Guidelines for the Management of Basal Cell Carcinoma
A wide range of different treatments has been described for the management of BCC, and both the British Association of Dermatologists (BAD) and the American Academy of Dermatology have published professional guidelines on their appropriate use. Usually the aim of treatment is to eradicate the tumour in a manner likely to result in a cosmetic outcome that will be acceptable to the patient. Some techniques [e.g. cryosurgery, curettage, RT, photodynamic therapy (PDT)] do not allow histological confirmation of tumour clearance. These techniques are generally used to treat low-risk tumours, although RT also has an important role in the management of high-risk BCC. Surgical excision with either intraoperative or postoperative histological assessment of the surgical margins is widely used to treat both low- and high-risk BCC, and is generally considered to have the lowest overall failure rate in BCC treatment. In rare advanced cases, where tumour has invaded facial bones or sinuses, major multidisciplinary craniofacial surgery may be necessary.
There are few randomized controlled studies comparing different skin cancer treatments, and much of the published literature on the treatment of BCC consists of open studies, some with low patient numbers and relatively short follow-up periods.
Broadly, the available treatments for BCC can be divided into surgical and nonsurgical techniques, with surgical techniques subdivided into two categories: excision and destruction.
A wide range of different treatments has been described for the management of BCC, and both the British Association of Dermatologists (BAD) and the American Academy of Dermatology have published professional guidelines on their appropriate use. Usually the aim of treatment is to eradicate the tumour in a manner likely to result in a cosmetic outcome that will be acceptable to the patient. Some techniques [e.g. cryosurgery, curettage, RT, photodynamic therapy (PDT)] do not allow histological confirmation of tumour clearance. These techniques are generally used to treat low-risk tumours, although RT also has an important role in the management of high-risk BCC. Surgical excision with either intraoperative or postoperative histological assessment of the surgical margins is widely used to treat both low- and high-risk BCC, and is generally considered to have the lowest overall failure rate in BCC treatment. In rare advanced cases, where tumour has invaded facial bones or sinuses, major multidisciplinary craniofacial surgery may be necessary.
There are few randomized controlled studies comparing different skin cancer treatments, and much of the published literature on the treatment of BCC consists of open studies, some with low patient numbers and relatively short follow-up periods.
Broadly, the available treatments for BCC can be divided into surgical and nonsurgical techniques, with surgical techniques subdivided into two categories: excision and destruction.
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