Guidelines of care for the management of basal cell carcinoma

• Published in: Journal of the American Academy of Dermatology Vol. 78; no. 3; pp. 540 - 559
• Main Authors: Bichakjian, Christopher, Armstrong, April, Baum, Christian, Bordeaux, Jeremy S., Brown, Marc, Busam, Klaus J., Eisen, Daniel B., Iyengar, Vivek, Lober, Clifford, Margolis, David J., Messina, Jane, Miller, Alexander, Miller, Stanley, Mostow, Eliot, Mowad, Christen, Nehal, Kishwer, Schmitt-Burr, Kristi, Sekulic, Aleksandar, Storrs, Paul, Teng, Joyce, Yu, Siegrid, Huang, Conway, Boyer, Kevin, Begolka, Wendy Smith, Alam, Murad, Kim, John Y.S., Kozlow, Jeffrey H., Mittal, Bharat, Moyer, Jeffrey, Olencki, Thomas, Rodgers, Phillip
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2018
• Subjects: Administration, Cutaneous; Aminoquinolines - therapeutic use; Anilides - therapeutic use; Antineoplastic Agents - therapeutic use; basal cell carcinoma; biopsy; Carcinoma, Basal Cell - diagnosis; Carcinoma, Basal Cell - secondary; Carcinoma, Basal Cell - therapy; curettage; Dermatologic Surgical Procedures; Early Detection of Cancer; Humans; Imiquimod; metastasis; Neoplasm Grading; Neoplasm Staging; Neoplasms, Second Primary - diagnosis; Neoplasms, Second Primary - prevention & control; Photochemotherapy; Photosensitizing Agents - therapeutic use; phototherapy; Pyridines - therapeutic use; Radiotherapy; Skin Neoplasms - diagnosis; Skin Neoplasms - pathology; Skin Neoplasms - therapy; staging; surgery; surveillance; topical therapy; United States; RCT; NCCN; STEVIE; metastasis; AJCC; phototherapy; surveillance; staging; cSCC; MM; PDT; curettage; BCC; C&E; AAD; NMSC; MMS; SMO; ALA; biopsy; radiotherapy; basal cell carcinoma; MAL; PI; topical therapy; surgery; 5-FU
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2017.10.006

Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.