually given after surgery, but it can also be given to reduce the chance of developing breast cancer in women at high risk. ‫عالج‬‫سرطان‬‫الثدي‬‫بالهرمونات‬* ‫أورام‬‫الثدي‬‫لها‬‫عالقة‬‫شدٌدة‬‫الهرمونات‬‫األنثوٌة‬‫وخصوصا‬ ‫االستروجٌن‬(‫هرمون‬‫االستروجٌن‬‫ٌجعل‬‫بعض‬‫أنواع‬‫الخالٌا‬ ‫السرطانٌة‬ً‫ف‬‫الثدي‬‫تنمو‬‫إن‬‫كان‬ً‫ف‬‫الورم‬ً‫السرطان‬‫عدد‬‫كبٌر‬‫من‬ ‫مستقبالت‬ً‫هرمون‬‫االستروجٌن‬estrogen receptors - ERs ‫والبروجٌستٌرون‬progesterone receptors - PgRs)‫ولذلك‬‫كان‬ ‫العالج‬‫بالهرمونات‬‫أو‬‫ما‬‫ٌمنع‬‫إفرازها‬‫أو‬‫تأثٌرها‬‫على‬‫الثدي‬‫من‬‫أول‬ ‫الطرق‬‫المستخدمة‬ً‫ف‬‫عالج‬‫أورام‬،‫الثدي‬‫ولقد‬‫كان‬‫الكتشاف‬ ‫مستقبالت‬‫الهرمونات‬‫بأورام‬‫الثدي‬‫فضل‬‫كبٌر‬ً‫ف‬‫اختٌار‬‫المرٌضات‬ ً‫الالت‬‫ٌوجد‬‫لدٌهن‬‫مستقبالت‬‫للهرمونات‬ً‫ف‬‫أورامهن‬+ER‫أو‬/‫و‬ +PR‫للعالج‬،ً‫الهرمون‬‫فإن‬ً‫حوال‬ً‫ثلث‬‫مرٌضات‬‫سرطان‬‫الثدي‬ ‫توجد‬‫لدٌهن‬‫مستقبالت‬‫موجبة‬‫وذلك‬ً‫ٌعن‬‫أن‬ً‫ثلث‬‫مرٌضات‬‫سرطان‬ ‫الثدي‬‫سوف‬‫ٌستجبن‬‫استجابة‬‫جٌدة‬‫للعالج‬ً‫الهرمون‬. ‫أما‬‫إذا‬‫كانت‬‫مستقبالت‬‫الهرمونات‬‫سالبة‬-ER‫أو‬-PR‫فال‬‫ٌنصح‬ ‫بإعطاء‬‫أي‬‫عالج‬ً‫هرمون‬‫بسبب‬‫تعرض‬‫المرٌضة‬‫لكل‬‫مضاعفات‬ ‫العالج‬‫بدون‬‫وجود‬‫فائدة‬‫تذكر‬‫كما‬‫سجل‬ً‫ف‬‫معظم‬-‫إن‬‫لم‬‫ٌكن‬‫كل‬- ‫الدراسات‬‫العلمٌة‬.‫وأٌضا‬‫أثبتت‬‫الدراسات‬‫الحدٌثة‬‫بوضوح‬‫أن‬‫العالج‬ ً‫الهرمون‬‫فعال‬ً‫ف‬‫جمٌع‬‫األعمار‬‫لعالج‬‫السرطان‬ًٌ‫الثد‬‫الذي‬‫ٌحمل‬ ‫مستقبالت‬‫الهرمونات‬.‫كما‬‫أنه‬‫ٌقلل‬‫من‬‫احتمالٌة‬‫اإلصابة‬‫بسرطان‬ ‫الثدي‬ً‫ف‬‫السٌدات‬ً‫الالت‬‫لدٌهن‬‫قابلٌة‬‫عالٌة‬‫لإلصابة‬‫بالمرض‬. ‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬ *‫المصدر‬:-sehha.com
  17. 17. •‫استهداف‬‫العالجٌة‬‫الدوائٌة‬‫المستهدفة‬‫لخالٌا‬ ‫السرطانٌة‬ً‫ف‬‫الثدي‬ •‫العالجات‬‫المستهدفة‬ً‫ه‬‫أحدث‬‫العالجات‬ ‫لسرطان‬‫الثدي‬. •‫ٌعملون‬‫على‬‫بروتٌنات‬‫معٌنة‬‫داخل‬‫الخالٌا‬ ،‫السرطانٌة‬‫مثل‬‫البروتٌن‬HER-2(‫الذي‬‫تم‬ ‫مناقشته‬) •‫ٌمكن‬‫أن‬‫العالجات‬‫المستهدفة‬‫وقف‬‫بروتٌن‬ HER-2‫من‬‫تحفٌز‬‫نمو‬‫الورم‬ً‫السرطان‬ •‫العالجات‬‫المستهدفة‬‫لها‬‫آثار‬‫جانبٌة‬‫أقل‬‫من‬ ‫العالج‬ً‫الكٌمٌائ‬،‫التقلٌدي‬‫وغالبا‬‫ٌستخدم‬‫هذا‬ ‫العالج‬‫مرافقا‬‫مع‬‫العالج‬ً‫الكٌمٌائ‬.Targeted Drug Therapies for Breast Cancer Targeted therapies are newer treatments for breast cancer. They act upon specific proteins within cancer cells, like the HER-2 protein discussed earlier. Targeted therapies can stop the HER-2 protein from stimulating tumor growth in cancers that have this protein. Targeted therapies have fewer side effects than traditional chemotherapy and are often used in combination with chemotherapy.
  18. 18. • Life After Breast Cancer • Cancer treatment can be both physically and emotionally exhausting. It can be difficult to keep up with activities of daily life, and you may feel isolated or overwhelmed. Friends and family can be invaluable sources of support and assistance during this time. Some people choose to join a local or an online support group to share their experiences. ‫الحٌاة‬‫بعد‬‫سرطان‬‫الثدي‬ ‫ٌمكن‬‫أن‬‫ٌكون‬‫عالج‬‫السرطان‬ ‫مرهقا‬‫جسدٌا‬‫وعاطفٌا‬‫والشعور‬ ‫بالعزلة‬‫وصعوبة‬‫مواكبة‬‫الحٌاة‬ ‫الٌومٌة‬‫العادٌة‬‫ومن‬‫هنا‬‫ٌكون‬ ‫األهل‬‫واألصدقاء‬‫تقدٌم‬‫الدعم‬‫ال‬ ‫ٌقدر‬‫بثمن‬‫من‬‫الناحٌة‬‫النفسٌة‬ ‫وقد‬‫ٌختار‬‫بعض‬‫الناس‬‫االتصال‬ ‫بغٌرهم‬‫عن‬‫طرٌق‬‫التواصل‬ ً‫االجتماع‬(‫اإلنترنت‬)‫لتبادل‬ ‫الخبرات‬.
  19. 19. •‫نصائح‬‫لجمٌع‬‫السٌدات‬ •‫إذا‬‫كنت‬‫تشعرٌن‬‫بكتلة‬ً‫ف‬،‫الثدي‬‫ال‬،‫تتجاهلٌها‬‫حتى‬‫لو‬‫كان‬‫فحص‬ ‫الماموجرام‬‫طبٌعٌا‬. •‫إذا‬‫كانت‬‫الحلمة‬‫تتقشر‬‫أو‬‫ٌتطور‬‫علٌها‬،‫الغشاء‬‫فان‬‫ذلك‬‫عادة‬‫ما‬ ‫ٌكون‬‫مؤشرا‬‫على‬‫مرض‬ً‫ف‬‫الحلمة‬‫حٌث‬‫أن‬‫األمر‬‫مرتبط‬ً‫ف‬ ‫معظم‬‫الحاالت‬‫بالسرطان‬. •‫إي‬‫نوع‬‫من‬‫اإلفراز‬‫غٌر‬ً‫الطبٌع‬‫من‬،‫الحلمة‬‫سواء‬‫كان‬‫الحلٌب‬ ‫أو‬‫إفرازا‬،‫دموٌا‬‫ٌتطلب‬‫الفحص‬. •‫باإلضافة‬‫إلى‬‫ظهور‬‫الدمامل‬‫على‬،‫الثدٌٌن‬‫وخاصة‬‫إذا‬‫كانت‬ ‫باللون‬،ً‫البرتقال‬ً‫ٌنبغ‬‫أن‬‫تثٌر‬‫الشك‬. •‫مثل‬‫هذه‬‫الدمامل‬‫ترتبط‬ً‫ف‬‫معظم‬‫الحاالت‬‫بسرطان‬‫الثدي‬‫نادر‬ ‫الحدوث‬ً‫والعدوان‬‫والذي‬‫ٌتمٌز‬‫بالثدي‬‫الساخن‬‫واألحمر‬.

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