Superficial basal cell carcinoma, think deeper: Step sectioning of skin biopsy specimens yields 14% more aggressive subtypes

• DOI: 10.1371/journal.pone.0256149
• Publication Date: 2022-01-20T18:35:00Z
• Authors: Mary-Ann El Sharouni; Paul J. van Diest; Willeke A. M. Blokx
• Keywords: Mohs surgery; Basal (medicine)

Introduction Because of different therapeutic regimens for superficial and non-superficial basal cell carcinomas (BCCs), accurate histopathological examination a punch biopsy to determine its subtype is essential. The aim the current study was evaluate additional yield more extensive step-section method that standard histologic at 4 levels. Material methods Data this prospective obtained from Pathology department Dutch tertiary hospital. Biopsy specimens subsequent patients March 2019 June 2020 were sectioned 8-levels instead regular 4-levels. Only with BCC in first 4-levels sectioning included (n = 100). After 8-level sectioning, it recorded which level (5–8) aggressive component found (i.e. nodular, infiltrative, or micronodular). Patients followed-up further treatment, case excision, excision specimen reviewed subtype. A logistic regression performed assess characteristics associated levels 5–8. Results In 14 (14%) 5–8, all nodular component. Thirteen these underwent confirming Of 86 had no deeper 26 (30.2%) excision; residual found, 15 BCC, 7 (1 6 combination superficial/nodular/infiltrative). multivariable analysis, head&neck localization finding 5–8 (OR 6.41 (95%CI 1.56–26.30), p 0.01)). Conclusions More specimens, especially area, leads diagnosis requiring clinical management strategies.