Basal cell carcinoma natural history

Prognosis
Although basal cell carcinoma rarely metastasizes, it grows locally with invasion and destruction of local tissues, without stopping. The cancer can impinge on vital structures and result in loss of extension or loss of function or rarely death. The vast majority of cases can be successfully treated before serious complications occur. The recurrence rate for the above treatment options ranges from 50% to 1% or less.

In choosing the therapy, one must weigh the benefit gained from the morbidity of the procedure. As most basal cell carcinomas are slow growing, and not deadly; the health and age of the patient must be considered. Although difficult to discuss, radiation therapy, topical chemotherapy, or no treatment at all should be considered in ill or frail individuals in difficult to excise tumor of no immediate harm to the individual. While methods with the highest cure rate should be considered for young and healthy individuals with long life expectancy. It is here that one should seriously consider the cure rate of Mohs surgery vs. standard excision by a plastic surgeon vs. radiation therapy.