Basal cell carcinoma: An updated review of pathogenesis and treatment options

Abstract

Basal cell carcinoma (BCC) remains the most common malignancy worldwide. BCC pathogenesis is a result of the interplay between one's environment, genetics, and phenotypic factors. BCC has a low mortality but given its increasing incidence and potential to cause local destruction thus resulting in significant morbidity, it is vital for dermatologists to remain up to date with recent updates in this malignancy's pathogenesis and treatment. This article provides a comprehensive review of the pathogenesis of BCC as well as the current treatments available and clinical trials underway. We also touch upon the updated National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology in respect to BCC's recommended treatment modalities.

The top 100 most cited articles in the treatment of basal cell carcinoma over the last decade: A bibliometric analysis and review

“…Impressively, post-SSE, the 5-year disease-free rate reportedly exceeds 98%. [ 20 ] A 2021 retrospective study comparing SSE with nonsurgical interventions in 68 BCC patients highlighted SSE’s superior efficacy. Moreover, integrating SSE with repair techniques outperformed nonsurgical and ablative therapies.…”

“…The Hh pathway is crucial in embryonic development, cell growth regulation, and tissue homeostasis, with around 90% of BCC cases linked to the hyperactivation of Hh proteins. [ 20 ] HPIs have risen as a significant treatment for locally advanced BCC (LaBCC) and metastatic BCC (mBCC). [ 18 , 25 ] LaBCC denotes the intricate scenario where a tumor either remains untreated for an extended period or persistently resists and recurs posttreatment, often leading to extensive tissue destruction that makes surgical or radiotherapeutic interventions impracticable.…”

Recurrent Deeply Invasive Basal Cell Carcinoma

“…Surgical excision is widely considered the gold standard for BCC treatment, particularly when diagnosed earlier, and is therefore the most common treatment 2,5,8 . The National Comprehensive Cancer Network currently recommends surgical excision for the following patients: those with low-risk BCC using 4-mm clinical margins and those with high-risk BCC using wider margins with linear or delayed repair with conventional re-excision 3,4,9 .…”

“…However, they may be destructive to surrounding tissues since they are locally invasive 4 . And even with the appropriate treatment, there is a considerable risk of BCC recurrence 5 …”

Non‐invasive imaging techniques in presurgical margin assessment of basal cell carcinoma: Current evidence

“…Basal cell carcinoma (BCC) is the most frequent skin tumour with an ever-increasing incidence due to chronic photoexposure, advanced age and immunosuppression. 1 The new diagnosed annual cases are about 3.6 million, 2 although the exact number is not known due to lack of non-melanoma skin cancer (NMSC) registries. 3 The EADO guidelines simplified the classification in common, locally advanced and rare metastatic BCC.…”