Combined curettage and excision: a treatment method for primary basal cell carcinoma.

A retrospective study of 403 primary basal cell carcinomas treated with aggressive curettage followed immediately by excision revealed microscopic tumor present in the curettage margin in 64 (15.9%) of the patients and in the excisional margin in 12 (2.5%) after curettage and excision. In 92% (11 of 12) of patients with persistent tumor after the combined curettage and excision technique the tumors were of the aggressive growth (fibrosing, sclerosing, scirrhous, and morpheaform) variety of basal cell carcinoma. Both lateral and deep margins were involved with tumor. The short-term cure rate was 97.6% for the combined technique. Excluding aggressive growth BCCs, the use of curettage allows the surgeon to define tumor borders better before excision. This proves especially beneficial in tumors with clinically indistinct borders.