Work-up and Diagnosis of Basal Cell Carcinoma of the Skin (BCC)

Rodrigo Arrangoiz MS, MD, FACS, FSSO
  • Workup begins with a history and physical examination:
    • For patients with a suspicious lesion
  • At the time of diagnosis, patients with BCC:
    • Should be given a full-body skin examination:
      • Because these individuals often have additional, concurrent cancers at other locations
    • A shave, punch, or excisional skin biopsy:
      • May be used for diagnosis of any suspicious lesion:
        • The biopsy should include deep reticular dermis:
          • Because infiltrative histology will often be present only at the deeper, advancing margins of a tumor
      • A punch biopsy:
        • Ranges in size from 2 to 8 mm and involves removing a cylinder of tissue to the level of the subcutaneous fat
      • A shave biopsy:
        • Involves injecting local anesthesia into the epidermis and upper dermis and performing a tangential sample at the base of the wheal
      • Excisional biopsy:
        • Involves removal of the entire lesion with a margin of clinically clear tissue
  • Imaging studies:
    • Should be performed when extensive disease:
      • Such as bone involvement, perineural invasion, or deep soft tissue involvement, is suspected
Figure 3
Magnetic resonance image of a patient with locally advanced basal cell carcinoma of the back
  • Location, independent of size, may constitute high risk, and these areas are defined as L, M, and H
Table 1
#Arrangoiz #CancerSurgeon #SurgicalOncologist #HeadandNeckSurgeon #MountSinaiMedicalCenter #MSMC #Miami #Mexico

Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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