Basal cell carcinoma: what is it? See symptoms, types and photos

What is basal cell carcinoma?

Basal cell carcinoma (BCC), also called basalioma , is a skin cancer that develops in the basal cells, that is, in the outer layer of the skin.

It rarely spreads to other parts of the body, but it can grow and destroy adjacent cells. It is the most common type of skin cancer and often appears in regions exposed to the sun such as the face, neck and hands.

This type of cancer is more common in light-skinned people and is more rare in dark skin. It is the least aggressive of skin cancers and is often cured.

It can be dangerous when located close to the brain or bones. In 70% of the cases it appears in the nose, but it is also common in other parts of the face, such as in the ears, neck, scalp, back and shoulders.

The disease can be found at ICD-10 (International Classification of Diseases) using code C44.

Types

There are several patterns in which basal cell carcinoma can settle. They are the same disease, but each has its own peculiarities.

Nodular-ulcerativo

This type of BCC often binds to the epidermis. It is formed by large tumor islands in the dermis. They can be round or oval. This is the most common type of basal cell carcinoma.

Micronodular

This type of BCC is similar to nodular-ulcerative, but its cell groupings are very small. It is the most aggressive type and can spread more easily to the surroundings.

Pigmented

In  pigmented basal cell carcinoma , the cancer forms round or oval tumor islands of dark color due to accumulations of melanin, the skin pigment.

Cystic

The cystic basal cell carcinoma has a wide round or oval shape and there are secretions in its center.

Infiltrative

Infiltrative BCC is common and aggressive. Your cells infiltrate the skin’s collagen.

Morfeico

The cells of this type of CBC form dense connective tissue.

Superficial

Superficial basal cell carcinoma adheres to the epidermis, the surface of the skin.

Causes

Like all cancers, basal cell carcinoma is caused by erratic and uncoordinated cell multiplication. This multiplication can be caused by several factors. Are they:

Excessive exposure to the sun

Especially in childhood and adolescence, frequent and unprotected exposure to strong sun can cause cellular mutation. The mutation can take 10 to 50 years to manifest as a carcinoma.

Exposure to chemical agents

Arsenic (found in fertilizers) and tar (present in cigarettes) can cause cellular changes that can develop into cancer.

Exposure to ionizing radiation

Ionizing radiation is any electromagnetic wave capable of detaching atoms from molecules. We are exposed to ionizing radiation all the time, coming from the planet’s own electromagnetic field or from space, but there are artificial sources that can make a difference. For example, X-ray machines use ionizing radiation to obtain your images.

Using the X-ray machine once is not enough to cause cancer, but people who work with the device need to wear protection such as lead aprons, as prolonged and daily exposure for years of work can be harmful.

Groups of risk

Clear Skin

The fair skin facilitates the development of skin cancers due to the greater sensitivity to ultraviolet rays (UV).

UV exposure

Most ultraviolet rays are emitted by the sun, but it is possible to be affected by them in tanning beds. They are divided into UV-A, UV-B and UV-C.

UV-C rays are completely absorbed by the atmosphere and are not a concern, but UV-B and UV-A rays can reach the Earth’s surface. They are primarily responsible for burns and skin cancer.

Constant exposure to ultraviolet rays can cause mutations in skin cells, which can cause cancer, but in low doses they are beneficial and are necessary for the production of vitamin D.

Radiotherapy

Radiotherapy is a type of treatment that uses radiation to reduce the size of tumors. Despite its use in cancer treatment, including basal cell carcinoma, exposure to uncontrolled radiation can lead to different cancers.

When radiation therapy is used to treat cancer in an internal organ, radiation must pass through the skin and this can facilitate the appearance of carcinomas.

X ray

X-rays also use radiation. The amount of radiation used in an X-ray exam is less than that of a radiotherapy treatment, but the repetition and prolonged exposure can be the cause of cellular changes that cause cancer.

Exposure to arsenic

Arsenic is a material that is released in volcanic eruptions, but that can be found in several places, from the atmosphere to the water. Exposure to this material can cause cancers.

Family history

If someone in your family has had basal cell carcinoma, your chances of having the disease are higher than that of someone who does not have it in your family history.

Advanced age

The main cause of basal cell carcinoma is exposure to the sun. The older a person is, the longer their skin has had exposure to sunlight and the higher the chance of developing skin cancer.

Men

Approximately 35% of men develop basal cell carcinoma while only 25% of women suffer from the condition.

Low immunity

When the immune system is deficient, it has greater difficulty in preventing the erratic growth of cells in the body, which facilitates the development of cancer.

Symptoms

Basal cell carcinoma is a non-aggressive skin cancer that appears most frequently in regions affected by the sun, such as the face, neck and hands, but nothing prevents it from appearing elsewhere. The tumor can have several aspects.

Lesions that do not close

An injury that does not heal for weeks can be a sign of basal cell carcinoma. It can heal and bleed again in a while.

Reddish spot

Often on the face, a red or pink spot can be a sign of BCC. This lesion can form an itchy crust, but it can stay in place without causing any discomfort.

Pink tumor

A small, hard lump with crusts in the center may appear. It grows slowly and continuously and can be accompanied by blood vessels on the surface. It is a sign of skin cancer.

Irregular “paint”

In some types of basal cell carcinoma, the tumor can be mistaken for a nevus or mole. Its shape is usually irregular. It appears as a shiny lump that may be pink, red or white in color, but in dark-haired people it may appear brown or black, which causes confusion with spots.

Scar appearance

With a light color, the tumor may have the appearance of a scar with undefined edges. It is brilliant and is a sign of an invasive tumor.

REGRA ABCD

You can perform a self-examination to identify an early-stage carcinoma. Only the doctor can make the diagnosis, but it is good to have this knowledge to know when to go to the doctor to investigate.

Each letter represents a characteristic to look for in a spot found on the skin that is under suspicion.

Asymmetry

Imagine a line in the middle of the dot and check that the two sides are the same. The lack of symmetry is usually a sign that the cells are reproducing erratically, so if the mole does not have the same two sides, it can be a sign that it is a skin cancer.

Jagged edges

If the edges are serrated or in any way irregular, it is good to go to the doctor to investigate further.

Cor

The spots should be only one color. If there are several colors in it, it could be a sign of skin cancer.

Diameter

Dots don’t grow. If your spot is increasing in size over time, go to the doctor to investigate.

Pictures of basal cell carcinoma

Here you can see images of some types of basalioma. Not everyone will look like these, but some might look like this

How is the diagnosis made?

It is common for the dermatologist to be able to identify a basal cell carcinoma on a physical examination through dermatoscopy , which uses a magnifying glass to analyze the skin, however, as a guarantee and for the differential diagnosis of a melanoma (the type of cancer of more aggressive skin) other tests are usually performed.

Dermatoscopia digital

Digital dermatoscopy uses enlarged digital photographs of the patient’s entire skin. The exam shows in detail what may or may not be skin cancer.

Microscopia confocal

To perform this image examination, a diode laser is used as a light source so that a machine can view the details of the cellular structure of the skin. The resolution of the images is close to that of a microscope and it is not necessary to cut the tissue.

Biopsy

For the biopsy, a piece of tumor tissue is extracted and analyzed under a microscope to identify the cells present. From the biopsy the diagnosis is made.

Is basal cell carcinoma curable?

Despite being a cancer, when in its initial stages, its cure rate is close to 100%. The larger the tumor, the more extensive the treatment. Although there is rarely metastasis of BCC, it can spread to surrounding tissues, making treatment more prolonged.

What is the treatment?

There are some methods of treating basal cell carcinoma. Your choice depends on the depth, location, size and age of the patient, in addition to the aesthetic result. The treatment can usually be carried out in the doctor’s office and the need for hospitalization is rare. Are they:

Curettage and electrodissection

This treatment is usually used for small tumors and has a cure rate of approximately 95%. It usually forms a white, round scar and therefore may not be recommended for the face, where cosmetic results are undesirable.

The treatment consists of anesthetizing the area, which is then scraped with a curette , a cutting device with a ring-shaped head. Then, an electrocautery pen destroys tumor waste and prevents bleeding.

CO2 laser

The CO2 laser destroys cancer cells by heat, as well as electrodissection, but it is more accurate and saves the region. It is recommended for more superficial tumors. This laser can also reduce scarring caused by other treatments.

Interferon alfa

Interferon is a protein that is used in the treatment of various skin diseases, from bacterial and fungal infections to tumors. The protein is injected directly into the tumor and helps the body fight cancer cells. Studies show a cure rate of 86 to 96%.

The advantage of this treatment is that it leaves no scars or aesthetic sequelae. However, it is necessary to have many visits to the doctor. Treatment lasts 3 weeks and 3 injections per week are required.

Mohs micrographic surgery

Mohs micrographic surgery is a meticulous technique. It consists of removing a thin layer of tumor tissue. This layer is then analyzed under a microscope, where the tumor cells are identified.

Then, another layer is removed and the process is repeated until there are no tumor cells in the removed layer, which means that the entire tumor has been removed.

Although laborious, the technique is accurate. She is able to remove the tumor completely, removing as little of the healthy skin as possible.

Usually, the removal of a tumor involves a safety margin that is based on the surgeon’s view, while in Mohs’ technique the microscope is used, reducing margins of error.

This technique is used in places like the face, as it damages the least possible healthy tissue and also has the highest cure rate, reaching 98%.

Surgical excision

With local anesthesia and the use of a scalpel, the tumor is removed entirely within a safe margin of healthy skin. The removed tissue is sent to a laboratory that will analyze whether the entire tumor has been removed under a microscope.

If the test indicates that there are still tumor cells, the excision can be repeated. This technique has a cure rate of 95% as well as curettage and electrodissection.

Radiotherapy

Using radiation, radiotherapy does not require cuts or anesthesia. The radiation is thrown at the tumor and its cells are destroyed. The process needs to be repeated several times over the course of a few weeks.

Radiotherapy can be used in tumors where surgery is complicated or in old age or poor health stages, when cuts and anesthesia can be problematic. The cure rate is 90% as there is no precise control over the identification of tumor cells.

The radiation damage affects only the region adjacent to the tumor, but there may be aesthetic problems. In addition, radiation can cause another skin cancer in later years.

Cryosurgery

This treatment can be used in patients with sensitivity to anesthesia and with bleeding problems. It consists of using liquid nitrogen to freeze the tumor, which falls in the days following the application.

Its cure rate varies between 85 and 90% and this method is not usually used. It is a very effective method against superficial tumors.

Topical medications

There are some topical medications that can be used. They are only approved for specific tumors. This treatment has an 80 to 90% cure rate and is only used in superficial tumors. Its main disadvantage is that there is no way to verify how much of the tumor was removed or whether the removal was complete.

Relapse

Patients who have had BCC are more likely to have the disease again over the years. After receiving a diagnosis, visits to the dermatologist should become routine.

The doctor should look all over the skin for signs of skin cancer, not just where he has been. Basal cell carcinoma in the nose or scalp are especially prone to relapse.

Medicines for basal cell carcinoma

Treatment for basal cell carcinoma does not usually require medication, but there are cases where they are used:

Topical treatment

  • Imiquimode;
  • Fluorouracil (Utoral).

Metastatic BCC

On the rare occasions when BCC metastasizes and surgical removal is not possible, there is a drug that can be used to remove the tumor. In cases where there is metastasis, basal cell carcinoma is tremendously advanced and the chances of a cure are greatly reduced.

The medicine used in these cases is Vismodegibe .

Attention!

NEVER  self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Prognosis

When found early, basal cell carcinoma has healing rates of almost 100%. He is not an aggressive cancer, his growth is slow and he rarely metastasizes.

Relapse can happen, but if the patient is attentive, just repeat the treatment. After treating a BCC, the patient can lead a perfectly normal life.

Complications

When left untreated, BCC can spread and damage tissues adjacent to the tumor. Its growth is slow, but present. The wounds opened by him can cause infections and, depending on the region where he is, it can affect the eyes.

Large injuries or that affect vessels or nerves increase the chances of recurrence.

Although rare, basal cell carcinoma can metastasize . This means that your cells can spread to other parts of the body. CBC is a  non- aggressive cancer but it is still a cancer  that is capable of killing and its treatment is indispensable.

The organs most commonly affected by basal cell carcinoma metastasis are the lymph nodes, lungs, bones and liver.

How to prevent

Although BCC is curable and not very aggressive, prevention is even more appropriate. There are a few ways to prevent skin cancer.

Know your skin

Knowing your skin is an important step. Knowing where there are stains and spots can facilitate the search for cancers that present themselves as new marks on the body.

Shade at peak solar times

Between 10 am and 4 pm is when the sun is at its strongest. Avoid being exposed to sunlight for a long time, especially at these times.

Use sunscreen

Avoiding sunburn reduces your chances of developing skin cancer. This is especially important for children and adolescents. Always use a broad spectrum sunscreen ( UVA / UVB) of SPF 15 or higher.

When staying in the sun for extended periods, it is recommended to use a water-resistant protector with SPF 30 or higher. Reapplication is necessary when there is excessive sweat or after swimming.

Protect newborns

Sunscreen cannot be used on babies under 6 months of age, so they must be protected from the sun.

Do self-exams and see a doctor

Look for signs of skin cancer frequently and go to your dermatologist for a complete skin exam once a year.

Common questions

Some doubts may exist:

Can basal cell carcinoma become melanoma?

No. They are different cancers precisely because of the type of cell affected. Basal cell carcinoma affects basal cells while melanoma originates from melanocytes. One cannot become the other.

If I already had basal cell carcinoma can I have it again?

Yes. If all the tumor tissue has been removed, it does not grow back, but nothing prevents another tumor from appearing.

In addition, if you have already had one, you are in the risk group to have another. But don’t worry, another basal cell carcinoma will have the same severity as the first. Do the self-examination and visit the dermatologist regularly.

Carcinoma basocelular mata?

It can kill, but its healing rate is extremely high, especially when found at the beginning. The disease should not be taken lightly as it is still a cancer , but it is one of the cancers with the highest cure rate and lowest mortality.


Basal cell carcinoma is a type of skin cancer that is not very aggressive and has high cure rates. However, prevention is very important and the use of sunscreen is essential to avoid developing this disease.

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