BASAL CELL CARCINOMA

Basal Cell Carcinoma (BCC) is the most common type of skin cancer. Although BCC can develop at any age, it occurs more frequently in individuals older than 40 years. Risk increases as age increases. The risk of getting BCC is also higher in fair-skinned individuals, those who have high sun exposure, those who use tanning beds, and those who have had frequent sunburns, especially during childhood. Basal cell carcinoma can occur anywhere, but most occur on the head, neck, or face. The diagnosis may be obvious to a doctor, but a biopsy is usually required to confirm the diagnosis. The biopsy is sent to the laboratory for special analysis under a microscope. Basal cell carcinoma can recur after treatment; if it does, retreatment is necessary. Patients who have had one BCC will frequently have additional BCCs develop as they get older. All BCCs should be removed. If you have any risk for skin cancer, you should see your doctor for a skin examination.

There are a few different types of basal cell carcinoma. Doctors classify them according to their shape, appearance, and color. The most common have a raised, purely white or pink border and a central depression. Others may develop ulcers or erode through the skin. They start off small, less than 1/4 inch, but can become quite large if left untreated. They can spread to other adjacent skin areas and in some cases can grow deeper. This is a particular problem on the face. Very few spread to distant areas on the body.

You should consult your doctor if you have any of the following warning signs of possible skin cancer:

• A suspicious-looking mole or area that concerns you.
• Any area that does not heal or recurrently bleeds.
• A raised skin mole with a central indentation.
• Any mole that changes shape or color.
• Any mole that has irregular or indistinct borders.
• Any mole that is asymmetric; that is, one side looks different from the other side.

Any suspicious-looking mole or abnormal area should be examined by your doctor. If cancer is suspected, your doctor may perform a biopsy or remove the mole or treat the mole by destroying it with freezing or burning. A skin biopsy is performed to remove a sample of the mole. This is usually done by first deadening the area with an anesthetic such as lidocaine. A sample of the mole is obtained using a special biopsy tool or by removal with a sharp, sterile knife. This sample is sent to a laboratory for analysis under a microscope. If the biopsy is positive for cancer, the mole will be completely removed.

Sometimes at the initial visit the mole will be completely removed without first performing a biopsy, especially if the mole is small. Your doctor will remove the entire abnormal area and send it for analysis at the laboratory.

Other methods such as electrosurgery (using an electric needle) and cryosurgery (freezing) are frequently used to treat BCC.

When diagnosed early, BCC is relatively easy to treat and recurrences are less common. When it is extensive, BCC can be more difficult to treat and referral to a specialist may be necessary.

• Obtain an annual skin examination from your doctor, more often if recommended by your doctor.
• See your doctor if you have a suspicious-looking mole or abnormal skin area.
• Always wear sunscreen with a sun protection factor (SPF) of 15 or higher when in direct sunlight.

• Avoid sunlight during the periods when most intense, especially from 11 am to 3 pm during summer days. (If you must be in the sun, wear long-sleeve shirts and pants and a hat).
• Avoid sunburns, especially in small children.
• Don't delay seeing your doctor if you have any of the warning signs of skin cancer.

• If you have a new mole or a suspicious-looking area on your skin.

American Academy of Dermatology
930 N. Meacham Road
Schaumburg, IL 60173
847-330-0230




Basal cell carcinoma. Note rolled translucent border and central ulceration in typical facial location. (from Noble J [ed]: Primary care medicine, ed 2, St. Louis, 1996, Mosby.)

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