How is Basal Cell Carcinoma Diagnosed?

If you or your health care provider suspects you have basal cell carcinoma (BCC), you will often be referred to a dermatologist, which is a doctor that specializes in diseases of the skin. When you meet with your dermatologist, s/he will likely take a medical history, perform a physical examination, examine any areas of concern, and decide whether a skin biopsy is warranted.

If a biopsy is necessary, a sample of the suspicious area will be taken for microscopic evaluation. Before removing a sample of the suspicious lesion, your skin will likely be numbed so that discomfort is minimized.

Once a biopsy is taken, it is sent to a laboratory so that a specialist can examine how the skin cells look under a microscope. For skin cancer, the specialists who examine the biopsied tissue under a microscope to diagnose skin disease are called pathologists or dermatopathologists. Biopsies are the fundamental ‘gold standard’ for diagnosing skin cancer because this method provides a high level of certainty.

When your medical provider receives the pathology report of the biopsy, s/he should discuss with you what additional steps might be necessary.

If a diagnosis of BCC is made, a full skin examination to look for other suspicious spots is usually recommended for follow-up on an ongoing regular basis. The goal is to find and remove other lesions before they become problematic. Individuals who have been diagnosed with BCC are at a high risk for having additional skin cancers at different skin sites, including squamous cell skin cancer and melanoma.