Dermapathologist Questions Basal Cell Carcinoma

What are the stages of basal cell carcinoma?

My mother-in-law was diagnosed with stage I basal cell carcinoma. She's worried about it spreading, obviously, but I tried to tell her that she should only focus on her treatment. Especially since this stage doesn't have many high-risk features, and early intervention for her is the best case scenario. If her cancer progresses into other stages though, what will it be like?

5 Answers

The three classic stages of basal cell carcinoma are: 1. superficial spreading 2. nodular 3. ulcerative. These are the most common classifications. Location is probably more important since these cancers around the eyes and lids can be more difficult to remove and need moh's surgery. The same can be said for overlarge tumors where direct closure is difficult.
Remove it now. Should be no problem. Stage 1 only means it has not spread beyond the original growth. Rarely spreads unless treated with x-ray
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Basal cell carcinoma rarely spreads. However, untreated, it can be locally invasive and destructive. Treatment is recommended so that there is no disfigurement or local spread. On the rare occasion that it does spread, there are new targeted therapies to help treat it.

Suzanne Sirota Rozenberg, DO, FAOCD
Thank you for the question.

Basal Cell Cancers are the least aggressive of all cancers and because they have a low potential to spread internally most Dermatologist including myself do not routinely give them a "Stage." With that said, a Stage I Basal Cell Cancer likely means that it is relatively small and relatively superficial even though it does have some depth into the middle portion of the skin (the dermis). If the cancer gets much bigger (for example over 2cm wide) or much deeper (for example into the subcutaneous fat or spreading internally), it would progress to higher Stages. It sounds like your mother-in-law has a fairly routine cancer that needs treatment and knowledge on how to prepare for treatment as well as how to prevent further cancers from forming.

Please look at our videos on Non-Melanoma Skin Cancer, to include Basal Cell Cancer, as well as the treatment videos that go along with this topic on our YouTube channel "Your Health University" so that you can get further information and hopefully alleviate some anxiety for you and your mother-in-law. Knowledge has an amazing way of quelling anxiety and helping you get the treatment you need.

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This is an important question for your dermatologist or dermatologic surgeon. Most basal cells are slow growing tumors limited to the skin and very few of them spread beyond the fat. Treatment is determined by the depth of invasion, size, and location. Most basal cells that metastasize (spread beyond the skin) had been present for a significant amount of time (years) and metastatic basal cell carcinoma is extremely rare. The most important thing to do is follow closely with your board certified dermatologist for proper care.