BCC generally has a clinical course characterized by slow growth, minimal soft tissue invasiveness, and a high cure rate. Occasionally, however, BCC behaves aggressively with deep invasion, recurrence, and potential regional and distant metastasis.
Aggressive-growth basal cell carcinoma (AG-BCC) defines a group of basal cell cancers that are histologically and clinically aggressive. This group includes morpheaform, infiltrating, and recurrent BCCs.
An advanced basal cell carcinoma is a BCC that has spread deeper into the tissue. It may look different on different people but is generally a solitary, shiny, bump with large blood vessels in it. It is generally slow growing but should be treated immediately.
For example, your tumor might be more aggressive. That means it grows faster and is deeper than typical BCC.
The overall 5-year recurrence rate has been estimated to be around 4–5 % [5]. Surgery and radiotherapy are the treatment of choice for most patients with high-risk lesions [6]. Despite that advanced disease is rare, BCC can progress to a point unsuitable for local therapy and prognosis for these patients is quite poor.
Stage 4 basal cell carcinoma
In stage 4, the cancer can be any size and has spread (metastasized) to one or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
The mortality rate for BCC is approximately 0.05% However, it is not something that you want to ignore and leave untreated. Basal Cell Carcinoma (BCC) is still a cancer and is locally invasive, aggressive and can cause considerable disfigurement by locally destroying skin, cartilage and even bone.
BCC is considered advanced when it has grown wide and deep into the skin; or has spread or cannot be cured by surgery or radiation after multiple treatments. Locally advanced BCC can look different on everyone. The following photos are examples of what locally advanced BCC might look like on different people.
The cancer is the result of cumulative damage of years spent in the sun, and may take 20 years to manifest. Although it's often more common in older people, it can occur in younger adults, too. Basal cell carcinoma spreads very slowly and very rarely will metastasize, Dr. Christensen says.
The currently accepted treatment of basal cell carcinoma is an elliptical excision with a 4-mm surgical margin of clinically normal skin [9].
There can be a wait up to a few months. BCC is the most common type of non melanoma skin cancer. It generally takes years to develop in most people. So waiting a short time is unlikely to do any harm.
Survival for most non-melanoma skin cancers is excellent. The 5-year relative survival for BCC is 100%.
If you've already had a BCC, you are at risk for developing others over the years, either in the same area or elsewhere on the body. You are also at increased risk of developing other forms of skin cancer, including squamous cell carcinoma (SCC) and melanoma.
Basal cell cancer is the most common form of skin cancer, accounting for nearly 80% of all skin cancers. Basal cell cancers arise from abnormal basal cells in the skin. It is rarely fatal, but it can be locally aggressive.
However, basal cell carcinomas typically don't hurt, and patients rarely feel anything out of the ordinary. Instead, the warning signs are primarily visual.
Basal cell carcinoma (BCC) is a type of skin cancer that can show up on the skin in many ways. Sometimes, it can be mistaken for a harmless pimple, scar, or sore. Most basal cell carcinoma's grow slowly.
For basal cell carcinoma, 2 or more of the following features may be present: An open sore that bleeds, oozes, or crusts and remains open for several weeks. A reddish, raised patch or irritated area that may crust or itch, but rarely hurts.
How dangerous is basal cell carcinoma, and how likely is it to spread? When found early, this type of skin cancer is highly treatable. Most basal cell carcinomas grow slowly, do not spread in the bloodstream or lymph nodes and are typically not a threat to life if they are not neglected.
During electrodessication and curettage, an outpatient procedure, doctors numb the skin using a local anesthetic and scrape off cancer cells with a tool called a curette, a small scoop that has sharp edges. They then apply electricity with a probe to stop any bleeding. This process is repeated several times.
There is no staging system for basal cell and squamous cell carcinoma because they are so often curable and usually do not spread to other parts of the body.
Death from basal and squamous cell skin cancers is uncommon. It's thought that about 2,000 people in the US die each year from these cancers, and that this rate has been dropping in recent years.
While basal cell skin cancer does not usually respond to chemotherapy, it often responds to a targeted drug called vismodegib, sold as Erivedge®. This targeted medication helps disrupt the activity of a group of proteins in the body called hedgehog. In children, these proteins tell healthy cells to grow and divide.
The tumors enlarge very slowly, sometimes so slowly that they go unnoticed as new growths. However, the growth rate varies greatly from tumor to tumor, with some growing as much as ½ inch (about 1 centimeter) in a year. Basal cell carcinomas rarely spread (metastasize) to other parts of the body.