Measurement of histological clearance margins in basal cell carcinoma

Aims Basal cell carcinoma (BCC) is a common cancer, with a high risk of local recurrence. A quantifiable measurement of the histological margins of BCC in excisions is a recurrent demand of clinicians; however, there are currently no international guidelines indicating its value. Methods and results...

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Bibliographic Details
Published in:Histopathology 2022-04, Vol.80 (5), p.799-808
Main Authors: Rimbert, Johan, Deshayes, Chloé, Battistella, Maxime, Cribier, Bernard, Vergier, Béatrice, Migeot, Virginie, Frouin, Eric
Format: Article
Language:English
Subjects:
Adult
Age Factors
Basal cell carcinoma
Carcinoma, Basal Cell - pathology
Carcinoma, Basal Cell - surgery
Dermatology
Female
France
Health Care Surveys
histological clearance margin
Humans
Male
margins
Margins of Excision
measurement
Middle Aged
Neoplasm Recurrence, Local - prevention & control
pathologists
Pathology
Pathology, Surgical
Practice Patterns, Physicians
practices
Questionnaires
Skin Neoplasms - pathology
Skin Neoplasms - surgery
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Summary:Aims Basal cell carcinoma (BCC) is a common cancer, with a high risk of local recurrence. A quantifiable measurement of the histological margins of BCC in excisions is a recurrent demand of clinicians; however, there are currently no international guidelines indicating its value. Methods and results A questionnaire validated by four experts in dermatopathology and formatted under a ‘Google Forms’‐type interface was sent by e‐mail to physicians specializing in surgical pathology or dermatopathology and practising in France from 20 March 2018 to 20 May 2018. The results were compared between subgroups according to age and subspecialisation, especially dermatopathology. The questionnaire was completed by 225 practitioners. Microscopic margins were systematically measured in 77.3% of cases, sometimes in 19.6% and never in 3.1%. The main reason was to report factually insufficient margins (66.5%), followed by laboratory routine (45%) or clinician requests (43.1%). For 72% of respondents, the clinical or histopathological criteria did not influence their practice. The most used tool was a graduated ruler placed under a microscope (44.3% of cases). Compared to other groups, dermatopathologists measured BCC margins less systematically [only in certain situations (33.3 versus 14.9%) or never (10.5 versus 0.6%) (P 
ISSN:0309-0167
1365-2559
DOI:10.1111/his.14557