Narrow‐margin excision is a safe, reliable treatment for well‐defined, primary pigmented basal cell carcinoma: an analysis of 288 lesions in Japan

Publisher： John Wiley & Sons Inc

E-ISSN： 1468-3083|29|9|1828-1831

ISSN： 0926-9959

Source： JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Vol.29, Iss.9, 2015-09, pp. : 1828-1831

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Abstract

AbstractBackgroundComplete excision is the most promising treatment for basal cell carcinoma (BCC) and a surgical margin of at least 4 mm is recommended. However, little is known about the appropriate surgical margin of pigmented BCC.ObjectiveTo investigate the reliability of narrower margin excision of well‐defined, pigmented BCC.MethodsWe identified a total of 263 patients with 288 well‐defined, primary pigmented BCC at the Department of Dermatology, Kyushu University (Fukuoka, Japan), between January 2006 and December 2013. All lesions were surgically excised with 1–6‐mm margins and analysed. For 30 recent lesions out of the 288 lesions, border gaps between dermoscopy and histopathology were assessed.ResultsOf the 288 lesions, 218 (75.7%) were excised with a narrow margin (≤3 mm) and 60 lesions (24.3%) with a wide margin (≥4 mm). Only two lesions (0.7%), which were excised with 2‐mm margins, were associated with tumour‐positive margins. Narrow‐margin excision showed a complete removal rate of 99% (2‐mm margins, 95.3%; 3‐mm margins, 100%). Dermoscopically determined borders almost exactly corresponded to the histopathological ones; 71.2% of border gaps between dermoscopy and histopathology were within 1 mm and there were no cases in which tumours spread beyond 1 mm of their dermoscopic borders.ConclusionSurgical excision with a 2–3‐mm margin is reliable treatment for well‐defined, primary pigmented BCC, with a complete removal rate of 99%.