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What Does Advanced Basal Cell Carcinoma Look Like?

Medically Reviewed by Brunilda Nazario, MD on January 25, 2021

Advanced basal cell carcinoma (BCC) can look different on everyone. But this kind of skin cancer does have some common traits. Mainly, it grows in a way that makes it tough to treat. 

There are several ways to deal with advanced BCC, but you’ll need to get care right away. It can be hard to get rid of, especially if it goes untreated for a long time. Here’s what you need to know.

Signs of Basal Cell Carcinoma

BCC generally starts out in the upper layer of your skin. That’s called your epidermis. Here’s what it may look like:

  • A bloody or oozing sore that doesn’t go away
  • A rough patch of skin, usually in a sun-exposed area
  • A reddish area that may hurt or itch
  • A shiny bump that’s clear, reddish, or white
  • A flat white, yellow, or “waxy” area that looks like a scar
  • A colored mole-like bump (especially on darker skin)

BCC tends to grow slower than other kind of cancer, but that’s not always the case. And if it’s advanced BCC, it can spread much deeper into your tissue. Call your doctor if you see any of these changes in your skin. Ask them about genetic conditions and other risk factors that can raise your chances of advanced BCC.

Size

In general, advanced BCC includes tumors that are:

  • Wider than 2 centimeters
  • Thicker than 2 millimeters

Location

You can have advanced BCC even if your tumor isn’t that big. That’s usually the case if your cancer grows in or spreads to certain hard-to-treat spots. These include:

  • Around your eyes or eyelids
  • Nose
  • Hair follicle on your lip
  • Ear or ear canal
  • Brain
  • On your nerves

If you get advanced BCC in these areas, you may have symptoms such as:

  • Vision changes
  • Hearing problems
  • Nerve issues, like muscle weakness
  • Changes in the way you look

Where It Can Spread

Advanced BCC can spread to other tissue around your original tumor. Sometimes it can be hard for your doctor to tell exactly where the cancer “border” ends.

Advanced BCC may invade areas such as:

  • Deeper layers of skin
  • Bones in your face
  • Cartilage, like in your ear or nose
  • Muscle
  • Nearby lymph nodes

Very rarely, BCC cells that start in your skin spread to other areas of your body. That’s called metastatic BCC. It’s the most serious form of basal cell carcinoma.

Metastatic BCC might show up in the following areas:

  • Lymph nodes
  • Liver
  • Bones
  • Lungs
  • Base of your skull

Pay Attention to Your Skin

Check your body often for changes. That way you’ll know when something on your body changes or starts to look “off.”

It’s also a good idea to get your skin checked by a dermatologist once a year, especially if you’ve had BCC before. That’s because you’re more likely to get it again. And it’s sometimes hard to tell if it’s come back. But dermatologists are trained to spot new or recurring signs of skin cancer. They’ll know for sure.  

WebMD Medical Reference

Sources

SOURCES:

Frontiers in Oncology: “Sonidegib for the Treatment of Advanced Basal Cell Carcinoma.”

Current Dermatology Reports: “Advanced Basal Cell Carcinoma: Epidemiology and Therapeutic Innovations.”

Dermatology and Therapy: “Clinical Management of Locally Advanced Basal-Cell Carcinomas and Future Therapeutic Directions,” “Sonidegib: Safety and Efficacy in Treatment of Advanced Basal Cell Carcinoma.” 

American Cancer Society: “What Are Basal and Squamous Cell Skin Cancers?”

Skin Cancer Foundation: “Basal Cell Carcinoma: Warning Signs.”

Merck Manual: “Basal Cell Carcinoma.”

Journal of Drugs in Dermatology: “Defining Locally Advanced Basal Cell Carcinoma.”

The Ohio State University Comprehensive Cancer Center: “Basal Cell Carcinoma.”

Clinical & Translational Oncology: “Management of high-risk and advanced basal cell carcinoma.”

Stanford Health Care: “Basal Cell Carcinoma Stages.”

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