Basal cell carcinoma (BCC) subtype identified on biopsy and excision specimens is the best predictor of depth of invasion, according to a study published online April 16 in the Journal of the American Academy of Dermatology.
Michael Jude Welsch, M.D., from the Penn State Milton S. Hershey Medical Center, and colleagues studied histologic specimens from 100 BCC biopsy samples. Anatomic site; histologic subtype; maximum depth of extension; contour of the lobules at the leading edge; elastosis features; and the incidence of necrosis, calcification, and ulceration were noted, and their correlation with depth of invasion was assessed.
The researchers found 62 percent concordance between the subtype of biopsy and excision specimen. The greatest mean depth was seen for micronodular tumors, followed by infiltrative, nodular, and superficial subtypes. Depth was significantly correlated to subtype from biopsy and excision, and this association was superior to age, contours of the excision specimens, presence of necrosis, and the extent of excisional solar elastosis. Depth was not correlated with gender, anatomic site, contours of biopsy specimens, elastosis color, elastosis type, the presence of ulceration, or calcification.
"Morphologic subtype has the highest correlation with depth and reporting should reflect the highest risk growth pattern if a biopsy specimen contains more than one pattern," the authors write.
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For a case of basal cell carcinoma occurring in a vaccination scar, read the article "Basal Cell Carcinoma Arising in a Bacille Calmette-Guérin Vaccination Scar."