Basal Cell Carcinoma (BCC)
Non-melanoma skin cancers are the most common type of cancer. Non-melanoma skin cancers include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). According to Cancer.org, every year there are more new cases of non-melanoma skin cancers than all new cases of breast, prostate, lung and colon cancer combined. Most skin cancers are curable when caught early.
What is basal cell carcinoma?
Basal cell carcinoma (BCC) is the most common form of skin cancer, accounting for 80% of skin cancer diagnoses. Each year more than 4 million Americans are diagnosed with BCC. Basal cells are the cells that produce new skin cells when the old ones die off.
BCC is typically slow-growing, but early diagnosis is especially important to avoid the risk of spread. If BCC does spread, it can grow wide and deep into the skin and destroy local tissue like cartilage and bone. In rare cases, BCC can be aggressive and even life-threatening.
Since BCC is typically found on the face, eyes, lips and nose, standard excision can be disfiguring. Consequently, microscopic surgery called Mohs surgery can spare healthy tissues and reduce the risk of recurrence.
What causes BCC?
The main cause is chronic exposure of unprotected skin to the ultraviolet (UV) rays of the sun and tanning beds. UV rays damage the skin’s DNA (the genes that control cell growth and function) causing the skin cells to grow out of control.
BCC commonly develops on sun-exposed skin anywhere on the body, with a predilection for the face, ears, neck and scalp.
Who is at risk for BCC?
Fair-skinned people with blonde or red hair, and blue, green or gray eyes are at the greatest risk. However, anyone who is exposed to long hours outside in the sun is also at risk.
Men develop BCC more often than women, though incidence in women is increasing. The average age at diagnosis is 60, but data reports that people in their 20s and 30s are also being diagnosed more frequently.
Other risk factors for developing BCC includes:
- A positive family history of BCC strongly predicts the development of BCC.
- A personal history of BCC or SCC is associated with an increased risk of a new BCC or development of SCC.
- People with a history of radiation exposure have a higher risk of developing skin cancer.
- People who have a compromised immune system are more likely to develop skin cancer, including organ transplant recipients.
What are the warning signs of BCC?
Not all BCCs look alike. There are five warning signs and commonly two or more are visible in a BCC tumor on sun exposed skin.
- An open sore that won’t heal. It may bleed, ooze or crust and look like it’s healing but comes back.
- A flat, scaly spot with pearly borders.
- A small pink lesion or bump with an ulcerated center.
- A shiny bump that is skin- colored, white, pink or red and may even have some blue, brown or black areas. In darker skin tones almost 50% of the BCC lesions are brown in color.
- A red patch or irritated area that itches or hurts or causes no symptoms at all.
- A lesion that looks like a scar and is flat white, yellow or waxy looking. This type may represent a more invasive BCC.
How is BCC diagnosed?
BCC is often readily recognizable based on the appearance of the lesion or tumor. Your board-certified dermatologist will conduct an examination and confirm a diagnosis with a biopsy, which is a small tissue sample that is sent to a lab for microscopic analysis.
What are the treatment options?
The choice of treatment depends on the location, size, depth of the tumor and your age and health. A key factor is whether treatment will affect your appearance. Because many BCCs are found around the eyes, lips, nose, and scalp, standard excision may be disfiguring. Therefore, micrographic surgery called Mohs surgery may be recommended to spare health tissue and reduce the risk of recurrence.
In cases where the tumor is determined to be superficial and low-risk, several treatment options including but not limited to topical therapies, photodynamic therapy or curettage can provide a cure rate of 80-90%.
Everyone should have an annual skin check for skin cancer. When you are concerned about a skin lesion, contact Phoenix Surgical Dermatology Group to schedule a consultation. Don’t wait. Early diagnosis and treatment are the keys to a successful outcome.