Incomplete BCC Excision — SCE Dermatology MCQ

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HardSkin CancerIncomplete BCC ExcisionSCE Dermatology

A 55-year-old woman has an excised BCC with incomplete deep margin clearance at a high-risk site. She is not a surgical candidate for re-excision. What is the most appropriate non-surgical alternative?

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Correct answer: E — Adjuvant radiotherapy to the excision site

The best answer is “Adjuvant radiotherapy to the excision site”. BAD guidance stratifies BCC by site, subtype, border and margin status; high-risk or incompletely excised disease requires specialist discussion, while treatment should balance clearance, function and tissue preservation. The alternatives “Cryotherapy, after clinicopathological correlation”, “Topical 5-FU, after specialist assessment”, “Observation, when the full phenotype supports it”, “Topical Imiquimod over the scar” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: BAD basal cell carcinoma guideline 2021: https://academic.oup.com/bjd/article/185/5/899/6599942