Basal Cell Carcinoma Excision Intraoperative Frozen Section For Tumour Clearance Rate And Reconstructive Surgery

Basal cell carcinoma (BCC) is the most common skin cancer. Its annual incidence in US is 2 million per year with an increase of 0.87%. The objective was to report intraoperative frozen section clearance rate of tumour margins and depth for excised basal cell carcinoma in a tertiary care centre and find the frequency of tumour in surgical margins with respect to location, size, and surgical reconstruction technique.

It was a prospective open-label interventional study conducted at the Dermatology department of tertiary care hospital Rawalpindi (Pakistan) in liaison with the histopathology department from January 2023 to April 2024. The patients with clinical diagnosis of basal cell carcinoma, of 10-35 mm located on the face were included as per inclusion/ exclusion criteria. An intraoperative frozen section for tumour margins and depth was taken from a histopathologist. The surgical defect was reconstructed after the negative report. p-value of <0.05 was considered significant for margin involvement, surgical technique, and location.

A total of 36 patients of BCC were enrolled. Tumour-free margins and depth were attained in 77.77% of cases. Tumour excision with a frozen section concerning surgical technique had a chi-square p-value ≤0.51, location ≤0.24, and size ≤0.84.

Intraoperative frozen section for basal cell carcinoma is a reliable technique for complete tumour excision. This technique is resource-intensive and time-consuming. It should be reserved for tumours at high-risk sites, and require complex reconstruction. Patients should be educated for follow up in case of induration, morphological changes, or new developments in surgical scar.