Deep Shave Removal of Suspected Basal Cell Carcinoma: A Prospective Study

Abstract

BACKGROUND Diagnosis and treatment of basal cell carcinoma (BCC) in the same visit by shave removal may decrease health care spending and promote patient satisfaction. OBJECTIVE To prospectively evaluate deep shave removal of lesions clinically suspicious for low-risk BCC on the trunk or extremities in immunocompetent patients. MATERIALS AND METHODS Deep shave removal with the intent to remove the entire tumor was performed from January 2015 to June 2016, and patients were followed prospectively for clinical evidence of tumor recurrence. RESULTS Seventy-seven lesions were removed from 51 patients, including 29 (37%) superficial and nodular BCCs, 27 (35%) superficial BCCs, 16 (21%) nodular BCCs, and 5 (6%) non-BCCs. Fifteen BCCs (21%) had positive residual margins after deep shave removal, which was significantly more likely to occur in nodular compared with superficial BCCs (odds ratio 5 7.8, 95% confidence interval 5 1.4-43), and underwent re-excision. Fourteen specimens initially reported to have negative margins after deep shave underwent resectioning, which revealed positive margins in 4 specimens (28.6%). No BCCs have recurred clinically after an average follow-up of 50 months (SE 3.2). CONCLUSION Consider deep shave removal for low-risk BCCs on the trunk or extremities in immunocompetent patients hoping to avoid a second treatment visit.

Basal Cell Skin Cancer, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology

“…144 Like C&E, there is concern for inaccurate margin status assessment with shave removal. 145 However, it is a recommended technique for low-risk BCCs located in the trunk or extremities. Shave removal studies have reported 0.5%-30% rate of recurrence over a 3-to 5-year follow-up, multiple tumors treated in single visits, and a risk for misdiagnosis of only 1%.…”

“…Shave removal studies have reported 0.5%-30% rate of recurrence over a 3-to 5-year follow-up, multiple tumors treated in single visits, and a risk for misdiagnosis of only 1%. [144][145][146][147]…”