Zainab Sawafta
Queen Elizabeth Hospital, UK
Title: Specialist excision of basal cell carcinoma leads to better outcomes
Biography
Biography: Zainab Sawafta
Abstract
Introduction: Basal Cell Carcinoma (BCC) is responsible for a significant healthcare burden, particularly among Caucasian populations. Its locally invasive and destructive potential results in high morbidity, if left untreated. The gold standard for this is surgical excision with histological analysis of margins. In the UK, BCC excisions are carried out in both primary and secondary care settings. Success of therapy is assessed through evaluation of excision margins, which we have compared between specialties.
Methods: A retrospective analysis of BCC histology reports was carried out over four months, analyzing excision margin based on specialty and operator experience. Biopsies were excluded. Data was taken from a District General Hospital histopathology laboratory, which analyses BCC specimens from Dermatology, Plastic Surgery, Oculoplastics, ENT and GP Departments.
Results: 549 patients had 629 lesions excised. Excisions carried out by specialty were as follows: 516 by Plastic Surgery, 78 by Dermatology, 26 by General Practice, 6 by Oculoplastics and 3 by ENT. Dermatology completely excised 86% of lesions with 8% less than 1 mm margin and 6% involving margins. Similarly, 85% of lesions were completely excised by Plastic Surgery, 10% less than 1 mm and 4% involving margins. GP completely excised 63% with 27% less than 1 mm and 8% involving margins. 18% of incomplete excisions were carried out by consultants.
Discussion: Findings show that specialties with higher caseload, therefore greater operator experience exhibit more favorable results when it comes to BCC excisions, compared to primary care. Consultants were far less likely to have incomplete excisions, compared to trainees or GPs.