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Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is the most common type of cancer in the world. It is estimated that there were 2,800,000 cases of BCC in the US in 2012. The BCC is also the most common type of skin cancer. Generally, BCC is not dangerous if it is treated early. It grows over the course of many years. We usually try to treat them within weeks to months of diagnosis to minimize scarring. Although patients with light skin and significant sun exposure are at highest risk for BCC, patients with darker skin types can also develop BCC.

Basal Cell Carcinomas typically appear as pearly, red bumps. Patients often note that the lesion has been there for months to years and only seek treatment when the lesion starts to become sore or bleed.

At the dermatology office, the BCC is typically biopsied to obtain a diagnosis. After confirmation of diagnosis, the various treatment options are discussed. The treatments vary based on size, location, and clinical sub-type. An in-depth discussion of the best treatment option for the particular lesion and the patient's needs is important.

The treatment options for BCC are as follows:

  • Topical treatments- Imiquimod (Aldara, Zyclara), ingenol mebutate (Picato), 5-fluorouracil (Efudex, Carac) (Time: 4-16 weeks, Cure rate: 50-90%)
  • Electrodessication and Currettage- Scraping and burning of the lesion. No pathology confirmation of removal. (Time: 15 minutes, Cure rate: 85-90%)
  • Excision- Cutting out the skin cancer with a scalpel. Surgical margins examined for clearance of tumor. Re-excision may be necessary if margins are not clear. (Time: 60-90 minutes, Cure rate: 85-90%)
  • Mohs Surgery- Cutting out the skin cancer under microscopic control. After removal of the skin cancer with small margins, the tissue is mapped out and cut in a way to be able to examine the deep and side margins. If the margins are clear, the wound can be closed. If the margins are not clear, a small amount of additional tissue is removed in only the involved area. This tissue is then inspected microscopically and if the margins are now clear, the wound can be closed. If not clear, the process is repeated until the margins are finally clear and the wound is finally closed. (Time: 2 hours- 8 hours, Cure rate: 90-99%)
  • Radiation and Electronic Brachytherapy- Lesion is exposed to radiation in multiple doses. Eight to twenty sessions may be needed. (Time: 15 minute appointment per session over 1 month period, Cure rate:85-90%)

 
ADSCI - Advanced Dermatology Skin Cancer Institute Linage Dermatology Linage Skin Care