BCC Skin Cancer Surgery

BCC, or Basal Cell Carcinoma, is a common type of skin cancer. It’s often the result of long-term exposure to the sun, particularly intense exposure experienced during childhood. It is typically found on the face and neck, but it can develop anywhere on your body.

This type of cancer develops in the basal cells, the deepest layer of the skin. Unlike other forms of skin cancer, BCC rarely spreads to other parts of the body, making it less likely to be life-threatening. But don’t underestimate it; if left untreated, it can grow deep beneath the skin into the underlying tissue and bone, causing significant damage and disfigurement.

Anca Breahna is a highly respected and experienced plastic surgeon with an outstanding track record in the treatment of skin cancer.

What is BCC Skin Cancer Surgery?

BCC Skin Cancer Surgery refers to the surgical removal of Basal Cell Carcinomas. The purpose is to remove the entire tumour, ensuring that all cancerous cells are eradicated while minimising damage to the surrounding healthy tissue. This is particularly important for BCCs found on the face, as you would want to minimise scarring and maintain as much normal function as possible.

The exact technique used for BCC Skin Cancer Surgery may vary depending on several factors, including the size and location of the tumour and whether the cancer has recurred following previous treatments.

Who Needs BCC Skin Cancer Surgery?

If you’re diagnosed with BCC, surgery will likely be recommended as your primary treatment. That’s because surgical techniques have a high success rate in removing BCCs and reducing the chance of recurrence. You’re a suitable candidate for surgery if:

• Diagnosis of BCC: The first and most obvious factor is the confirmed diagnosis of Basal Cell Carcinoma. A biopsy – where a small sample of the suspicious skin is taken and examined under a microscope – is usually performed to confirm the diagnosis. The findings from the biopsy can also provide information about the subtype of BCC and the depth of the cancer, both of which can impact the decision on whether to proceed with surgery
• Location and size of the tumour: The exact location and size of the tumour can influence the decision for surgery. BCCs that are small and located in less cosmetically sensitive areas, such as the trunk, are usually straightforward to treat with surgery. Larger tumours, or those in cosmetically sensitive areas like the face or near the eyes, might also be treated with surgery, but a technique that minimises damage to surrounding tissue, such as Mohs surgery, might be preferred
• General health of the patient: Surgery, even minor procedures, always carries some risk. If you have certain health conditions, such as heart disease or diabetes, or if you’re older, these risks might be increased. Anca will take your overall health into consideration when deciding whether surgery is the best option for you
• Previous treatments: If you’ve already had treatment for BCC and it’s come back, surgery might still be an option, but a more careful approach is usually required to ensure all the cancer is removed. The type of previous treatment you’ve had, and how long ago you had it, can influence the decision on whether to proceed with surgery
• Patient preference: Lastly, your own feelings about surgery are important. You might prefer to avoid surgery due to the potential for scarring, or you might be anxious about the procedure. Anca will discuss all treatment options with you, including the risks and benefits, to help you make an informed decision

It’s worth mentioning that older individuals and those with certain health conditions may face increased risks during surgery.

Benefits of BCC Skin Cancer Surgery

Surgery to treat BCC comes with many benefits. Here are some of them:

• High success rate: Surgical removal of BCCs has a high success rate, with many studies indicating a cure rate close to 95% when performed correctly
• Reduced risk of recurrence: Complete removal of the tumour reduces the chance of the cancer returning in the same spot
• Preservation of healthy tissue: Modern surgical techniques aim to remove the cancer while causing minimal damage to the surrounding healthy skin
• Immediate results: Once the surgery is performed, the cancerous cells are immediately removed from your body

The exact benefits you experience may depend on the specific type of BCC you have and the surgery method used.

Types of BCC Skin Cancer Surgery Procedures

There are different types of surgical procedures to treat BCC. The one chosen for you will depend on the size, depth, and location of the carcinoma, as well as your overall health and personal preferences. Here are the main types of BCC Skin Cancer Surgery:

• Excisional Surgery: This traditional surgery involves cutting out the tumour along with a margin of healthy skin around it to ensure all cancerous cells are removed. The wound is then stitched up
• Mohs Surgery: This technique involves removing the tumour layer by layer. Each layer is checked under a microscope for cancer cells until no more are found. This method is used as it preserves as much healthy tissue as possible and is particularly useful for BCCs that are large, recurring, or located in cosmetically sensitive areas like the face
• Curettage and Electrodessication: This procedure involves scraping away the cancerous growth with a curette (a long, thin instrument with a looped end), then using an electric needle to destroy any remaining cancer cells and minimise bleeding
• Cryosurgery: The cancerous cells are frozen and destroyed with liquid nitrogen. This method is generally less invasive but may have a slightly higher chance of the cancer returning

Each type of surgery has its own pros and cons. The most suitable one for you will depend on factors that you will discuss with Anca during the consultation.

How is BCC Skin Cancer Surgery Performed?

Performing BCC Skin Cancer Surgery involves several critical steps and can vary depending on the specific type of surgery being used. The following sections break down the process into detailed steps for better understanding.

• Preparation: Before the surgery, Anca will mark out the area to be treated, and local anaesthetic will be administered to numb the area. This means you’ll be awake during the procedure, but you won’t feel any pain
• Excisional Surgery: If Anca is performing an excisional surgery, she will cut out the visible BCC along with a border of healthy skin. This is to ensure that all cancer cells, even those that might have spread into the surrounding skin, are removed. The size of the border of healthy skin removed depends on the size and location of the BCC. The wound is then closed with stitches, and a dressing is applied. In some cases, if the BCC is large, your plastic surgeon might not be able to close the wound directly with stitches. In this scenario, a skin graft or skin flap (where skin from another part of the body is used) might be needed to cover the wound and help it heal
• Mohs Surgery: For Mohs surgery, the process is slightly different. Anca removes a thin layer of skin containing the tumour and then examines it under a microscope. If cancer cells are detected at the edges of the skin sample, your plastic surgeon will remove and examine another layer of skin. This is repeated until no more cancer cells are detected. The aim is to ensure all the cancer is removed while taking away as little healthy skin as possible
• Curettage and Electrodessication: In this procedure, your plastic surgeon uses a curette, a tool designed to scrape away the cancerous skin. After the visible cancer is removed, an electric needle (electrode) is used to treat the area and kill any remaining cancer cells. This process may be repeated a few times to make sure all the cancer is removed
• Cryosurgery: This procedure uses liquid nitrogen to freeze and kill the cancer cells. Your plastic surgeon applies the liquid nitrogen directly onto the skin, which causes the area to scab over. When the scab falls off, new, healthy skin appears underneath

Recovery after BCC Skin Cancer Surgery

The recovery process following BCC Skin Cancer Surgery largely depends on the type of procedure performed and the individual’s overall health. Here’s what you might generally expect:

• After the surgery: Once the procedure is complete, you’ll likely have a wound dressing in place. The medical team will provide you with instructions on how to care for the wound and when to return for a follow-up appointment
• Pain Management: Some discomfort is expected after the surgery, although this is usually manageable with over-the-counter pain relief medication. Any pain should start to subside within a few days
• Wound Care: You’ll need to keep the area clean and dry to prevent infection. Your medical team will provide detailed instructions on cleaning the wound, changing dressings, and signs of infection to watch out for, such as redness, swelling, or a foul-smelling discharge
• Rest and Resume Activity: Most individuals can resume normal activities within a day or two after surgery, but strenuous activity, heavy lifting, and swimming should be avoided until the wound has fully healed
• Follow-Up Appointments: You will have follow-up appointments to monitor your recovery and check for signs of the cancer returning. If the cancer was extensive, your plastic surgeon might refer you to a specialist for additional treatment

Risks of BCC Skin Cancer Surgery

While BCC Skin Cancer Surgery is generally considered safe and effective, as with any surgical procedure, there are potential risks involved. These might include:

• Bleeding: Although rare, there’s a small risk of significant bleeding during or after the procedure
• Infection: Any surgical wound can potentially become infected. You’ll be given advice on how to reduce this risk and what symptoms to look out for
• Scarring: Any form of skin surgery leaves a scar. However, techniques are used to minimise this as much as possible. If a large area of skin is removed, skin grafting may be necessary to help with healing and minimise scarring
• Recurrence of Cancer: There’s always a risk that some cancer cells might be missed, and the cancer could return. Regular follow-up appointments are key in early detection of any new or recurring cancers
• Nerve damage: If the carcinoma is located near nerves, there’s a small risk of nerve damage during surgery. This can lead to numbness or changes in sensation in the surrounding skin

Medical References about BCC Skin Cancer

• Basal Cell Carcinoma – Mayo Clinic
• Mohs Surgery – Cleveland Clinic
• Treatment – Skin cancer (non-melanoma) – NHS
• Skin Cancer Types: Basal Cell Carcinoma Diagnosis and Treatment – American Academy of Dermatology
• Basal Cell Carcinoma: Causes, Symptoms & Treatment – Cleveland Clinic