A Large Percentage of Excision Specimens Show Residual Basal Cell Carcinoma: A Retrospective Chart Review

Treatment of basal cell carcinoma (BCC) is recommended. However, patients often note that the biopsy site appears resolved and inquire about the need for additional treatment.

This study aims to determine the rate of residual BCC on excision specimens after initial shave biopsy to aid in decision-making on the necessity of further treatment.

A retrospective chart review was conducted that reviewed excision specimen pathology reports of previously biopsy-proven basal cell carcinomas for the presence of residual tumor between 2012 and 2022 at a single institution.

Two thousand one hundred seventeen cases met inclusion criteria. Overall, 39.4% of patients had residual BCC after an initial shave biopsy. Using an odds ratio and 95% confidence interval, a significant relationship was found between larger lesions, longer time between biopsy and excision, and lesions on high-risk body sites with increased odds of residual BCC. A significant relationship was found between negative or not specified margins on shave biopsy with decreased odds of residual BCC.

The results show that a large percentage of patients have residual BCC following initial biopsies. These results should be included in physician-patient discussions about treatment options for BCC.