The Upgrading Clinical Subtype Classification of Basal Cell Carcinoma is Useful to Correlate With Its Histologic...

Area of Science:

• Dermatology
• Oncology
• Surgical Pathology

Background:

• Current basal cell carcinoma (BCC) clinical subtype classification lacks correlation with tumor invasiveness and histologic patterns.
• Accurate classification is crucial for predicting BCC behavior and guiding treatment.

Purpose of the Study:

• To propose an upgraded clinical subtype classification for BCC.
• To evaluate the correlation of this new classification with histologic subtypes and tumor invasiveness.

Main Methods:

• Retrospective analysis of 425 BCC lesions from 422 patients treated with Mohs micrographic surgery (MMS).
• Classification of BCCs using a proposed system of basic and combined clinical subtypes.
• Correlation analysis with histologic subtypes and invasiveness, including surgical margin and MMS stage.

Main Results:

• Superficial-elevated (SE) was the most common basic subtype (23.1%), and nodulo-infiltrative (N-I) the most common combined subtype (8.7%).
• Non-aggressive subtypes showed higher rates of pigmentation (63.1%) and non-aggressive histologic patterns (91.4%).
• Aggressive subtypes required wider surgical margins and more MMS stages.

Conclusions:

• The proposed upgrading classification for BCC clinical subtypes is concise and descriptive.
• This classification demonstrates a strong correlation with histologic subtypes and tumor invasiveness.
• The enhanced classification aids in predicting BCC behavior and optimizing treatment strategies.