Basal Cell Skin Cancer: What It Is, Types, and Signs

In the United States, skin cancer is the most common form of cancer, and its two most common types are basal cell and squamous cell. If a doctor has said "basal cell carcinoma" or you have found a growth on your skin that does not go away, below is what this tumor is, what it looks like, whether it metastasizes, and which examinations help make the diagnosis.

What basal cell skin cancer is

Basal cell carcinoma is a tumor arising from the basal layer of the skin epithelium and is one of the types of skin cancer. It develops from atypical basal cells of the epidermis and follicular epithelium. In terms of malignancy, basal cell carcinoma occupies an intermediate position between benign and malignant tumors: it is characterized by slow infiltrative growth and is a locally destructive tumor.

Basal cell carcinoma and basal cell carcinoma

Basal cell cancer and basal cell carcinoma are the English-language names for this type of skin cancer (basal cell cancer, basal cell carcinoma); in Russian-language literature the tumor is more often called basal cell carcinoma. There is nothing to say here about Malherbe's epithelioma: there is no confirmed association between it and basal cell carcinoma, so only a doctor can clarify the diagnosis.

Causes and risk factors

The main cause is ultraviolet radiation: prolonged sun exposure, operation of certain types of gas-discharge lamps, and failure to follow safety precautions during welding work. Other causes include electric shock, exposure to high temperatures and ionizing radiation, and contact with carcinogenic substances — arsenic, cadmium, resin, tar, soot, and certain dyes. Basal cell carcinoma most often occurs after the age of fifty, in men and women at equal rates, and in children — in very rare cases.

What increases the likelihood of the tumor:

• a lot of time in the sun or sunburns in the past;
• fair skin, light hair and eyes;
• skin cancer in a close relative;
• age over fifty years.

How it manifests and what it looks like

The tumor occurs on exposed areas of the skin — usually on the face, neck, and scalp. Most often affected are the nasolabial folds, the alae of the nose, the upper lip, the inner and outer corners of the eyes, and the temples.

Nodular basal cell carcinoma is an exophytic round pink tumor that bleeds easily, with a depression in the center of the nodule. Flat basal cell carcinoma is a plaque-like formation with raised, distinct, ridge-like edges. Superficial basal cell carcinoma is a pink spot with raised edges and a shiny surface, and it may be multiple; of all the forms, it is the most benign and can exist for decades, slowly enlarging. The nodular form is the most common. Histologically, superficial multicentric, sclerodermiform, and fibroepithelial variants are also distinguished.

It usually begins with a painless nodule on the skin of the face, which ulcerates and becomes covered with a crust. For months and years it grows outward, ulcers appear, the surface becomes lobulated, and telangiectasias are visible. Over time, basal cell carcinoma can turn into a flat plaque over 10 cm with a scaly surface, into a fungating nodule, or into a deep ulcer that destroys muscles and bones.

Whether metastases occur

Basal cell carcinoma does not metastasize — this is how it differs from true malignant tumors. At the same time, it grows into surrounding tissues and destroys them: in advanced ulcerated forms, invasion of the skull bones is possible, and this significantly worsens the prognosis. With treatment, the prognosis is favorable: 90% of basal cell carcinomas can be completely cured, and for local forms — almost 100%.

How it is diagnosed and when to see a doctor

Any suspicious growth on the skin and any change in its appearance should be checked by a doctor. Diagnosis of basal cell carcinoma is based on cytological examination of the tumor; because the neoplasm is accessible, this is usually not difficult, and skin biopsy is also used. The size of the tumor is described with letters and numbers: T1 — up to 2 cm, T2 — up to 5 cm, T3 — more than 5 cm, T4 — invasion into cartilage, muscles, bones. Treatment works better when skin cancer is found early.

A growth on the skin is not in itself a reason to call an ambulance; if the condition sharply worsens, call 103 or 112.

This material is for reference: it explains what is happening and what to ask the doctor, but it does not replace consultation with a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer