Abstract
Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.
Original language | English (US) |
---|---|
Pages (from-to) | 540-559 |
Number of pages | 20 |
Journal | Journal of the American Academy of Dermatology |
Volume | 78 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2018 |
Keywords
- basal cell carcinoma
- biopsy
- curettage
- metastasis
- phototherapy
- radiotherapy
- staging
- surgery
- surveillance
- topical therapy
ASJC Scopus subject areas
- Dermatology
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Guidelines of care for the management of basal cell carcinoma. / Work Group; Invited Reviewers.
In: Journal of the American Academy of Dermatology, Vol. 78, No. 3, 03.2018, p. 540-559.Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Guidelines of care for the management of basal cell carcinoma
AU - Work Group
AU - Invited Reviewers
AU - Bichakjian, Christopher
AU - Armstrong, April
AU - Baum, Christian
AU - Bordeaux, Jeremy S.
AU - Brown, Marc
AU - Busam, Klaus J.
AU - Eisen, Daniel B.
AU - Iyengar, Vivek
AU - Lober, Clifford
AU - Margolis, David J.
AU - Messina, Jane
AU - Miller, Alexander
AU - Miller, Stanley
AU - Mostow, Eliot
AU - Mowad, Christen
AU - Nehal, Kishwer
AU - Schmitt-Burr, Kristi
AU - Sekulic, Aleksandar
AU - Storrs, Paul
AU - Teng, Joyce
AU - Yu, Siegrid
AU - Huang, Conway
AU - Boyer, Kevin
AU - Begolka, Wendy Smith
AU - Alam, Murad
AU - Kim, John Y.S.
AU - Kozlow, Jeffrey H.
AU - Mittal, Bharat
AU - Moyer, Jeffrey
AU - Olencki, Thomas
AU - Rodgers, Phillip
N1 - Funding Information: April Armstrong, MD, MPH, served as an advisory board member for Abbvie, Amgen, Janssen-Ortho, Merck, Novartis, Pfizer and UCB, receiving honoraria; as a consultant for Celgene, Eli Lily, Jannsen-Ortho, and Modernizing Medicine, receiving honoraria; as a speaker for Abbvie, receiving honoraria; and as a principal investigator (PI) for Eli Lily, Janssen-Ortho, Novartis, and Regeneron, receiving grants/research funding. Jeremy S. Bordeaux, MD, MPH, served as an advisory board member for Lubax, receiving honoraria; as an employee of Massachusetts General Hospital, receiving a salary; and in another role with Journal Watch Dermatology, receiving honoraria. Marc Brown, MD, served as an advisory board member for DUSA Pharmaceuticals, receiving no compensation. David J. Margolis, MD, PhD, served as an advisory board member for Astellas, Celleration, and Kerecis, receiving fees; as a PI for Valeant, receiving grants/research funding; and as a Data Safety Monitoring Board member for DermaSciences, Macrocure, and Sanofi/Regeneron, receiving fees. Stanley Miller, MD, served as an employee of UpToDate, Inc, receiving patent royalties and other compensation. Eliot Mostow, MD, MPH, served as a consultant for Elsevier, receiving a salary; as a speaker and PI for Healthpoint, receiving honoraria and grants/research funding; and as an advisory board member for Vivacare, receiving honoraria. Christen Mowad, MD, served on the board of directors for Elsevier, receiving honoraria; in other roles with UpToDate, Inc, receiving patient royalties and other compensation; and as a PI for Amgen, receiving fees. Dr Mowad also had a relative serving as an employee of Takeda Pharmaceuticals, receiving a salary. Aleksander Sekulic, MD, PhD, served as an advisory board member for Roche and as a PI for Genentech, receiving fees. Conway Huang, MD, served as a consultant for Castle Biosciences, Inc, receiving honoraria. Murad Alam, MD, served as a consultant for Amway, receiving honoraria, and as a PI for OptMed and 3M, receiving no personal compensation. Thomas Olenecki, DO, served as a PI for BMS, Exelixis, Genentech, Pfizer, and Tracon, receiving grants and research funding. Christopher Bichakjian, MD, Christian Baum, MD, Klaus J. Busam, MD , Daniel B. Eisen, MD, Vivek Iyengar, MD , Clifford Lober, MD, JD, Jane Messina, MD , Alexander Miller, MD, Kishwer Nehal, MD, Kristi Schmitt-Burr, Paul Storrs, MD, Joyce Teng, MD, PhD, Siegrid Yu, MD, John Y.S. Kim, MD, Jeffrey H. Kozlow, MD, MS, Bharat Mittal, MD, Jeffrey Moyer, MD, Phillip Rodgers, MD, Kevin Boyer, MPH, and Wendy Smith Begolka, MBS, have no relevant relationships to disclose. Funding Information: We thank Charniel McDaniels, MS, for technical assistance in development of this manuscript. We also thank the AAD Board of Directors, the Council on Science and Research, the Clinical Guidelines Committee, and all commenting Academy members for their thoughtful and excellent feedback. The AAD strives to produce clinical guidelines that reflect the best available evidence supplemented with the judgment of expert clinicians. Significant efforts are taken to minimize the potential for conflicts of interest to influence guideline content. The management of conflict of interest for this guideline complies with the Council of Medical Specialty Societies’ Code of Interactions with Companies. Funding of guideline production by medical or pharmaceutical entities is prohibited, full disclosure is obtained and evaluated for all guideline contributors throughout the guideline development process, and recusal is used to manage identified relationships. The AAD conflict of interest policy summary may be viewed at www.aad.org. Disclosure: The below information represents the authors’ disclosed relationships with industry during guideline development. Relevant relationships requiring recusal for drafting of guideline recommendations and content by work group members were not noted for this guideline. April Armstrong, MD, MPH, served as an advisory board member for Abbvie, Amgen, Janssen-Ortho, Merck, Novartis, Pfizer and UCB, receiving honoraria; as a consultant for Celgene, Eli Lily, Jannsen-Ortho, and Modernizing Medicine, receiving honoraria; as a speaker for Abbvie, receiving honoraria; and as a principal investigator (PI) for Eli Lily, Janssen-Ortho, Novartis, and Regeneron, receiving grants/research funding. Jeremy S. Bordeaux, MD, MPH, served as an advisory board member for Lubax, receiving honoraria; as an employee of Massachusetts General Hospital, receiving a salary; and in another role with Journal Watch Dermatology, receiving honoraria. Marc Brown, MD, served as an advisory board member for DUSA Pharmaceuticals, receiving no compensation. David J. Margolis, MD, PhD, served as an advisory board member for Astellas, Celleration, and Kerecis, receiving fees; as a PI for Valeant, receiving grants/research funding; and as a Data Safety Monitoring Board member for DermaSciences, Macrocure, and Sanofi/Regeneron, receiving fees. Stanley Miller, MD, served as an employee of UpToDate, Inc, receiving patent royalties and other compensation. Eliot Mostow, MD, MPH, served as a consultant for Elsevier, receiving a salary; as a speaker and PI for Healthpoint, receiving honoraria and grants/research funding; and as an advisory board member for Vivacare, receiving honoraria. Christen Mowad, MD, served on the board of directors for Elsevier, receiving honoraria; in other roles with UpToDate, Inc, receiving patient royalties and other compensation; and as a PI for Amgen, receiving fees. Dr Mowad also had a relative serving as an employee of Takeda Pharmaceuticals, receiving a salary. Aleksander Sekulic, MD, PhD, served as an advisory board member for Roche and as a PI for Genentech, receiving fees. Conway Huang, MD, served as a consultant for Castle Biosciences, Inc, receiving honoraria. Murad Alam, MD, served as a consultant for Amway, receiving honoraria, and as a PI for OptMed and 3M, receiving no personal compensation. Thomas Olenecki, DO, served as a PI for BMS, Exelixis, Genentech, Pfizer, and Tracon, receiving grants and research funding. Christopher Bichakjian, MD, Christian Baum, MD, Klaus J. Busam, MD Daniel B. Eisen, MD, Vivek Iyengar, MD Clifford Lober, MD, JD, Jane Messina, MD Alexander Miller, MD, Kishwer Nehal, MD, Kristi Schmitt-Burr, Paul Storrs, MD, Joyce Teng, MD, PhD, Siegrid Yu, MD, John Y.S. Kim, MD, Jeffrey H. Kozlow, MD, MS, Bharat Mittal, MD, Jeffrey Moyer, MD, Phillip Rodgers, MD, Kevin Boyer, MPH, and Wendy Smith Begolka, MBS, have no relevant relationships to disclose. Publisher Copyright: © 2017 American Academy of Dermatology, Inc.
PY - 2018/3
Y1 - 2018/3
N2 - Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.
AB - Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.
KW - basal cell carcinoma
KW - biopsy
KW - curettage
KW - metastasis
KW - phototherapy
KW - radiotherapy
KW - staging
KW - surgery
KW - surveillance
KW - topical therapy
UR - http://www.scopus.com/inward/record.url?scp=85047730231&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047730231&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2017.10.006
DO - 10.1016/j.jaad.2017.10.006
M3 - Article
C2 - 29331385
AN - SCOPUS:85047730231
VL - 78
SP - 540
EP - 559
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
SN - 0190-9622
IS - 3
ER -