Basal Cell Carcinoma Treatment, Causes, and Diagnosis

Basal cell carcinoma (BCC) is a type of skin cancer that originates from the basal cells, which are found in the lowest layer of the epidermis. It is the most common type of skin cancer, accounting for about 80% of all cases of skin cancer.

Read this blog further to get a quick overview of this important topic for pathology  and ace your NEET PG exam preparation.

Classification of Basal Cell Carcinoma

Basal cell carcinoma (BCC) is classified into several subtypes based on their appearance and location on the skin. Here are some of the most common types of BCC:

1. Nodular BCC: This is the most common type of BCC, accounting for about 80% of cases. Nodular BCC appears as a raised, shiny bump that may be pink, red, or white in color.
2. Superficial BCC: Superficial BCC appears as a red, scaly patch on the skin. It typically grows slowly and may be mistaken for a rash or other skin condition.
3. Morpheaform BCC: Morpheaform BCC is a rare, aggressive form of BCC that appears as a flat, scar-like lesion on the skin.
4. Infiltrating BCC: Infiltrating BCC grows deeply into the skin and may appear as a non-healing sore or ulcer on the skin.
5. Pigmented BCC: Pigmented BCC appears as a dark, brown or black patch on the skin. It is more common in people with dark skin.
6. Fibroepithelioma of Pinkus: This is a rare subtype of BCC that appears as a raised, dome-shaped growth on the skin.

The type of BCC will affect the treatment options and prognosis, as some subtypes are more aggressive than others. Your dermatologist will perform a skin biopsy to determine the subtype of BCC and develop a treatment plan that is tailored to your individual needs.

Symptoms of Basal Cell Carcinoma

Basal cell carcinoma (BCC) is a type of skin cancer that usually develops in areas of the skin that are regularly exposed to the sun, such as the face, scalp, neck, and hands. The symptoms of BCC can vary depending on the subtype of the cancer, but some common symptoms include:

• A small, smooth, shiny, or waxy bump on the skin that is pearly or translucent in appearance.
• A flat, pink, or flesh-colored lesion that looks like a scar or a patch of dry skin.
• A reddish or brown patch of skin that is scaly or crusty and does not heal.
• A sore that continuously bleeds, scabs over, and then reopens.
• A growth with a depressed center and elevated, rolled borders that may have abnormal blood vessels.
• An open sore that oozes or bleeds and does not heal within a few weeks.
• A growth that looks like a white, waxy scar and is slow-growing.
• A bump that is itchy, painful, or tender to the touch.

Causes of Basal Cell Carcinoma

Basal cell carcinoma (BCC) is primarily caused by long-term exposure to ultraviolet (UV) radiation from the sun or tanning beds. UV radiation can damage the DNA in skin cells, leading to mutations and the uncontrolled growth of abnormal cells that form tumors. Other factors that can increase the risk of developing BCC include:

1. Fair skin: People with fair skin are more susceptible to the damaging effects of UV radiation and are at a higher risk for developing BCC.
2. Age: BCC is more common in older people, although it can occur at any age.
3. Gender: BCC is more common in men than women.
4. Personal or family history of skin cancer: People who have had BCC or other types of skin cancer are at a higher risk of developing it again. Additionally, people with a family history of skin cancer are also at a higher risk.
5. Exposure to radiation: People who have received radiation therapy in the past may be at a higher risk of developing BCC.
6. Weakened immune system: People with a weakened immune system, such as those who have undergone an organ transplant or are living with HIV/AIDS, are at a higher risk of developing BCC.
7. Exposure to certain chemicals: Exposure to certain chemicals, such as arsenic, may increase the risk of developing BCC.

It's important to note that not everyone who is exposed to UV radiation or has these risk factors will develop BCC. However, taking steps to protect your skin from UV radiation, such as wearing protective clothing and using sunscreen, can help reduce your risk of developing BCC.

Diagnosis of Basal Cell Carcinoma 

Diagnosis of basal cell carcinoma (BCC) typically involves a combination of a physical exam, medical history, and skin biopsy. Here's what you can expect during the diagnosis process:

1. Physical exam: Your doctor or dermatologist will examine your skin to look for any signs of BCC, including any unusual bumps or lesions.
2. Medical history: Your doctor will ask you about your personal and family medical history, including any history of skin cancer or other skin conditions.
3. Skin biopsy: If your doctor suspects that a lesion or bump may be BCC, they will perform a skin biopsy, which involves removing a small sample of tissue for examination under a microscope. There are several types of skin biopsy, including shave biopsy, punch biopsy, and excisional biopsy. Your doctor will determine the best type of biopsy based on the size, location, and appearance of the lesion.
4. Other tests: In some cases, your doctor may recommend additional tests, such as imaging tests or blood tests, to determine the extent of the cancer and if it has spread to other parts of the body.

Once a diagnosis of BCC has been made, your doctor will determine the stage of the cancer based on the size, location, and extent of the tumor, as well as whether it has spread to other parts of the body. This information will help your doctor develop a treatment plan that is tailored to your individual needs. It's important to remember that early detection and treatment of BCC can greatly improve your chances of a successful outcome.

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Treatment of Basal Cell Carcinoma

The treatment of basal cell carcinoma (BCC) depends on several factors, including the size and location of the tumor, the type of BCC, and the patient's overall health. Here are some common treatment options for BCC:

1. Surgery: Surgery is often the preferred treatment for BCC. It involves removing the tumor and a small amount of surrounding tissue. The type of surgery will depend on the size and location of the tumor, and may include excisional surgery, Mohs surgery, or curettage and electrodesiccation.
2. Radiation therapy: Radiation therapy uses high-energy beams of radiation to kill cancer cells. It may be used for BCC that is difficult to remove with surgery, or for patients who are not good candidates for surgery.
3. Topical medications: Topical medications, such as imiquimod and 5-fluorouracil, can be applied directly to the skin to treat small, superficial BCCs. They work by stimulating the body's immune system to attack the cancer cells.
4. Photodynamic therapy: Photodynamic therapy involves applying a special cream to the skin that makes cancer cells more sensitive to light. The area is then exposed to a special light that kills the cancer cells.
5. Cryotherapy: Cryotherapy involves freezing the tumor with liquid nitrogen, causing the cancer cells to die.
6. Laser surgery: Laser surgery uses a high-energy beam of light to destroy cancer cells. It may be used for small, superficial BCCs that are located on the face.

It's important to note that the treatment of BCC may cause scarring or other cosmetic issues, particularly if the cancer is located on the face. Your doctor will discuss the potential risks and benefits of each treatment option with you to help you make an informed decision about your care.

Prognosis of Basal Cell Carcinoma

The prognosis for basal cell carcinoma (BCC) is generally very good, as it is a slow-growing cancer that is usually limited to the skin. BCC rarely spreads to other parts of the body and is highly treatable if caught early. The 5-year survival rate for people with BCC is nearly 100%.

However, if left untreated, BCC can grow larger and deeper into the skin, making it more difficult to treat. In rare cases, BCC can spread to other parts of the body, such as the lymph nodes or internal organs, which can be life-threatening.

Factors that can affect the prognosis for BCC include the size and location of the tumor, whether it has spread to other parts of the body, and the patient's age and overall health.

It's important to remember that early detection and treatment of BCC is key to a successful outcome. Regular skin exams and sun protection measures, such as wearing protective clothing and using sunscreen, can help reduce your risk of developing BCC and other types of skin cancer. If you notice any changes in your skin, such as new or unusual growths, it's important to see a dermatologist or other healthcare provider right away for evaluation.

This is everything that you need to know about basal cell carcinoma  for your pathology preparation. To scale up your NEET PG preparation with the best-in-class video lectures, QBank, Mock Tests, and more, download the PrepLadder App!
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