Treatment of non-melanoma skin cancer in North Sardinia: is there a need for biopsy?

Non-melanoma skin cancer (NMSC) is the most common type of skin cancer. Important controversial issues are the need for incisional biopsies, surgical margin, and timing of follow-up. Methods. A retrospective study was undertaken on 2544 lesions. Accuracy of diagnosis and prevalence of incomplete excision were evaluated, comparing clinical and histological diagnosis using χ2 tests with Yates' correction. Kaplan-Meier recurrence graphs have been obtained. Results. Lesions were correctly diagnosed in 94% of basal cell carcinomas (BCC) and in 69% of squamous cell carcinomas (SCC) (p < 0.001). Positive margins on pathological examination were 6.6% for BCC and 6.8% for SCC. A significant difference for incomplete excision has been found for BCC in the face (p < 0.001). Kaplan-Meier survival curves showed a different pattern for BCC and SCC. Conclusions. On the basis of our data, if clinical diagnosis is BCC, excision and reconstruction may be undertaken without an incisional biopsy. Alternatively, if clinical diagnosis is SCC, it is advisable to consider an incisional biopsy, before definitive surgical treatment.