Basal Cell Carcinoma Treatment Flashcards
What are the options for basal cell carcinoma treatment?
Excision (absolutely first-line)
Mohs micrographic surgery
Radiotherapy
Topical 5-fluorouracil cream
Why excision to treat BCC?
Commonly removes all malignant cells
Also allows diagnosis to be made histologically
What is Mohs micrographic surgery, how does it work, and why use it to treat BCC?
Aims for extremely narrow excision margins
- uses repeat histology to guide fine limit of excision border
Useful where there is limited local skin for closure and/or if there are nearby structures that are best avoided
Why radiotherapy to treat BCC?
Used to shrink lesions and reduce troublesome bleeding, often in cases where resection is difficult because:
- lesion is so large that flap reconstruction would be necessary
- patient is unsuitable for general anaesthetic
Why topical 5-fluorouracil cream to treat BCC?
Commonly used for areas of skin with multiple/recurrent actinic keratosis
Recently used in some instances of basal cell carcinoma (just remember it’s not contraindicated so can be used)
Why not use chemotherapy for treatment of BCC?
- Significant side-effects
- Existing variety of effective local therapies
- BCCs do not metastasise
TLDR - unnecessary and not indicated