SCC Risk Stratification — SCE Dermatology MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: A — High risk — tumour diameter >4 cm is a high-risk feature in cSCC associated with increased recurrence and metastatic potential
The correct answer is A, high risk, tumour diameter greater than 4 cm is a high-risk feature in cSCC associated with increased recurrence and metastatic potential. BAD 2020 guidance stratifies cSCC by clinicopathological features that predict local recurrence, nodal metastasis and disease-specific death, and tumour diameter is one of these validated factors, with larger lesions carrying progressively worse outcomes. A diameter exceeding 4 cm places the tumour above the low-risk threshold and escalates management: wider excision margins, discussion at a specialist skin cancer MDT, consideration of imaging, sentinel lymph node biopsy and adjuvant radiotherapy, plus more intensive follow-up. This reflects the biology that larger tumours have had longer to invade deeper structures, lymphatics and perineural spaces, increasing occult spread risk even when other features look favourable.
Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/skin-conditions