Mohs Surgery & Skin Cancer
Basal Cell Carcinoma
The Most Common Skin Cancer — Diagnosis & Treatment in Alcoa, TN
Basal cell carcinoma is the most frequently diagnosed cancer in the United States — more common than all other cancers combined. While it rarely spreads to other parts of the body, it can be locally destructive, invading deep into underlying tissue including muscle, cartilage, and bone if left untreated. Early diagnosis and complete removal are essential.
What Is Basal Cell Carcinoma?
BCC originates in the basal cells — the deepest layer of the outer skin (epidermis). It most commonly develops on areas of the body with significant sun exposure: the face, scalp, ears, neck, chest, and hands. However, it can occur anywhere, including areas that are rarely exposed to the sun.
BCC grows slowly and almost never metastasizes. This is reassuring — but it does not mean BCC is harmless. Untreated BCC can burrow deep below the skin's surface, invade nerves and blood vessels, and cause significant disfigurement.
What Does Basal Cell Carcinoma Look Like?
Pearly or waxy bump — often with visible blood vessels (telangiectasias), typically on the face or neck
Flat, flesh-colored or brown scar-like lesion — may be superficial BCC on the trunk
Pink growth with raised edges and a crusted center
A sore that heals and returns, or bleeds spontaneously
Shiny, skin-colored or pink patch on the scalp or forehead
Because BCC can mimic benign skin conditions, any new or changing lesion — especially one that bleeds, doesn't heal, or looks unusual — deserves evaluation by a board-certified dermatologist.
Subtypes of Basal Cell Carcinoma
Nodular BCC
The most common subtype. Presents as a round, pearly or translucent bump, often with rolled borders and central crusting. Usually found on the face.
Superficial BCC
Appears as a flat, reddish-pink scaly patch. Often found on the trunk or shoulders. May resemble eczema or psoriasis and is frequently undertreated.
Morpheaform (Sclerosing) BCC
One of the most aggressive subtypes. Appears as a flat, white or yellowish scar-like lesion. Borders are poorly defined, and the tumor often extends significantly beyond what is visible. Mohs surgery is strongly preferred.
Infiltrative BCC
Similar to morpheaform — poorly defined margins and deep infiltration make standard excision high-risk for incomplete removal. Mohs is the treatment of choice.
Basosquamous (Metatypical) BCC
A rare, aggressive hybrid between BCC and squamous cell carcinoma. Has higher metastatic potential than typical BCC and requires aggressive treatment.
Treatment Options
Mohs Micrographic Surgery — Gold Standard
Offers the highest cure rates for BCC (up to 99% for primary tumors, up to 95% for recurrent tumors) with maximum tissue preservation. Recommended for BCC on the face, ears, nose, eyelids, lips, scalp, and any high-risk or recurrent tumor.
Standard Excision
Appropriate for low-risk BCC on the trunk or extremities with well-defined borders. Tissue is sent to pathology, and a second procedure may be required if margins are positive.
Electrodesiccation and Curettage (ED&C)
Appropriate for small, low-risk, well-defined superficial BCCs on the trunk or extremities. Not recommended for the face, scalp, or high-risk sites.
Topical Therapies
Imiquimod and 5-fluorouracil creams can be used for select superficial BCCs. Response rates are lower than surgical methods and long-term data is limited.
Radiation Therapy
May be considered for patients who are not surgical candidates.
High-Risk Features That Point to Mohs
Tumor location on face, ears, or scalp
Diameter > 2 cm
Poorly defined borders
Aggressive histologic subtype (morpheaform, infiltrative, basosquamous)
Recurrent tumor
Perineural or vascular invasion
Immunosuppressed patient
Schedule a Consultation
Call our Alcoa office — same-week evaluation available for suspicious lesions.
(865) 268-4444