Follow-up of basal cell carcinomas: an audit of current practice

• Published in: Journal of the European Academy of Dermatology and Venereology 2006-07, Vol.20 (6), p.698-701
• Main Authors: Mc Loone, NM, Tolland, J, Walsh, M, Dolan, OM
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Basal Cell - diagnosis; Carcinoma, Basal Cell - surgery; Female; follow-up; Follow-Up Studies; Guideline Adherence; Humans; Incidence; Male; Medical Audit; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - epidemiology; Practice Guidelines as Topic; Practice Patterns, Physicians' - statistics & numerical data; primary basal cell carcinomas; Prognosis; Risk Factors; Skin Neoplasms - diagnosis; Skin Neoplasms - surgery; surgical excision; Treatment Outcome
• ISSN: 0926-9959; 1468-3083
• DOI: 10.1111/j.1468-3083.2006.01576.x

Background  Follow‐up of patients after treatment of basal cell carcinoma (BCC) allows for monitoring of recurrence and detection of new tumours, but adds a significant burden to outpatient clinics. At the skin tumour clinic in the dermatology department, the Royal Hospitals, Belfast, all patients are reviewed for 2 years after surgical excision of a low‐risk primary BCC. Objectives  An audit was undertaken to determine the quality of data set recorded relating to prognostic factors for BCCs to determine the rate of recurrence and number of new primary tumours detected and to determine the completeness of follow‐up by patients. Method  Patients who had primary BCCs treated by excision were identified from a database held at the clinic. Medical charts were reviewed to determine data recorded about lesions, the number of recurrent BCCs and new tumours detected, and the number of patients completing follow‐up. Results  Between January 1999 and December 2000, 114 patients had 121 primary BCCs excised. BCC location and size were recorded in 100% and 35% of cases, respectively. Histological type was stated for morphoeic or multifocal lesions. Two years of follow‐up was completed by 53% of patients and 1 year by 78% of patients. The rate of recurrence was low, with 2 BCC recurring within 2 years of excision. The risk of developing a new BCC was 11.6% in the first year and 6.3% in the second year. Conclusions  Follow‐up of patients after excision of a low‐risk BCC at the clinic has been reduced to 1 year. A proforma has been developed to encourage documentation of prognostic factors.