Biopsy for BCC

Hi Doglover07 and a very warm welcome to the online community

I'm sorry to read that after having a punch biopsy you've been diagnosed with a nodular, infiltrating BCC. I don't know if the 'hole' beneath your scab is normal after having had that type of biopsy as mine was an excision closed with stitches.

If you don't get any response from other members in the group who have had secondary intention healing, then you could type 'secondary intention' into the search bar in this group to find previous posts which mention it. You could then respond to the poster if you wanted to ask any further questions.

Can I ask why you think that Mohs surgery is the 'gold standard'. The reason that I ask is that if you take a look at this leaflet about BCC and it's treatment from BAD (British Association of Dermatologists), you'll see that it's just one of a range of different treatment options, with the commonest treatment being simple surgery. It goes on to say that Mohs surgery is used to treat more complex BCCs, such as those present at difficult anatomical sites, and, as it's a time consuming process, is only undertaken when simple surgery may not be suitable.

There are plenty of people in the group who have had simple surgery and have been very pleased with the results, just as there are people who are happy with the Mohs micrographic surgery (link).

It would probably be a good idea to have a look at some of the threads which talk about both types of procedures. I'm going to tag BillBill and  into my reply to you as they have had simple surgery and Mohs surgery respectively. They're usually around the group so hopefully will come and tell you about their experiences with these two types of surgery.

Let us know what you decide to do and when you have a date for your op.

x

Hi, 

Thank you for responding.

I was concerned that the consultant was very blasé and just stated that they’d take an extra .5cm all around to hopefully ensure removal. That in addition to an already large site was alarming. As this is in the middle of my nose I’d prefer to lose as little tissue as possible.

I’ve decided to get a secondary opinion privately before making a final decision. X

A second opinion is a good idea Doglover07 as that should help you make up your mind which way you want to go. 

Just to add that it's amazing how wounds heal. I had about a 4 inch wound on my arm and a further 2 inch wound in my armpit when I had operations to remove a melanoma and a sentinel lymph node. Now you can hardly see them.

Do let us know what you decide to do.

x

Hello Doglover07,

As she mentioned Latchbrook tagged me as I've had several BCCs and SCCs removed.  All have been excised with conventional surgery and the results have all been excellent.  Only one was a largish carcinoma and that was a squamous cell carcinoma which, because of its size, involved a skin graft too.  The scars from the smaller cancers have long since ceased to be visible and even the one involving a skin graft is only noticeable if attention is drawn to it.  Most have been on my face.

I fully understand your desire for a second opinion and to have the best treatment possible. My sole purpose in writing is to try to give some reassurance that if you do have a standard excision my experiences have all been wholly positive.

Good Luck, Bill

Hi Doglover07

I had x2 punch biopsy one on top of nose and one a bit further up both infiltrating bcc, they stitched those up, I had MOHS surgery followed by a forehead flap done last October 19, it’s not for the faint hearted and 3 big procedures, MOHs is gold standard and I would do it again in a heartbeat, all my friends are amazed at how good it looks now, I basically have  a new tip of nose and partly down septum, I do have a big scar from just inside hairline down to corner of my left eye, You can hardly tell the line is so faint now and it’s only been 7 months. I don’t know we’re you live but I am in north west and there are 2 surgeons at St Helens hospital that do MOHs , I would definitely recommend either of them. 
good Luck

Frankie1

Hi,

Thank you for the responses. I think if the initial biopsy was small it would be ok but due to the starting point I’m keen for Moh’s to keep it as small as necessary but all gone! 
I’m in the north west but the consultant wouldn’t even discuss Moh’s - simple surgery or radiation- my choice!
I've a consultation at a private clinic on Monday so will see what advice he gives me. 

Thank you! 

Hi 

good luck let us know how you get on

Frankie1

Hi Doglover07, 

I had a punch biopsy on the tip of my nose and another near my eyebrow in early March, though mine were sutured rather than secondary intention. They healed quickly, but I do have a hole in both spots. The skin looks normal, just indented. 

Good luck with your private consultation. 

Hi,

Just back from appointment with private dermatologist. He recommends Moh’s surgery & can do it within a month with, hopefully, a nose flap repair. 
Just relieved that someone has now had a look & discussed all options with me. 
Thank you for the support x

That's great that you can have it done so quickly Doglover07. I guess it's a great relief now you've been able to discuss all the options.

Will you be having it done privately or on his NHS list?

x