Treatment Algorithm for Basal Cell Carcinoma - Flowchart
Treatment Algorithm for Basal Cell Carcinoma - Flowchart Basal Cell Carcinoma Basal Cell Carcinoma
«Flowchart»

TREATMENT FOR BASAL CELL CARCINOMA

TREATMENT FOR BASAL CELL CARCINOMA

TREATMENT FOR BASAL CELL CARCINOMA

TREATMENT FOR BASAL CELL CARCINOMA


Regional lymph node exam
Consider imaging
Multidisciplinary management
Surgery, if possible
Hedgehog pathway inhibitor
Primary or adjuvant radiation therapy
Consideration for clinical trials, systemic therapy


Regional lymph node exam
Consider imaging
Multidisciplinary management
Surgery, if possible
Hedgehog pathway inhibitor
Primary or adjuvant radiation therapy
Consideration for clinical trials, systemic therapy


Regional lymph node exam
Consider imaging
Multidisciplinary management
Surgery, if possible
Hedgehog pathway inhibitor
Primary or adjuvant radiation therapy
Consideration for clinical trials, systemic therapy


Regional lymph node exam
Consider imaging
Multidisciplinary management
Surgery, if possible
Hedgehog pathway inhibitor
Primary or adjuvant radiation therapy
Consideration for clinical trials, systemic therapy


Mohs surgery or
Excision with complete histologic margin evaluation


Mohs surgery or
Excision with complete histologic margin evaluation


Mohs surgery or
Excision with complete histologic margin evaluation


Mohs surgery or
Excision with complete histologic margin evaluation

Suspicious lesion

Suspicious lesion

Suspicious lesion


EDC
Cryosurgery
PDT
Imiquimod
Topical 5-FU
Excision
Mohs surgery*


EDC
Cryosurgery
PDT
Imiquimod
Topical 5-FU
Excision
Mohs surgery*


EDC
Cryosurgery
PDT
Imiquimod
Topical 5-FU
Excision
Mohs surgery*


EDC
Cryosurgery
PDT
Imiquimod
Topical 5-FU
Excision
Mohs surgery* * *

End

End

End


If tumor-free plane is not achievable
If extensive perineural or large-nerve involvement


If tumor-free plane is not achievable
If extensive perineural or large-nerve involvement


If tumor-free plane is not achievable
If extensive perineural or large-nerve involvement


If tumor-free plane is not achievable
If extensive perineural or large-nerve involvement

* If lesion meets appropriate use criteria for Mohs surgery.

Note: For nonsurgical candidates (>60 yr), radiation may be considered regardless of tumor characteristics.

* If lesion meets appropriate use criteria for Mohs surgery.

Note: For nonsurgical candidates (>60 yr), radiation may be considered regardless of tumor characteristics.

* If lesion meets appropriate use criteria for Mohs surgery.

*

Note: For nonsurgical candidates (>60 yr), radiation may be considered regardless of tumor characteristics.


Full-body exam
Biopsy


Full-body exam
Biopsy


Full-body exam
Biopsy


Full-body exam
Biopsy


Locally advanced/surgically unresectable tumor
Metastatic tumor


Locally advanced/surgically unresectable tumor
Metastatic tumor


Locally advanced/surgically unresectable tumor
Metastatic tumor Locally advanced

High risk tumor (surgically resectable)


Critical area
Histologically aggressive
Perineural invasion
Large size (>2 cm)
Recurrent
Radiation field

High risk tumor (surgically resectable)


Critical area
Histologically aggressive
Perineural invasion
Large size (>2 cm)
Recurrent
Radiation field


Critical area
Histologically aggressive
Perineural invasion
Large size (>2 cm)
Recurrent
Radiation field High risk tumor

Low risk tumor


<2 cm size
Superficial (epidermis/dermis)

Low risk tumor


<2 cm size
Superficial (epidermis/dermis)


<2 cm size
Superficial (epidermis/dermis) Low risk tumor