BASAL CELL CARCINOMA:
DIAGNOSIS

If your healthcare provider suspects you have a basal cell carcinoma (BCC), you should be referred to a dermatologist. If your BCC is found early, it can usually be treated in the dermatologist’s office during a single visit.

Process for diagnosing BCC

Your dermatologist will take a medical history, addressing your sun-exposure history, any other relevant medical information, and your (as well as your family’s) history of any other skin cancers
The dermatologist may suggest a full head-to-toe skin examination to look for other problem areas. You can always ask your dermatologist to perform one if s/he doesn’t suggest it and you haven’t had one recently. They will usually use a dermatoscope (a specialised magnifying glass) to help look at the lesions in more detail
The dermatologist will determine if you need a skin biopsy. S/he will numb the skin and take part or all of the spot. Biopsy is the only way to know whether the spot is actually cancer or not. That sample will be examined by a specialist who will look at the tissue under the microscope

Focused dermatologist is performing dermoscopy on young man

Preparation for a Dermatology Appointment for a Suspected Skin Cancer

Your dermatologist will review the biopsy procedure with you, discuss the potential risks and benefits, answer your questions, and obtain your consent before doing the biopsy. In most cases, a biopsy can be completed in one office visit. It can leave a little scar. Your dermatologist will provide you with specific details before the procedure.

Questions to Ask Your Doctor When You Are Told You Need a Biopsy

How long will the biopsy take?

Are there risks to performing this biopsy?

Will I have stitches?

Will the biopsy remove the lesion in its entirety?

Should I have someone drive me?

Will I be left with a scar?

What type of activity limitations will I have? For how long?

How long will it take to receive my results?

How should I care for the biopsy site after the procedure?

Will I have to come back to get stitches out?

Will the procedure be covered by insurance and what, if any, out-of-pocket expenses will there be?

Click here to download and print a PDF of these questions.

After the biopsy is completed, it will be sent to a pathology laboratory where it will be examined by a pathologist or dermatopathologist under a microscope to determine whether you have a skin cancer. A pathologist is a medical professional who uses laboratory tests and direct evaluation of cells, tissues, and organs to diagnose disease. A dermatopathologist specializes in skin pathology, a subspecialty of pathology and dermatology.

What Will the Pathology Report Tell Me?

The specialist looking at your biopsy writes a report called a pathology report. The pathology report will contain some key information about the biopsy, such as the following:

Whether the specialist thinks it is cancer or not
If there is cancer, what type
The stage of the cancer based on the tumour characteristics
Whether the cancer has any “high-risk/aggressive” features

You may want to obtain a copy of your pathology report and should be able to request this from the team looking after you.

Questions to Ask Your Doctor When You Receive Your Pathology Results

What type of skin cancer do I have?

What is the stage or grade?

Are there any high-risk or aggressive features that I should know about?

Did the biopsy remove all of the skin cancer?

How will I know if my cancer has spread?

Will I require surgery? If so, what type?

What are the treatment options? What are the plusses and minuses of each type?