title: Non-melanoma Skin Cancer in Canada Chapter 4: Management of Basal Cell Carcinoma.
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is the most common malignancy. Growth of BCCs leads to local destruction of neighbouring healthy skin and underlying tissue and can result in significant functional and cosmetic morbidity.
  
  
  OBJECTIVE
  To provide guidance to Canadian health care practitioners regarding management of BCCs.
  
  
  METHODS
  Literature searches and development of graded recommendations were carried out as discussed in the accompanying Introduction.
  
  
  RESULTS
  Although BCCs rarely metastasize, they can be aggressive and disfiguring. This chapter describes the natural history and prognosis of BCCs. Risk stratification is based on clinical features, including the site and size of the tumour, its histologic subtype (nodular vs sclerosing), and its history of recurrence.
  
  
  CONCLUSIONS
  Various options should be considered for BCC treatment, including cryosurgery, curettage, and topical or photodynamic approaches, as well as fixed-margin surgery and Mohs micrographic surgery. Stratification of recurrence risk for individual BCCs determines the most appropriate therapeutic course.
authors.affiliation: University of British Columbia, Vancouver, BC, Canada David.Zloty@vch.ca.
authors.forename: David
authors.initials: D
authors.lastname: Zloty
authors.affiliation: University of Western Ontario, London, ON, Canada.
authors.forename: Lyn C
authors.initials: LC
authors.lastname: Guenther
authors.affiliation: University of Alberta, Edmonton, AB, Canada.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Sapijaszko
authors.affiliation: Kirk Barber Research and University of Calgary, Calgary, AB, Canada.
authors.forename: Kirk
authors.initials: K
authors.lastname: Barber
authors.affiliation: Clinique Dermatologique Joël Claveau, Québec, QC, Canada.
authors.forename: Joël
authors.initials: J
authors.lastname: Claveau
authors.affiliation: SCRIPT, Toronto, ON, Canada.
authors.forename: Tamara
authors.initials: T
authors.lastname: Adamek
authors.affiliation: SCRIPT, Toronto, ON, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Ashkenas
mesh_terms: D002170:Canada; D002280:Basal Cell Carcinoma / Q000628:therapy*; D006801:Humans; D015580:Mohs Surgery; D010778:Photochemotherapy; D012878:Skin Neoplasms / Q000628:therapy*
keywords: Mohs micrographic surgery; basal cell carcinoma; cryosurgery; photodynamic therapy; radiation therapy; surgical margin