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. 2023 Oct 30:6:e50309.
doi: 10.2196/50309.

The Importance of Basal Cell Carcinoma Risk Stratification and Potential Future Pathways

Sharad Paul  1   2 , Allanah Knight  2
Affiliations

The Importance of Basal Cell Carcinoma Risk Stratification and Potential Future Pathways

Sharad Paul et al. JMIR Dermatol. .

Abstract

Background: Basal cell carcinoma (BCC) is the most common human cancer. Although there are surgical and topical treatments available, surgery remains the mainstay of treatment, leading to higher costs. What is needed is an accurate risk assessment of BCC so that treatments can be planned in a patient-centered manner.

Objective: In this study, we will review the literature about guidelines for the management of BCC and analyze the potential indicators of high-risk BCC. Using this risk assessment approach, we will propose pathways that will be able to optimize treatments more efficiently.

Methods: This paper presents a perspective from a skin cancer expert and clinic involved in the treatment of both simple and complex cases of BCC. It addresses the key challenges associated with accurate risk stratification prior to any treatment or procedure. Different immunohistochemical and angiogenic markers for high-risk BCC were reviewed in this study.

Results: The expression of interleukin-6, vascular endothelial growth factor, and mast cells within BCC correlates with its aggressiveness. Other immunohistochemical markers, such as Cyclin D1 and Bcl-2, also play a significant role-Cyclin D1 is higher in the aggressive BCC, while Bcl-2 is lower in the aggressive BCC, compared to the nonaggressive variants.

Conclusions: Based on our research, we will conclude that using immunohistochemical and angiogenic markers for risk assessment and stratification of BCC can help optimize treatment, ensuring that surgical procedures are used only when necessary.

Keywords: BCC; angiogenic; angiogenic agents; angiogenic marker; basal cell carcinoma; cancer; carcinoma; dermatology; histology; immunohistochemistry; management; markers; risk assessment; skin; skin cancer; surgery; tumour markers.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Basal cell carcinoma (clinical appearance); low risk nodular BCC and high risk infiltrating BCC.
Figure 2
Figure 2
Basal cell carcinoma (histology); low risk nodular BCC and high risk infiltrating BCC.
Figure 3
Figure 3
Clinical and pathological parameters to determine basal cell carcinoma (BBC) risk (adapted from Badash et al [9]).
See this image and copyright information in PMC

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