SKIN CANCER: WHAT HAPPENS NEXT AFTER DIAGNOSIS

Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC) & Melanoma

A diagnosis of skin cancer raises an immediate question: what happens next?

The answer depends on the type of skin cancer, pathology findings, depth and subtype of the tumor, anatomic location, margin status, and individual risk factors. Treatment may range from surgical excision in the office to referral for Mohs surgery, surgical oncology, or multidisciplinary care.

At International Vein & Skin Institute, pathology findings are reviewed with the patient and the next step is explained clearly. Selected skin cancers are treated surgically at IVSI when standard excision is appropriate. When the diagnosis, location, or risk characteristics require specialized treatment, referral is recommended and coordinated.

UNDERSTANDING THE DIAGNOSIS

BASAL CELL CARCINOMA (BCC)

Basal cell carcinoma is the most common type of skin cancer.

BCC is typically slow-growing and rarely spreads to distant parts of the body, but it can continue to grow and become locally destructive when left untreated.

Some basal cell carcinomas are relatively straightforward to treat with standard surgical excision. Others have characteristics—such as aggressive histologic subtype, recurrence, poorly defined borders, or location in a high-risk anatomic area—that require more specialized surgical management.

SQUAMOUS CELL CARCINOMA (SCC)

Cutaneous squamous cell carcinoma is an invasive skin cancer arising from keratinocytes.

SCC may develop in areas of chronic sun damage or in association with precancerous changes such as actinic keratosis. Compared with BCC, squamous cell carcinoma has a greater potential for local invasion and metastatic spread, making appropriate risk assessment and timely treatment important.

Treatment depends on the characteristics of the individual tumor. Selected lesions can be treated with standard surgical excision, while higher-risk SCC may require Mohs surgery or multidisciplinary management.

MELANOMA

Melanoma is biologically different from BCC and SCC and follows a different treatment pathway.

Important pathology findings include tumor thickness (Breslow depth), ulceration, margin status, and other characteristics used to determine treatment and staging.

Depending on these findings, management may require wide local excision, sentinel lymph node evaluation, oncology consultation, or other specialized care.

WHAT HAPPENS NEXT AT IVSI

After a skin cancer diagnosis, Dr. Jozef Tryzno reviews the pathology findings together with the clinical and anatomic characteristics of the lesion.

The next step may include:

Surgical excision at IVSI when standard excision is an appropriate treatment
Additional treatment when pathology shows that further removal is necessary
Referral for Mohs micrographic surgery when margin-controlled surgery is more appropriate
Referral to appropriate specialists for definitive melanoma treatment and staging
Follow-up and skin surveillance based on the diagnosis and individual risk

The goal is not to perform every possible skin cancer procedure within one office. It is to determine which treatment pathway is appropriate for the individual diagnosis and to direct care accordingly.

BASAL CELL CARCINOMA — TREATMENT PLANNING

Treatment of basal cell carcinoma is based on the histologic subtype, tumor size and depth, location, borders, previous treatment, and other risk characteristics.

TOPICAL TREATMENT — SELECTED BCC

For selected superficial, low-risk basal cell carcinomas, topical treatment may be considered as an alternative to surgical removal.

Prescription medications such as imiquimod or topical 5-fluorouracil (5-FU) may be used for appropriately selected lesions. Treatment requires application over a prescribed period and typically produces a localized inflammatory reaction during treatment.

Topical treatment is not appropriate for every BCC. Selection depends on the histologic subtype, lesion characteristics and location, and the ability to adequately monitor the treated area.

Clinical follow-up after treatment is important to assess response and determine whether additional treatment is necessary.

STANDARD SURGICAL EXCISION

Selected basal cell carcinomas can be treated at IVSI with standard surgical excision.

When performed at IVSI:

Local anesthesia is administered
Incision is performed using a surgical CO₂ laser in cutting mode
The tumor is removed with margins selected for the lesion being treated
The wound is closed with sutures
Removed tissue is submitted for histopathologic examination and margin assessment

The objective is complete tumor removal while preserving surrounding healthy tissue and function.

Final pathology determines whether the examined margins are clear. Additional treatment is recommended when further tumor removal is necessary.

WHEN MOHS SURGERY IS MORE APPROPRIATE

Some basal cell carcinomas are better treated with Mohs micrographic surgery, particularly when tumor characteristics or anatomic location make precise margin control especially important.

This may include selected:

Recurrent tumors
Poorly defined tumors
Aggressive histologic subtypes
Tumors involving high-risk or tissue-sensitive facial locations

Mohs surgery is not performed at IVSI. When Mohs surgery is the more appropriate treatment, the patient is referred for specialized care.

SQUAMOUS CELL CARCINOMA — TREATMENT PLANNING

Treatment of squamous cell carcinoma is based on the size, depth, differentiation, anatomic location, pathology findings, and individual risk factors.

STANDARD SURGICAL EXCISION

Selected SCCs can be treated with standard surgical excision when the characteristics of the tumor make this an appropriate approach.

The tumor is removed with surgical margins, the wound is repaired, and the specimen is submitted for histopathologic examination and margin assessment.

WHEN SPECIALIZED TREATMENT IS NEEDED

Certain squamous cell carcinomas carry greater risk because of factors such as:

Greater tumor size or depth
Poor differentiation
Perineural involvement
Recurrence
High-risk anatomic location
Immunosuppression or other significant patient risk factors

Depending on these findings, standard surgical excision, Mohs surgery, specialized surgical treatment, or multidisciplinary care may be considered.

Treatment options are reviewed with the patient, and appropriate referrals are provided when specialized treatment or consultation is selected or recommended.

MELANOMA — A DIFFERENT TREATMENT PATHWAY

A diagnosis of melanoma requires careful review of the pathology because treatment planning and staging depend on the characteristics of the individual tumor.

After melanoma is diagnosed, important findings may include:

Breslow depth
Ulceration
Margin status
Other histopathologic characteristics relevant to staging and treatment

Depending on the pathology, treatment may include wide local excision, sentinel lymph node biopsy, additional staging, and oncology or surgical oncology care.

While the initial diagnosis of melanoma may be established through a biopsy performed at IVSI, once melanoma is confirmed, the patient is referred to the appropriate specialists for definitive treatment, staging, and ongoing melanoma management.

FOLLOW-UP AND SKIN CANCER SURVEILLANCE

A previous skin cancer diagnosis increases the importance of continued skin surveillance.

Follow-up is individualized according to the type of cancer, pathology findings, treatment performed, and individual risk profile. Patients may be advised to undergo periodic skin examinations and to monitor for new or changing lesions between visits.

Patients with melanoma follow the surveillance recommendations of their treating melanoma specialists. Follow-up for other skin cancers is individualized according to diagnosis, treatment, and risk.

DISCUSS NEXT STEPS IN YOUR CARE

If you have received a skin biopsy or pathology report showing basal cell carcinoma, squamous cell carcinoma, melanoma, or another concerning skin lesion, a consultation can help clarify what the diagnosis means and what treatment pathway is appropriate.

📞 Call (847) 518-9999 to discuss next steps in care.

Medical Disclaimer
This information is provided for educational purposes only and does not replace individualized medical evaluation. Treatment recommendations depend on clinical findings, diagnostic requirements, and patient-specific factors. Outcomes may vary, and no specific medical or cosmetic result can be guaranteed.

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