Basal Cell Carcinoma Flashcards
Which of the following is the most common form of cancer?
1 - Malignant Melanoma
2 - Breast cancer
3 - Squamous Cell Carcinoma
4 - Basal Cell Carcinoma
4 - Basal Cell Carcinoma
Typically how many basal cell carcinomas are there per year in the UK?
1 - 2000
2 - 20,000
3 - 200,000
4 - 2,000,000
3 - 200,000
Which of the following is NOT a risk factor for basal cell carcinoma?
1 - UV radiation exposure (especially at a young age)
2 - Fair skin
3 - Age
4 - Ionising radiation
5 - Repeated micro-injuries
6 - Scars/chronic ulcers
7 - Prolonged chemical exposure
8 - Immunosuppression
9 - History of skin cancer
3 - Age
What is the most common location for basal cell carcinomas to appear on an individual?
1 - back and legs
2 - head and neck
3 - arms and legs
4 - feet and legs
2 - head and neck
Typically those with the most exposure to the sun like the face
Which 2 of the following mutations in the basal cells of the skin is associated with basal cell carcinomas?
1 - APC
2 - BRAF
3 - TP53
4 - PTCH
3 - TP53
4 - PTCH
Do basal cell carcinomas typically metastasise?
- no
- typically do not move beyond the basal cells of the skin
- BUT in rare cases they can
Of the 4 images below, which is a basal cell carcinoma?
- top left
There are 3 main types of basal cell carcinomas, which of the following is NOT one of these?
1 - Bulla
2 - Superficial
3 - Nodular
4 - Morphoeic/infiltrative
1 - Bulla
- Superficial= just surface of skin
- Nodular = raised up with clear margins
- Morphoeic/infiltrative = margins difficult to see with some spread on surface
Of the different types of basal cell carcinoma, which is high-risk for extensive local spread and high recurrence rates?
1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular
1 - Morphoeic/infiltrative
Nodular and superficial are low risk
There are 3 main types of basal cell carcinomas, which of the these is most common?
1 - Superficial
2 - Nodular
3 - Morphoeic/infiltrative
2 - Nodular
Superficial is the 2nd most common
In the image below, which type of basal cell carcinoma is this?
1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular
3 - Nodular
- typically they have an ulcerative centre, similar to a rodent bite
- can contain telangiectasia, where small capillaries become clear and appear like spider webs
There are 3 main types of basal cell carcinomas (BCC), with Nodular being the most common type. Which of the following is NOT a characteristic of a nodular BCC?
1 - pearly, shiny papule appearance
2 - small arborising telangiectasias
3 - rolled borders
4 - always a depressed/ulcerative centre
4 - always a depressed/ulcerative centre
They can have depressive and ulcerative centres, but this is NOT always the case
Are basal cell carcinomas sensitive and likely to bleed?
- Yes
Very sensitive and likely to bleed on even minor trauma
In the image below, which type of basal cell carcinoma is this?
1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular
1 - Morphoeic/infiltrative
- most aggressive form of BCC
- ill defined edges and centre is eroded away
- MOHS surgery is often the preferred choice
In the image below, which type of basal cell carcinoma is this?
1 - Morphoeic/infiltrative
2 - Superficial
3 - Nodular
2 - Superficial
Often appear as a plaque with:
- stretched appearance with a rolled edge
- can be shiny with some pigmentation
- can sometimes be pigmented
Which of the following remains the main stay treatment for nodular BCC?
1 - Excision
2 - Curettage
3 - Efudix (5-FU) chemo drug
4 - Radiotherapy
1 - Excision
- MOHS surgery is often the preferred choice
Curettage = inject local anaesthetic, scrape and repeat
Efudix = 2 cycles typically
What is the ONLY modifiable risk factor for skin cancer?
1 - sun exposure
2 - weight
3 - immunotherapy
4 - smoking
1 - sun exposure
Avoiding peak UV times can help mitigate the risks associated with skin cancer. What are peak UV times?
1 - 9am - 1pm
2 - 11am - 12pm
3 - 11am - 3pm
4 - 1-3pm
3 - 11am - 3pm
Which of the following are ways to minimise UV exposure and reduce the risk of skin cancer?
1 - Wear hats, sun glasses, clothes
2 - Sunscreen on face and as needed elsewhere
3 - Broad spectrum of >SPF30
4 - Suncream containing UVA: 4-5 stars
5 - all of the above
5 - all of the above
If identified and treated early, what are the recurrence free rates of BCC?
1 - 25%
2 - 50%
3 - 65%
4 - 95%
4 - 95%
Which of the following remains the main stay treatment for superficial BCC?
1 - Excision
2 - Curettage
3 - Imiquimod 5% cream 5-6 wks
4 - Efudix (5-FU) chemo drug
5 - Cryotherapy (2 cycles 20s)
6 - photo dynamic therapy (PDT)
1 - Excision
Curettage = inject local anaesthetic, scrape and repeat
Efudix = 2 cycles typically
PDT = cream applied to lesion and then red light applied, needs 2 treatments
Typically what is used for high risk basal cell carcinomas such as Morphoeic/infiltrative?
1 - Excision followed by curettage
2 - Imiquimod 5% cream 5-6 wks then excision
3 - Cryotherapy (2 cycles 20s) then excision
4 - Excision followed by radiotherapy
4 - Excision followed by radiotherapy
Is Mohs Micrographic Surgery or basic excision surgery more effective at inducing remission in low and high risk tumours?
Mohs Micrographic Surgery
If a patient has excision of a BCC, they may also have radiotherapy afterwards. Which of the following is NOT an indication that a patient should have radiotherapy following excision?
1 - Close or positive margins
2 - Aged >65 years old
3 - Recurrence after previous resection
4 - Tumour invading bone / muscle
2 - Aged >65 years old
