Frequency of margin involvement after excision of skin basal cell carcinomas with 5 millimeter margins

Skin basal cell carcinoma (BCC) is the most common cancer in human beings. Prevalence of this tumor has increased over the past decades. The standard treatment is complete excision, however some risks for recurrence still exist. The aim of this study was to determine the frequency of margin involvement in skin BCC as well as to investigate the demographic characteristics of the patients This study was conducted from April 2011 to April 2012 on the patients who had skin lesions suspected for BCC. The patients were undergone elliptical excision surgeries for removing their suspected lesions with 5-millimeter margins of clinically normal skin in Farchian Hospital, Hamadan, Iran. Following data were collected and recorded: age, sex, anatomical location, duration of the disease, primary clinical diagnosis, histopathologic type, and margin involvement. In total, 125 lesions from 115 patients were investigated (70 males, 45 females). The range of the ages of the patients were from 32 to 93 years, with a mean of 64.6 years. The most common histopathological type was nodular type (61.0%). Twenty percent of the excised lesions showed margin involvement. Risk factors for incomplete excision were older age and anatomical locations (ears and peri-ocular lesions). There was no statistically significant differences between sex, histological type, primary clinical diagnosis, and duration of the disease. In almost all cases, the clinical and histopathological diagnoses were similar. To avoid repeated surgeries and to reduce the risk of incomplete excision for lesions on high risk locations, particularly in elderly, it is recommended that BCCs be excised with wide margins or Mohs micrographic surgery.