What is the rate of recurrence for basal cell carcinoma (BCC)?

Updated: Mar 02, 2020
  • Author: Robert S Bader, MD; Chief Editor: William D James, MD  more...
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Answer

The 5-year recurrence rate is about 5%, but it depends on the histologic subtype and type of treatment; the recurrence rate is less than 1% for primary (previously untreated) BCCs treated with Mohs micrographic surgery. Most reports show that the distance to the closest resection margin is an important predictor of recurrence. [50]

The following is a list of treatments and their 5-year recurrence rates for primary (previously untreated) BCCs:

  • Surgical excision - 10.1%

  • Radiation therapy - 8.7%

  • Curettage and electrodesiccation - 7.7%

  • Cryotherapy - 7.5%

  • All non-Mohs modalities - 8.7%

  • Mohs micrographic surgery - 1%

These rates are probably affected by the fact that clinicians use cryotherapy, curettage, and desiccation mostly on smaller and better-demarcated lesions.

Pieh et al reported a recurrence rate of 5.36% after the first excision of the tumor; the rate increased to 14.7% after the second operation, and the rate reached 50% after the third and fourth operations. [51] The highest recurrence, approximately 60%, was seen with lesions arising from the medial canthus.

Recurrences usually occur 4-12 months after initial treatment. One meta-analysis found that the 3-year cumulative risk of devloping a second BCC after an index BCC is about 44%, which is a 10-fold increase over that of the general population. [52, 53] Tumors on the nose or T-zone of the face have a higher incidence of recurrence. Recurrence is most common on the nose and nasolabial fold, but this observation may be secondary to lack of adequate margins obtained in these areas. Infiltrative, micronodular, and multifocal types are more likely than nodular types to recur.


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