David Zloty1, Lyn C Guenther2, Mariusz Sapijaszko3, Kirk Barber4, Joël Claveau5, Tamara Adamek6, John Ashkenas6. 1. University of British Columbia, Vancouver, BC, Canada David.Zloty@vch.ca. 2. University of Western Ontario, London, ON, Canada. 3. University of Alberta, Edmonton, AB, Canada. 4. Kirk Barber Research and University of Calgary, Calgary, AB, Canada. 5. Clinique Dermatologique Joël Claveau, Québec, QC, Canada. 6. SCRIPT, Toronto, ON, Canada.
Abstract
BACKGROUND: Basal cell carcinoma (BCC) is the most common malignancy. Growth of BCCs leads to local destruction of neighbouring healthy skin and underlying tissue and can result in significant functional and cosmetic morbidity. OBJECTIVE: To provide guidance to Canadian health care practitioners regarding management of BCCs. METHODS: Literature searches and development of graded recommendations were carried out as discussed in the accompanying Introduction. RESULTS: Although BCCs rarely metastasize, they can be aggressive and disfiguring. This chapter describes the natural history and prognosis of BCCs. Risk stratification is based on clinical features, including the site and size of the tumour, its histologic subtype (nodular vs sclerosing), and its history of recurrence. CONCLUSIONS: Various options should be considered for BCC treatment, including cryosurgery, curettage, and topical or photodynamic approaches, as well as fixed-margin surgery and Mohs micrographic surgery. Stratification of recurrence risk for individual BCCs determines the most appropriate therapeutic course.
BACKGROUND:Basal cell carcinoma (BCC) is the most common malignancy. Growth of BCCs leads to local destruction of neighbouring healthy skin and underlying tissue and can result in significant functional and cosmetic morbidity. OBJECTIVE: To provide guidance to Canadian health care practitioners regarding management of BCCs. METHODS: Literature searches and development of graded recommendations were carried out as discussed in the accompanying Introduction. RESULTS: Although BCCs rarely metastasize, they can be aggressive and disfiguring. This chapter describes the natural history and prognosis of BCCs. Risk stratification is based on clinical features, including the site and size of the tumour, its histologic subtype (nodular vs sclerosing), and its history of recurrence. CONCLUSIONS: Various options should be considered for BCC treatment, including cryosurgery, curettage, and topical or photodynamic approaches, as well as fixed-margin surgery and Mohs micrographic surgery. Stratification of recurrence risk for individual BCCs determines the most appropriate therapeutic course.