Treatment of Recurrent, Aggressive, or High-Risk Basal Cell Carcinoma
This protocol addresses basal cell carcinoma (BCC) presenting with features that elevate the risk of incomplete removal or local recurrence—situations where the choice of surgical technique and the rigour of margin verification carry decisive clinical weight.
Clinical Scenario
This management pathway applies when any of the following high-risk features is present:
- Recurrent basal cell carcinoma
- Aggressive histopathological subtype
- Location on a critical anatomical site
- Poorly defined tumour margins
- Perineural invasion
- Multiple basal cell carcinomas
Surgical Approach
For these high-risk presentations, the intervention centres on controlled surgical excision with systematic margin assessment. The specific technique—and the criteria governing its selection—are laid out in the full structured protocol. The complete decision algorithm remains in the regimen.
Treatment Goal
Complete resection with histologically confirmed tumour-free surgical margins.
References
DOI: 10.1016/j.ejca.2023.113254
- Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites.
- Micrographically controlled surgery (3D) shall be offered in high-risk BCC (recurrent, aggressive subtypes, location in critical anatomical sites, poorly defined margins)
- Incompletely excised BCC lesions, particularly high-risk BCCs, and those incompletely removed at the deep margin, shall be re-excised