Basal Cell Carcinoma Skin Cancer - BCC

Reconstructive Basal Cell Carcinoma Skin Cancer Surgery by an Experienced Expert Plastic Surgeon Dr. Costanzo

Dr. Costanzo, Board Certified Plastic Surgeon has years of experience treating Skin Cancers, Melanoma, Squamous Cell Carcinoma and Basal Cell Carcinoma and then Reconstructing with Skin Grafts, Skin Flaps, Z-Plasty and Tissue Rearrangement, serving Thousand Oaks, Beverly Hills, Los Angeles, Encino, Calabasas, Ventura, Simi Valley, Sherman Oaks, Tarzana, Woodland Hills, Santa Barbara, Oxnard, Orange & Riverside County

CHARACTERISTICS OF BASAL CELL CARCINOMA (BCC)

Most Common Form- skin cancer

Sun Exposure & Sun Burns- are a direct cause for development, sometimes taking 20 - 30 years to grow

"Rodent Ulcers"- another term for BCC, because if left neglected they can burrow through skin, muscle and bone

Metastases- rarely does BCC spread to other organs

Appearance

Elevated, pearly white colored, irregular shaped and ulcerated lesion is the most common form

Pigmented, nodular shaped or irritated reddish plaque are can also characterize a BCC

TREATMENT

• Complete surgical excision is the primary mode
• Cryotherapy (freezing), Topical 5 - Fluorouracil may have value in very early BCC
• Radiation therapy can be used to help maintain local spread of the disease

WHAT IS MOH'S SURGICAL TREATMENT?

This is a form of serial excision where the skin cancer is removed, the specimen then placed on a grid and inspected under a microscope. The tumor cells are then mapped out. If the cells involve or come close to the cut surgical margin, further skin is removed precisely in the mapped out area. The process is repeated until no tumor cells are visible under the microscope

WHAT IS RAPID FROZEN SECTION (RFS) ?

The skin cancer is removed and then the tissue specimen is frozen. Next, several cuts are made through the frozen tissue and inspected for tumors cells either close or touching the surgical excisional margin. If the cells are found in this area, another specimen of skin is removed, analyzed in a similar manner and repeated until no tumor cells are present under the microscope. Since the skin cancer is not completely mapped out and only isolated areas are looked at, rapid frozen section has only about a 95% accuracy rate. Therefore, about 5% of the time, when the same tissue specimen is examined fully a few days later, tumor cells may be found to be present, thereby requiring further treatment

Advantages and Disadvantages of Either Moh's or Rapid Frozen Section Treatment

Moh's has the advantage of a more accurate initial analysis of the tissue. This is of value in areas where preservation of skin is important for reconstruction of the area, such as the nose and lip. The main disadvantage of Moh's is that it might take several hours to complete. Moh's is many cases is unnecessary and time consuming, especially in those areas of the face and body which have plenty of skin available for reconstruction