At the OSUCCC – James, we understand the importance of regular cancer screenings to help reduce the risk of common skin cancers like basal cell carcinoma. With our advanced screening and diagnosis techniques, you can feel confident that we’re here to help you. Our team uses the latest technology to detect basal cell carcinoma early. Our goal is to make sure you have the best possible treatment outcomes and can focus on living your life to the fullest.
Diagnosis of basal cell carcinoma
It’s recommended that you have regular skin exams if you’re at risk of developing basal cell carcinoma or have concerns about changes to your skin.
To make a diagnosis for basal cell carcinoma, your doctor will need to first perform a skin exam and ask you some questions about your health history. During the exam, a doctor will examine the skin for signs of abnormal growths, including size, color, shape and texture. If your doctor has any concerns about specific areas, they may perform a biopsy. Your doctor will determine which type of biopsy to perform based on their findings.
Biopsy
A doctor removes a sample of skin cells so they can be analyzed under a microscope by a specially trained OSUCCC – James pathologist. Your doctors will discuss the risks and benefits of each type of biopsy with you.
There are several ways to remove skin cells for biopsy, including:
- Shave Biopsy: A doctor uses a sterile blade to shave off a growth that looks abnormal.
- Punch Biopsy: A special instrument is used to cut out circular pieces of skin or tissue.
- Incisional Biopsy: A doctor removes part of a growth using a scalpel.
- Excisional Biopsy: The doctor removes the entire growth or abnormal area of skin using a scalpel.
Once the biopsy is performed, your doctors will determine if the sample is basal cell carcinoma, another type of skin cancer, or if it’s benign (not cancerous). If it’s cancerous, additional tests may be necessary to determine the extent of the basal cell carcinoma, and a customized treatment plan will be developed for you.
Non-melanoma skin cancer staging
Staging determines how advanced a cancer is in a person and if it has spread to other parts of the body.
Basal cell carcinoma (BCC) is a type of non-melanoma skin cancer that doesn't have its own staging system like other cancers. Instead, BCC staging is grouped together in the same category as squamous cell carcinoma (SCC), another type of non-melanoma skin cancer.
Because BCC rarely spreads beyond the skin, instead of using stages, doctors look at different factors to decide if the cancer is at a lower or higher risk of coming back. These factors include details such as the tumor's location, size, shape and how deep it has grown into the tissues. By reviewing these factors, your doctors can figure out the risk level (and how likely it is for the cancer to return) and the best way to treat it.
Staging basal cell carcinoma of the head and neck
However, it’s important to note that basal cell carcinoma does have its own staging system that only applies to tumors on the head and neck. This system doesn’t apply to staging BCC on other parts of the body.
The following stages are used for basal cell carcinoma that’s located only on the head or neck:
Stage 0
Stage 0 cancer involves abnormal cells in the top skin layer (basal cells). These cells might turn cancerous and spread to nearby tissues. This stage is also known as carcinoma in situ.
Stage I
In stage I, cancer is present. The tumor is no bigger than two centimeters and may have one high-risk feature.
Stage II
In stage II, the tumor is either:
- Larger than two centimeters; or
- Any size with two or more high-risk features.
Stage III
In stage III, the tumor has extended to the jaw, eye socket or side of the skull. It may have also spread to a single lymph node on the same side of the body as the tumor, with the lymph node not exceeding three centimeters in size.
Or
Cancer has spread to one lymph node on the same side as the tumor, not exceeding three centimeters. The tumor is either:
- Not larger than two centimeters with one high-risk feature,
- Larger than two centimeters.
Stage IV
In stage IV, one of the following applies:
- The tumor can be any size and may have spread to the jaw, eye socket or skull. Cancer has spread to one lymph node on the same side as the tumor (larger than three centimeters but not larger than six centimeters) or to multiple lymph nodes (none larger than six centimeters).
- The tumor can be any size and may have spread to the jaw, eye socket, skull, spine or ribs, with cancer spreading to one lymph node larger than six centimeters.
- The tumor can be any size and has spread to the base of the skull, spine, or ribs; cancer may have spread to the lymph nodes.
- Cancer has spread to other parts of the body, such as the lung.
Staging basal cell carcinoma staging of the eyelid
Additionally, basal cell carcinoma of the eyelid doesn’t have its own staging system. Instead, the following stages are used for non-melanoma skin cancer on the eyelid, which includes both basal cell carcinoma and other types of eyelid skin cancer.
The TNM staging system is a globally recognized method for classifying the extent of how much cancer has spread. TNM stands for Tumor (T), Nodes (N), and Metastasis (M). The T category describes the size and extent of the primary tumor. N indicates whether and to what extent the cancer has spread to nearby lymph nodes. Lastly, M signifies whether the cancer has spread (metastasized) to other parts of the body.
This staging system provides a detailed picture of the cancer's progression, helping your doctor create the most effective treatment plan for you. If you have been diagnosed with non-melanoma skin cancer of the eyelid, you should talk to your doctor about what your TNM classification means and how it can impact your treatment options.
Tumor (T)
The Tumor category for non-melanoma skin cancer of the eyelid goes from T1 to T4. For example, T1 indicates that a small tumor hasn’t invaded deeper tissues while T4 may be a more advanced tumor that has grown into surrounding structures.
Nodes (N)
In some cases of non-melanoma skin cancer, the tumor can spread to nearby lymph nodes. For the N category, this can go from N0, meaning no evidence that the tumor has spread to the lymph nodes, to N2, which means it has.
Metastasis (M)
The M category refers to metastasis, which indicates if the non-melanoma skin cancer has spread to nearby areas. It ranges from M0, meaning no metastasis or M1, indicating spread of the tumor.
If you have received a basal cell carcinoma diagnosis or if you want a second opinion, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.