Basal Cell Carcinoma

Basal cell carcinomas, or BCCs, the most common form of skin cancer, are abnormal, uncontrolled growths or lesions that arise in the skin’s basal cells, which line the deepest layer of the epidermis or the outermost layer of the skin. BCCs often look like open sores, red patches, pink growths, shiny bumps, or scars. They are usually caused by a combination of cumulative UV exposure and intense, occasional UV exposure, basal cell carcinomas can be highly disfiguring if allowed to grow, but they almost never metastasize beyond the original site.

There are an estimated 2.8 million cases of BCC diagnosed in the U.S. each year. More than one out of every three new cancers are skin cancers and the vast majority are BCCs.

Almost all BCCs occur on parts of the body excessively exposed to the sun — especially the face, ears, neck, scalp, shoulders, and back. On rare occasions, tumors can develop on unexposed areas.

Who gets it?

Anyone with a history of sun exposure can develop basal cell carcinoma. However, people who are at highest risk have fair skin, blond or red hair, and blue, green, or grey eyes. The disease is rarely seen in children, but occasionally a teenager is affected.

Men with BCC have outnumbered women with the disease, but more women are getting BCCs than in the past. Workers in occupations that require long hours outside and people who spend a lot of time in the sun are particularly susceptible.

Risk of recurrence

People who have had one BCC are at risk for developing others over the years, either in the same area or elsewhere on the body.

BCCs on the scalp and nose are especially troublesome, with recurrences typically taking place within the first two years following surgery. Should a cancer recur, your physician might recommend a different type of treatment.

Treatment

A diagnosis of basal cell carcinoma is confirmed with a biopsy. A piece of tissue is then removed and sent to be examined in the laboratory to seek a definitive diagnosis. If tumor cells are present, treatment is required. Fortunately, there are several effective methods for eradicating BCC. Choice of treatment is based on the type, size, location, and depth of penetration of the tumor, the patient’s age and general health, and the likely cosmetic outcome of specific treatments.

In many cases a simple excision can be curative. This might be done by your dermatologist. In others a technique called Mohs’ surgery can be performed, and you may be referred to a Mohs’ surgeon. In some cases other treatments including radiation or topical therapies may be considered.