Materiały źródłowe

• #1 Nonmelanoma Skin Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3339125/

  Nonmelanoma skin cancer (NMSC) represents the most common form of cancer in Caucasians, with continuing increase in incidence worldwide. Basal cell carcinoma (BCC) accounts for 75% of cases of NMSC, and squamous cell carcinoma (SCC) accounts for the remaining majority of NMSC cases. […] In this article, we review the aetiology, diagnosis and management of NMSC. […] The diagnosis of NMSC in classical cases can be made clinically. With the exception of BCC of the superficial subtype, the majority of NMSC arises over sun-exposed skin. SCC tends to present as rapidly growing pink or red nodules, which may be hyperkeratotic or ulcerated. […] The clinical features of BCC depend upon the subtype. Nodular BCC is the commonest subtype accounting for over 60% of cases of BCC, and presents as pink nodules, with rolled edges, surface telangiectasia and ulceration or crusting. […] Dermoscopy has been used as an aid for diagnosis of BCC, with leaf-like areas, blue-grey blotches, wheel-spoke like areas, and arborising blood vessels seen on examination. Skin biopsy, in addition to confirmation of diagnosis, allows stratification of tumours into high- and low-risk malignancies.

• #2

  http://www.bccancer.bc.ca/health-info/types-of-cancer/skin/skin-non-melanoma

  Non-melanoma skin cancer is the most common cancer diagnosed in Canada. The main types of non-melanoma skin cancers are Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). […] How is non-melanoma skin cancer diagnosed? Tests that may help diagnose non-melanoma skin cancer include: Physical exam by a family doctor or dermatologist (skin doctor), including exam of lymph nodes. Biopsy: a doctor removes a sample of skin. The tissue is then examined by a specialist doctor (pathologist) under a microscope. […] There are two main types of non-melanoma skin cancer. Basal cell carcinoma (BCC) is the most common type of skin cancer, accounting for about 75-80% of all skin cancers. Squamous cell carcinoma (SCC) is the second most common type of skin cancer, making up about 20% of all skin cancers.

• #3 The incidence and clinical analysis of non-melanoma skin cancer | Scientific Reports

  https://www.nature.com/articles/s41598-021-83502-8

  Non-melanoma skin cancers (NMSCs) are the most common malignancies diagnosed in Caucasian populations. Basal cell carcinoma (BCC) is the most frequent skin cancer, followed by squamous cell carcinoma (SCC). Unfortunately, most European cancer registries do not record individual types of NMSC. […] To evaluate the incidence of primary BCCs and SCCs regarding age, sex, tumour site and tumour subtype to determine trends in epidemiology of both cancers. Retrospective analysis of BCCs and SCCs diagnosed and treated across seven sites in Poland from 1999 to 2019. We recorded 13,913 NMSCs occurring in 10,083 patients. BCC represented 85.2% of all cases. SCC patients were older than BCC patients (77.111.3 years vs. 70.112.3 years, p0.01). […] BCC and SCC are common malignancies developing at various ages and anatomical sites. These data underline the need for better registration policies regarding NMSC in order to improve prevention and treatment strategies for these tumours.

• #4 Diagnosis of non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/diagnosis

  Diagnosis is the process of finding out the cause of a health problem. Diagnosing cancer often means first ruling out other health conditions that share similar symptoms with cancer. […] Diagnosing non-melanoma skin cancer usually begins with a visit to your family doctor. Your doctor will ask you about any signs or symptoms you have and will do a skin exam. Based on this information, your doctor will refer you to a specialist, such as a dermatologist or surgeon. […] The following tests are usually used to rule out or diagnose non-melanoma skin cancer. […] A skin exam allows your doctor to look for any signs of skin cancer or an abnormal area of skin. During a skin exam, your doctor will check the entire surface of your skin, especially areas of skin exposed to the sun. […] Some non-melanoma skin cancers can spread to the lymph nodes. Your doctor may also feel nearby lymph nodes to see if they are larger than normal.

• #5 Skin cancer (non-melanoma) | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/skin-cancer-non-melanoma/

  Your GP can examine your skin for signs of skin cancer. They may refer you to a skin specialist (dermatologist) or a specialist plastic surgeon if they are unsure or suspect skin cancer. […] The specialist will examine your skin again and will perform a biopsy to confirm a diagnosis of skin cancer. […] A diagnosis of non-melanoma skin cancer will usually begin with a visit to your GP who will examine your skin and decide whether you need further assessment by a specialist. […] If skin cancer is suspected, you may be referred to a skin specialist (dermatologist) or specialist plastic surgeon. The specialist should be able to confirm the diagnosis by carrying out a physical examination. […] However, they will probably also perform a biopsy – a surgical procedure where either a part or all of the tumour is removed and studied under a microscope.

• #6 Nonmelanoma skin cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nonmelanoma-skin-cancer/diagnosis-treatment/drc-20579827

  Tests and procedures used to diagnose nonmelanoma skin cancer skin include: […] A member of your healthcare team asks about your health history and looks at your skin for signs of nonmelanoma skin cancer. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. […] If a biopsy shows nonmelanoma skin cancer, other tests also may be needed to check if cancer has spread beyond the skin. […] If your healthcare professional suspects that you may have nonmelanoma skin cancer, you may be referred to a specialist. […] Below are some basic questions to ask your healthcare professional about nonmelanoma skin cancer. […] Do I have nonmelanoma skin cancer? What kind? […] How is this type of skin cancer different from other types? […] Has my cancer spread? […] What treatment do you recommend?

• #7 Nonmelanoma Skin Cancer: Diagnosis

  https://encyclopedia.nm.org/Wellness/BackandNeck/Tools/34,BMelD1

  Diagnosing skin cancer starts with checking out a bump, spot, sore, colored area, or other mark on your skin. Any area of skin that doesnt look normal and may have disease is called a lesion. Most lesions are not cancer, but some may be cancer. You may need to see a dermatologist. This is a healthcare provider with special training in diagnosing and treating skin problems. […] If your healthcare provider thinks you might have nonmelanoma skin cancer, you will need certain exams and tests to be sure. Diagnosing skin cancer starts with your healthcare provider asking you questions. They will ask you about your health history, symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam and skin exam. […] Make sure to tell your healthcare provider if youve had skin cancer in the past. Also tell them if anyone in your family has had skin cancer.

• #8 Nonmelanoma Skin Cancer: Diagnosis

  https://healthinfo.coxhealth.com/YourFamily/children/34,BMelD1

  Diagnosing skin cancer starts with checking out a bump, spot, sore, colored area, or other mark on your skin. Any area of skin that doesnt look normal and may have disease is called a lesion. Most lesions are not cancer, but some may be cancer. You may need to see a dermatologist. This is a healthcare provider with special training in diagnosing and treating skin problems. […] If your healthcare provider thinks you might have nonmelanoma skin cancer, you will need certain exams and tests to be sure. Diagnosing skin cancer starts with your healthcare provider asking you questions. They will ask you about your health history, symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam and skin exam. […] Some skin lesions may look suspicious for skin cancer and need to be removed. A biopsy is a small piece (sample) of tissue thats taken to be checked in a lab. Your healthcare provider will likely take a biopsy of any lesion that may look like cancer.

• #9 Diagnosis of non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/diagnosis

  Diagnosis is the process of finding out the cause of a health problem. Diagnosing cancer often means first ruling out other health conditions that share similar symptoms with cancer. […] Diagnosing non-melanoma skin cancer usually begins with a visit to your family doctor. Your doctor will ask you about any signs or symptoms you have and will do a skin exam. Based on this information, your doctor will refer you to a specialist, such as a dermatologist or surgeon. […] The following tests are usually used to rule out or diagnose non-melanoma skin cancer. […] A skin exam allows your doctor to look for any signs of skin cancer or an abnormal area of skin. During a skin exam, your doctor will check the entire surface of your skin, especially areas of skin exposed to the sun. […] Some non-melanoma skin cancers can spread to the lymph nodes. Your doctor may also feel nearby lymph nodes to see if they are larger than normal.

• #10 Basal and Squamous Cell Skin Cancer Tests | Skin Cancer Biopsy | American Cancer Society

  https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/how-diagnosed.html

  Most basal and squamous cell skin cancers are brought to a doctors attention because of signs or symptoms a person is having. […] If you have an abnormal area that might be skin cancer, your doctor will examine it and might do tests to find out if it is cancer or some other skin condition. […] If skin cancer is found and theres a chance it might have spread to other areas of the body, other tests might be done as well. […] Usually the first step is for your doctor to ask about your symptoms, such as when the mark first appeared on the skin, if it has changed in size or appearance, and if it has been painful, itchy, or bleeding. […] The doctor may also feel the nearby lymph nodes, which are bean-sized collections of immune system cells under the skin in certain areas. Some skin cancers can spread to lymph nodes. When this happens, the nodes might be felt as lumps under the skin.

• #11 Diagnosis of non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/diagnosis

  During a skin biopsy, the doctor removes tissues or cells from the skin so they can be tested in a lab. A report from a pathologist will show whether or not cancer cells are found in the sample. The type of biopsy used often depends on what the growth or abnormal area looks like and where it is located. […] An excisional biopsy (a type of surgical biopsy) removes the entire growth or abnormal area using a scalpel. It is usually done when the doctor thinks the whole growth or area needs to be examined to make a proper diagnosis.

• #12 Basal and Squamous Cell Skin Cancer Tests | Skin Cancer Biopsy | American Cancer Society

  https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/how-diagnosed.html

  If the doctor thinks that a suspicious area might be skin cancer, the area (or part of it) will be removed and sent to a lab to be looked at under a microscope. This is called a skin biopsy. […] Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a very small needle. […] If an FNA doesn’t find cancer in a lymph node but the doctor still suspects the cancer has spread there, the lymph node may be removed by surgery and examined. […] But if your doctor thinks you might be at risk for the cancer spreading outside the skin, imaging tests such as an MRI or CT scan might be done.

• #13 Diagnosis of non-melanoma skin cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/skin-non-melanoma/diagnosis

  During a skin biopsy, the doctor removes tissues or cells from the skin so they can be tested in a lab. A report from a pathologist will show whether or not cancer cells are found in the sample. The type of biopsy used often depends on what the growth or abnormal area looks like and where it is located. […] An excisional biopsy (a type of surgical biopsy) removes the entire growth or abnormal area using a scalpel. It is usually done when the doctor thinks the whole growth or area needs to be examined to make a proper diagnosis.

• #14 Nonmelanoma Skin Cancer: Diagnosis

  https://healthlibrary.brighamandwomens.org/InteractiveTools/Quizzes/34,BMelD1

  What is a biopsy? Some skin lesions may look suspicious for skin cancer and need to be removed. A biopsy is a small piece (sample) of tissue thats taken to be checked in a lab. Your healthcare provider will likely take a biopsy of any lesion that may look like cancer. […] Types of biopsies The different types of biopsies include: […] Shave biopsy. This type of biopsy removes the top layers of skin of a lesion. This type of biopsy is often used for very flat skin lesions. Your healthcare provider will inject the area with numbing medicine and then shave off the lesion with a sharp blade. Sometimes part of the lesion may be left behind. You may need another procedure to remove it completely. […] Punch biopsy. This type uses a special tool to take a deep sample of skin. This may be done if the lesion is small, when just a part of a larger lesion needs more study. Or it may be done if your healthcare provider wants more information about the undersurface of the lesion. The tool is like a very small paper hole punch or apple corer. It removes a short cylinder of tissue. First, your healthcare provider uses a numbing medicine on the area. The punch tool is turned on the surface of the skin until it cuts through all the layers of skin. This includes the dermis, epidermis, and the most superficial parts of the skin fat (subcutis). The provider removes the biopsy sample and may then stitch together the edges of the wound. […] Excisional biopsy. This type of biopsy is often used when your healthcare provider needs a wider or deeper piece of the skin. The entire lesion and sometimes part of the surrounding skin is removed. First, your healthcare provider uses numbing medicine on the area. Then the provider uses a surgical knife (scalpel) to remove a full thickness wedge of skin. The wound is closed with surgical thread (stitches), staples, tape, or surgical glue. What the provider uses depends on how large the incision is and where it is. […] Incisional biopsy. This procedure is like an excisional biopsy. But only part of the lesion is removed.

• #15 Nonmelanoma Skin Cancer: Diagnosis

  https://healthlibrary.vidanthealth.com/Wellness/Nutrition/Tools/34,BMelD1

  Incisional biopsy. This procedure is like an excisional biopsy. But only part of the lesion is removed. […] Lab tests of your biopsy sample A biopsy sample is sent to a lab, where a physician called a pathologist looks at it under a microscope. […] If skin cancer is found, the pathologist will look at certain features of the lesion. These include the type of skin cancer, and the thickness of the lesion. This can help your healthcare provider figure out the extent (stage) of the skin cancer. The stage of skin cancer helps decide treatment choices. […] Getting your biopsy results Your biopsy results will likely be ready in a few days to a week or so. Your healthcare provider will give you the results. They will talk with you about other tests that you may need if skin cancer is found. Make sure you understand the results and what follow-up you need.

• #16 Nonmelanoma Skin Cancer: Diagnosis

  https://healthlibrary.vidanthealth.com/Wellness/Nutrition/Tools/34,BMelD1

  Punch biopsy. This type uses a special tool to take a deep sample of skin. This may be done if the lesion is small, when just a part of a larger lesion needs more study. Or it may be done if your healthcare provider wants more information about the undersurface of the lesion. The tool is like a very small paper hole punch or apple corer. It removes a short cylinder of tissue. First, your healthcare provider uses a numbing medicine on the area. The punch tool is turned on the surface of the skin until it cuts through all the layers of skin. This includes the dermis, epidermis, and the most superficial parts of the skin fat (subcutis). The provider removes the biopsy sample and may then stitch together the edges of the wound. […] Excisional biopsy. This type of biopsy is often used when your healthcare provider needs a wider or deeper piece of the skin. The entire lesion and sometimes part of the surrounding skin is removed. First, your healthcare provider uses numbing medicine on the area. Then the provider uses a surgical knife (scalpel) to remove a full thickness wedge of skin. The wound is closed with surgical thread (stitches), staples, tape, or surgical glue. What the provider uses depends on how large the incision is and where it is.

• #17 Nonmelanoma Skin Cancer: Diagnosis

  https://healthlibrary.vidanthealth.com/Wellness/Nutrition/Tools/34,BMelD1

  Make sure to tell your healthcare provider if youve had skin cancer in the past. Also tell them if anyone in your family has had skin cancer. […] What is a biopsy? Some skin lesions may look suspicious for skin cancer and need to be removed. A biopsy is a small piece (sample) of tissue thats taken to be checked in a lab. Your healthcare provider will likely take a biopsy of any lesion that may look like cancer. […] Types of biopsies The different types of biopsies include: […] Shave biopsy. This type of biopsy removes the top layers of skin of a lesion. This type of biopsy is often used for very flat skin lesions. Your healthcare provider will inject the area with numbing medicine and then shave off the lesion with a sharp blade. Sometimes part of the lesion may be left behind. You may need another procedure to remove it completely.

• #18 Nonmelanoma Skin Cancer Diagnosis – Blue Ridge Cancer Care

  https://blueridgecancercare.com/disease-drug-information/types-of-cancer/nonmelanoma-skin-cancer/diagnosis/

  If you have a change on the skin, the doctor must find out whether it is due to cancer or to some other cause. Your doctor removes all or part of the area that does not look normal. The sample goes to a lab. A pathologist checks the sample under a microscope. This is a biopsy. A biopsy is the only sure way to diagnose skin cancer. […] You may have the biopsy in a doctors office or as an outpatient in a clinic or hospital. Where it is done depends on the size and place of the abnormal area on your skin. You probably will have local anesthesia. […] There are four common types of skin biopsies: Punch biopsy: The doctor uses a sharp, hollow tool to remove a circle of tissue from the abnormal area. Incisional biopsy: The doctor uses a scalpel to remove part of the growth. Excisional biopsy: The doctor uses a scalpel to remove the entire growth and some tissue around it. Shave biopsy: The doctor uses a thin, sharp blade to shave off the abnormal growth.

• #19 Basal and Squamous Cell Skin Cancer Tests | Skin Cancer Biopsy | American Cancer Society

  https://www.cancer.org/cancer/types/basal-and-squamous-cell-skin-cancer/detection-diagnosis-staging/how-diagnosed.html

  If the doctor thinks that a suspicious area might be skin cancer, the area (or part of it) will be removed and sent to a lab to be looked at under a microscope. This is called a skin biopsy. […] Skin biopsies are done using a local anesthetic (numbing medicine), which is injected into the area with a very small needle. […] If an FNA doesn’t find cancer in a lymph node but the doctor still suspects the cancer has spread there, the lymph node may be removed by surgery and examined. […] But if your doctor thinks you might be at risk for the cancer spreading outside the skin, imaging tests such as an MRI or CT scan might be done.

• #20 Non Melanoma Diagnostic Process | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/cancer/non-melanoma/patient-care-resources/diagnosis.html

  If needed, you may undergo further imaging tests, blood work, or a biopsy. […] After this testing, it typically takes a few days to 2 weeks to review the results and confirm your diagnosis. Getting your test results can take time because your care team is working hard to determine an accurate diagnosis for you. […] Many health care professionals collaborate in the process and provide expert analysis, including your oncologist (cancer doctor), radiologist, and pathologist. Years of experience studying lung cancer every day means your pathologist can accurately identify critical details, such as whether the cancer: […] Is invades into the skin or just involves the top layer of the skin (epidermis), including a measurement of the tumor thickness […] Shows ulceration, where tumor cells push through the epidermis

• #21 Skin cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/skin-cancer/diagnosis-treatment/drc-20377608

  A skin cancer diagnosis often starts with an exam of your skin. A healthcare professional might remove some skin to test it for cancer. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. To get a piece of skin, a healthcare professional may use a cutting tool to cut away some or all of the worrying skin growth. […] The skin tissue sample goes to a lab for testing. Tests can show whether the sample contains cancer cells. […] Some people with skin cancer may need other tests to find out whether the cancer has spread. This is called cancer staging. The stage of the cancer tells the healthcare team about its size and whether it has spread. […] Not everyone with skin cancer needs cancer staging. Most skin cancers don’t spread. […] If your healthcare professional thinks there’s a risk that your cancer may have spread, you might have staging tests.

• #22 Non-melanoma skin cancer diagnosis: a comparison between dermoscopic and smartphone images by unified visual and sonification deep learning algorithms

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8453469/

  Non-melanoma skin cancer (NMSC) is the most frequent keratinocyte-origin skin tumor. It is confirmed that dermoscopy of NMSC confers a diagnostic advantage as compared to visual face-to-face assessment. […] This study evaluated by a dual convolutional neural network (CNN) performance metrics in dermoscopic (DI) versus smartphone-captured images (SI) and tested if artificial intelligence narrows the proclaimed gap in diagnostic accuracy. […] The use of dermoscopy, the standard of care by physicians, confers a diagnostic advantage for NMSC identification over visual inspection. A Cochrane review concluded that dermoscopy increases sensitivity of NMSC diagnostics by 14% over visual inspection. […] These levels of human performance leave room for improvement by a CNN usage in dermatology in to avoid unnecessary excisions or extended surgical interventions and possible disfigurement.

• #23 Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

  https://www.mdpi.com/2075-4418/13/4/793

  High-risk NMSC may invade local anatomic structures, more, about 5% of squamous cell carcinomas have a high risk of distant metastasis and indicate optimal diagnostic imaging, including computed tomography and magnetic resonance imaging. […] Lesion characterization, differentiation, and risk stratification are required for future clinical decision-making, surgical versus nonsurgical lesion management, and for prognostic evaluation. […] The staging and risk stratification of NMSCs is based on their clinical-pathological features that are defined by National Comprehensive Cancer Network (NCCN) guidelines (2014) to differentiate low and high-risk carcinomas recurrence and metastasis. […] Many NMSCs could be managed without additional information provided by imaging and are not required in low-risk patients (pT1a). However, in pT1b to pT4b stages, additional information is necessary to optimize management, so ultrasound, computed tomography (CT) scan, positron emission tomography (PET) studies, as well as magnetic resonance imaging (MRI) are optional imaging modalities before operation or sentinel node biopsy (SNB).

• #24 Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

  https://www.mdpi.com/2075-4418/13/4/793

  Compared to CT scans, MRI provides good soft tissue contrast and is a good helping tool for examination or evaluation of configuration, intra-tumoral homogeneity, signal intensity, cyst formation, and haemorrhage. […] The study by Rajesh et al. demonstrated significantly shorter survival among patients with clinically suspected perineural invasion with squamous cell carcinoma and basal cell carcinomas, with imaging evidence of perineural spread. […] The treatment response improved with utilization of immunotherapy, however, new critical issues have arisen for radiologists, such as the atypical response pattern, pseudo-progression, as well as immune-related adverse events that require early identification for optimized and improved patient prognosis and management.

• #25 Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

  https://www.mdpi.com/2075-4418/13/4/793

  Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. […] Nonmelanoma skin cancer patients would benefit greatly from an improved diagnostic imaging-based risk stratification and staging method that takes into account patient characteristics. […] Risk stratification and staging tools are crucial in treatment planning and prognostic evaluation. […] PET/CT appears more sensitive and superior to CT and MRI for nodal and distant metastasis as well as in surveillance after surgery. […] Imaging is required when the risk of invasion is concerned. Imaging is an indispensable tool for the detection of nodal and distant disease and staging of aggressive neoplasms.

• #26 Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

  https://www.mdpi.com/2075-4418/13/4/793

  The application of high-frequency US (HFUS) in nonmelanoma skin cancer facilitated high diagnostic accuracy in NMSC phase staging. […] However, biopsy and histopathological analysis are gold standards and compulsive for correct staging even if HFUS detects nodular features to confirm the diagnosis. […] Ultrasound, in the detection and staging of NMSCs, is more sensitive and specific than physical evaluation and is considered superior in the detection of lymph nodes metastasis during NMSC surveillance compared to other diagnostic tools such as CT or PET/CT scan. […] In NMSCs, diagnostic imaging is performed in high-risk patients with suspicion of bony or other soft invasions, such as suspicious perineural invasion, therefore, an MRI scan is performed to assess the lesion extension and depth in soft tissue; and positron emission tomography (PET)/CT, 18F-fluorodeoxyglucose (FDG) is helpful in assessing nodal and distant metastases.

• #27

  https://link.springer.com/article/10.1007/s00432-021-03809-x

  Non-melanoma skin cancer (NMSC) is the most frequent keratinocyte-origin skin tumor. It is confirmed that dermoscopy of NMSC confers a diagnostic advantage as compared to visual face-to-face assessment. […] This study evaluated by a dual convolutional neural network (CNN) performance metrics in dermoscopic (DI) versus smartphone-captured images (SI) and tested if artificial intelligence narrows the proclaimed gap in diagnostic accuracy. […] The use of dermoscopy, the standard of care by physicians, confers a diagnostic advantage for NMSC identification over visual inspection. A Cochrane review concluded that dermoscopy increases sensitivity of NMSC diagnostics by 14% over visual inspection. […] These levels of human performance leave room for improvement by a CNN usage in dermatology in to avoid unnecessary excisions or extended surgical interventions and possible disfigurement.

• #28 Nonmelanoma Skin Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3339125/

  Nonmelanoma skin cancer (NMSC) represents the most common form of cancer in Caucasians, with continuing increase in incidence worldwide. Basal cell carcinoma (BCC) accounts for 75% of cases of NMSC, and squamous cell carcinoma (SCC) accounts for the remaining majority of NMSC cases. […] In this article, we review the aetiology, diagnosis and management of NMSC. […] The diagnosis of NMSC in classical cases can be made clinically. With the exception of BCC of the superficial subtype, the majority of NMSC arises over sun-exposed skin. SCC tends to present as rapidly growing pink or red nodules, which may be hyperkeratotic or ulcerated. […] The clinical features of BCC depend upon the subtype. Nodular BCC is the commonest subtype accounting for over 60% of cases of BCC, and presents as pink nodules, with rolled edges, surface telangiectasia and ulceration or crusting. […] Dermoscopy has been used as an aid for diagnosis of BCC, with leaf-like areas, blue-grey blotches, wheel-spoke like areas, and arborising blood vessels seen on examination. Skin biopsy, in addition to confirmation of diagnosis, allows stratification of tumours into high- and low-risk malignancies.

• #29 Nonmelanoma Skin Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3339125/

  Nonmelanoma skin cancer (NMSC) represents the most common form of cancer in Caucasians, with continuing increase in incidence worldwide. Basal cell carcinoma (BCC) accounts for 75% of cases of NMSC, and squamous cell carcinoma (SCC) accounts for the remaining majority of NMSC cases. […] In this article, we review the aetiology, diagnosis and management of NMSC. […] The diagnosis of NMSC in classical cases can be made clinically. With the exception of BCC of the superficial subtype, the majority of NMSC arises over sun-exposed skin. SCC tends to present as rapidly growing pink or red nodules, which may be hyperkeratotic or ulcerated. […] The clinical features of BCC depend upon the subtype. Nodular BCC is the commonest subtype accounting for over 60% of cases of BCC, and presents as pink nodules, with rolled edges, surface telangiectasia and ulceration or crusting. […] Dermoscopy has been used as an aid for diagnosis of BCC, with leaf-like areas, blue-grey blotches, wheel-spoke like areas, and arborising blood vessels seen on examination. Skin biopsy, in addition to confirmation of diagnosis, allows stratification of tumours into high- and low-risk malignancies.

• #30 Skin cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/skin-cancer/diagnosis-treatment/drc-20377608

  Skin cancer staging tests might include: Imaging tests make pictures of the inside of the body. The pictures might show the size of the skin cancer and whether it has spread. […] A sentinel lymph node biopsy is a procedure to remove some lymph nodes for testing. When skin cancer spreads, it typically goes to the lymph nodes first. […] Your healthcare team uses the results of these tests to give your cancer a stage. The stages of skin cancer range from 0 to 4. […] A stage 4 skin cancer often is a cancer that has spread to the lymph nodes or to other parts of the body. […] Make an appointment with a doctor or other healthcare professional if you have any skin changes that worry you. If your healthcare professional thinks you might have skin cancer, that person may refer you to a specialist. […] Some basic questions to ask about skin cancer include: Do I have skin cancer? What type of skin cancer do I have? Will I need other tests? How quickly does my type of skin cancer grow and spread? What are my treatment options? […] Your healthcare professional likely will ask about your symptoms.

• #31 Non-Melanoma Skin Cancer: Staging and Treatment | OncoLink

  https://www.oncolink.org/cancers/skin/non-melanoma-skin-cancers/non-melanoma-skin-cancer-staging-and-treatment

  There are two main types of non-melanoma skin cancer, named for the cells in which they start: Basal cell carcinoma (BCC): Starts in basal cells. Squamous cell carcinoma (SCC): Starts in squamous cells. […] Staging is the process of learning how much cancer is in your body, where it is, and if it has spread. Tests like a biopsy, chest x-ray, CT scan, MRI, and blood tests may be done to help stage your cancer. Your providers need to know about your cancer and your health so that they can plan the best treatment for you. […] Cancer staging looks at the size of the tumor and where it is, and if it has spread to other organs. The staging system for non-melanoma cancer is called the TNM system. It has three parts: T-Describes the size/extent of the tumor and if it has grown deeper into nearby structures or tissues, such as a bone. N-Describes if the cancer has spread to the lymph nodes. M-Describes if the cancer has spread to other organs (called metastases).

• #32 Non-Melanoma Skin Cancers | Huntsman Cancer Institute | University of Utah Health

  https://healthcare.utah.edu/huntsmancancerinstitute/skin-cancer/non-melanoma-skin-cancers

  Cancer stages show whether cancer has spread within the skin or to other parts of the body. Cancer spreads in the body in three ways: through tissue, the lymph system, or the blood. […] These are the stages used for skin cancer: Stage 0 (carcinoma in situ): Abnormal cells are in the squamous cell or basal cell layer of the epidermis. Stage 1: Cancer has formed, and the tumor is smaller than 2 centimeters at its widest point or has one high-risk feature. Stage 2: Tumor is either larger than 2 centimeters at the widest point, or of any size with more high-risk features. Stage 3: Tumor has spread to the jaw, eye socket, side of the skull, or one lymph node with the lymph node no larger than 3 centimeters. Stage 4: The tumor is any size and has spread to other parts of the body and/or lymph nodes.

• #33 Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

  https://www.mdpi.com/2075-4418/13/4/793

  Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. […] Nonmelanoma skin cancer patients would benefit greatly from an improved diagnostic imaging-based risk stratification and staging method that takes into account patient characteristics. […] Risk stratification and staging tools are crucial in treatment planning and prognostic evaluation. […] PET/CT appears more sensitive and superior to CT and MRI for nodal and distant metastasis as well as in surveillance after surgery. […] Imaging is required when the risk of invasion is concerned. Imaging is an indispensable tool for the detection of nodal and distant disease and staging of aggressive neoplasms.

• #34 Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment

  https://www.mdpi.com/2075-4418/13/4/793

  High-risk NMSC may invade local anatomic structures, more, about 5% of squamous cell carcinomas have a high risk of distant metastasis and indicate optimal diagnostic imaging, including computed tomography and magnetic resonance imaging. […] Lesion characterization, differentiation, and risk stratification are required for future clinical decision-making, surgical versus nonsurgical lesion management, and for prognostic evaluation. […] The staging and risk stratification of NMSCs is based on their clinical-pathological features that are defined by National Comprehensive Cancer Network (NCCN) guidelines (2014) to differentiate low and high-risk carcinomas recurrence and metastasis. […] Many NMSCs could be managed without additional information provided by imaging and are not required in low-risk patients (pT1a). However, in pT1b to pT4b stages, additional information is necessary to optimize management, so ultrasound, computed tomography (CT) scan, positron emission tomography (PET) studies, as well as magnetic resonance imaging (MRI) are optional imaging modalities before operation or sentinel node biopsy (SNB).

• #35 Noninvasive Imaging Tools Enable Better Detection of Skin Cancer | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/noninvasive-imaging-tools-enable-better-detection-skin

  Early detection is essential to successful treatment of skin cancers, especially serious forms such as melanoma. […] Skin cancer is very treatable if detected early. MSK is using new noninvasive imaging tools to detect and analyze these cancers. […] Early detection can be challenging, however. It is often difficult for a person doing self-exams at home to tell if a suspicious spot is growing or changing. Traditionally, dermatologists take a biopsy (a sample of the tissue) for examination under a microscope by a pathologist. […] Thanks to recent advances in imaging technology, Memorial Sloan Ketterings Dermatology Service can now offer noninvasive approaches. These methods help in detecting, diagnosing, and even treating skin cancer. […] One new tool is reflectance confocal microscopy (RCM). This technology uses a low-power laser to scan skin lesions.

• #36 Noninvasive Imaging Tools Enable Better Detection of Skin Cancer | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/noninvasive-imaging-tools-enable-better-detection-skin

  We can send these images electronically for examination and diagnosis by our doctors, Dr. Rossi says. In many cases, it eliminates the need for a conventional biopsy. […] Since RCM is noninvasive, this method allows doctors to reexamine the same area repeatedly over time without hurting or changing the tissue, he explains. […] Dr. Rossi says that MSK dermatologists are exploring the use of RCM in combination with another imaging technique called optical coherence tomography (OCT). […] RCM also provides guidance for surgery to remove skin cancers on the face and neck. […] It is critical that surgeons can clearly delineate a tumors borders during a procedure. […] The standard method of analyzing tissue requires a surgeon to remove a sample to be examined under a microscope. […] By using noninvasive imaging tools, MSK dermatologists are hoping to create a more streamlined approach, whether surgical or nonsurgical.

• #37 Non-Melanoma Skin Cancer Detection in the Age of Advanced Technology: A Review

  https://www.mdpi.com/2072-6694/15/12/3094

  Non-melanoma skin cancer is one of the most common cancer diagnoses in the world, and cases are rising globally. Consequently, novel technology to aid in screening is of interest. Deep learning is one type of artificial intelligence that has shown promise in image analysis and is an attractive tool for application in non-melanoma skin cancer diagnosis. […] Skin cancer is the most common cancer diagnosis in the United States, with approximately one in five Americans expected to be diagnosed within their lifetime. Non-melanoma skin cancer is the most prevalent type of skin cancer, and as cases rise globally, physicians need reliable tools for early detection. […] Ultimately, the available data for the detection and diagnosis of skin cancer using deep learning technology are promising, revealing sensitivity and specificity that are not inferior to those of trained dermatologists.

• #38 Non-Melanoma Skin Cancer Detection in the Age of Advanced Technology: A Review

  https://www.mdpi.com/2072-6694/15/12/3094

  Ultimately, these studies highlight a common fault of deep-learning-based models, which is their generalizability. […] Although there are promising data regarding the use of deep learning and deep neural networks in skin cancer detection and diagnosis, there is still a long way to go before this technology can be widely implemented. […] The available data for the detection and diagnosis of NMSC using deep learning technology are promising, revealing sensitivity and specificity that are not inferior to those of trained dermatologists.

• #39 Non-Melanoma Skin Cancer Detection in the Age of Advanced Technology: A Review

  https://www.mdpi.com/2072-6694/15/12/3094

  Ultimately, these studies highlight a common fault of deep-learning-based models, which is their generalizability. […] Although there are promising data regarding the use of deep learning and deep neural networks in skin cancer detection and diagnosis, there is still a long way to go before this technology can be widely implemented. […] The available data for the detection and diagnosis of NMSC using deep learning technology are promising, revealing sensitivity and specificity that are not inferior to those of trained dermatologists.

• #40 Skin cancer

  https://www.cancervic.org.au/cancer-information/types-of-cancer/skin_cancers_non_melanoma/diagnosing_skin_cancer.html

  If there is any doubt, the doctor may need to take a tissue sample (biopsy) to confirm the diagnosis. […] A biopsy is a quick and simple procedure that is usually done in the doctor’s room. […] Your doctor will get the results in 12 weeks. If all the cancer and a margin of healthy tissue are removed during the biopsy, this may be the only treatment you need. […] Usually a biopsy is the only information a doctor needs to stage skin cancer. […] Most BCCs and SCCs are successfully treated, especially when found early.

• #41 Skin Cancer: Diagnosis & Treatment | Orlando | UCF Health

  https://ucfhealth.com/our-services/dermatology/skin-cancer-diagnosis-treatment/

  Skin cancer is generally considered either melanoma or non-melanoma skin cancer. This differentiation is used because melanoma skin cancer is relatively more serious and spreads faster than non-melanoma types of skin cancer. […] Both squamous cell carcinoma and basal cell carcinoma are characterized as non-melanoma skin cancer. […] The most effective ways to determine potential skin cancer growth are regular examinations. Receive annual skin cancer screenings from your dermatologist, and complete regular self examinations in between your visits. […] If skin cancer is suspected, a skin biopsy will be performed to assess the suspicious cells. Depending on the results of the skin biopsy, one treatment method may be more effective than another. […] Mohs surgery has proven effective for treating both melanoma and non-melanoma skin cancers. […] Early detection and treatment of skin cancer are essential for preventing the disease from progressing and spreading to other tissues and organs.

• #42 How to Test, Diagnose and Detect Skin Cancer

  https://www.cancercenter.com/cancer-types/skin-cancer/diagnosis-and-detection

  Diagnosing skin cancer usually begins with a visual examination. The Skin Cancer Foundation and the American Cancer Society recommend monthly self-examinations and annual doctor visits to screen for skin cancer. If a suspicious spot is found, the doctor will first examine the area, noting its size, shape, color and texture, as well as any bleeding or scaling. […] A dermatologist may use a special microscope or magnifying lens to examine any suspicious spots more closely, a process called dermatoscopy. […] The two most common types of tests used in diagnosing skin cancer are biopsies and imaging tests. […] The care team may also take a biopsy of any suspicious lymph nodes to see if they contain cancer cells. […] In those cases, one of several medical imaging procedures may be used to determine whether cancer cells have metastasized to internal organs and bones. […] Skin cancer cannot be detected by a complete blood count or any other blood test.

• #43 Non Melanoma Diagnostic Process | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/cancer/non-melanoma/patient-care-resources/diagnosis.html

  Is aggressive or slow growing, which can be determined by looking at the type and number of growing and dividing cells, called mitotic figures […] Contains particular types of molecules that indicate the cancer subtype […] Your care team will also determine the stage of your cancer. Staging describes the size of the cancer and whether (and how far) it has spread. Staging is the most important step in planning your treatment. […] Stanford non-melanoma experts from several specialties meet as a team in tumor boards that occur as part of structured parallel visits among your cutaneous, surgical, and medical oncologists. Based on the diagnosis, we determine our recommendations for the best sequence of treatment for each patient. […] Your doctor or a team of doctors (including cutaneous, surgical, and medical oncologists) will meet with you to discuss the recommended treatment plan. Together, you and your doctors decide on the treatment options that are right for you.

• #44 Nonmelanoma Skin Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3339125/

  For SCC, in a similar study, Brodland et al. reported 141 patients treated with MMS and found that tumours 2 cm diameter or less were completely excised with a 4-mm margin in greater than 95% of cases. […] Tumours over 2 cm diameter required a 6-mm excision margin to provide greater than 95% complete histological cure. […] Radiotherapy is an effective treatment modality for select patients with NMSC unable to undergo surgery, as efficacy is overall lower than with MMS or SE with predetermined margins. […] Adjuvant radiotherapy may be beneficial postoperatively for tumours with perineural invasion or as palliative treatment when complete margin excision is not attainable due to extensive disease. […] Curettage and cautery (C and C) involves removing epidermis and dermis containing tumour tissue with a sharp ring curette instrument prior to charring of the base of the wound with electrocautery. […] This process can be repeated immediately once or twice and provides an effective treatment of low-risk NMSC.

• #45 Nonmelanoma Skin Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3339125/

  Cryosurgery involves the delivery of liquid nitrogen to freeze and then thaw the target tumour tissue, inducing local cellular destruction. […] High-risk NMSC is associated with lower cure rates, and cryosurgery is recommended for low-risk BCC. […] Photodynamic therapy (PDT) is an effective therapy for sBCC or low-risk nodular BCC of less than 2 mm thickness. […] PDT involves the topical application of 5-aminolaevulinic acid (ALA) or methyl aminolaevulinic (MAL). […] Imiquimod is a topical immunomodulator, activating cytotoxic T cell against tumour cells via binding to cell surface toll receptor 7 and/or 8. […] Imiquimod is an effective treatment for sBCC, though most studies report on short-term follow-up data only. […] 5-fluorouracil (5FU) is a pyrimidine antimetabolite that inhibits DNA synthesis. […] Topical treatment has been reported for sBCC. […] OTR or patients on long-term immunosuppression who develop NMSC have higher risk of tumour recurrence and must be monitored closely, ideally in dedicated renal transplant dermatology clinics.

• #46 What to Expect of Non Melanoma | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/cancer/non-melanoma/patient-care-resources/what-to-expect.html

  Different types of treatment for non-melanoma have different goals, such as: Destroying or surgically removing cancer cells in the skin to increase the chance of cure. […] Most skin non-melanoma is treated and cured with surgical removal. If the disease progresses or involves regional lymph nodes at the outset, we can treat your non-melanoma with several different methods, often combining them for the best chance at success. […] After you complete your non-melanoma treatment, your care team works with you to develop an ongoing care plan. Regular follow-up care, also known as surveillance, is important to monitor your overall health, manage any remaining side effects, and check for possible signs of the cancer coming back (recurring). […] Our Cancer Survivorship Program will help you adjust and cope with your new lifestyle after treatment for cancer.

• #47

  https://www.accc-cancer.org/home/learn/cancer-types/skin-cancer/advanced-non-melanoma-skin-cancers/advanced-nmsc-practices

  To help community cancer centers better diagnose and treat cutaneous non-melanoma skin cancers, ACCC has launched a new project designed to engage all members of multidisciplinary cancer care teams as well as non-oncology specialists on effective practices for supporting, treating, and managing patients with advanced non-melanoma skin cancer. […] Each type of non-melanoma skin cancer is different in terms of its biology, clinical behavior, and treatment recommendations, and requires distinct diagnostic and management considerations. […] However, given the limited network of specialists in this area, it is important for community-based providers to gain a better understanding of the different diagnostic, referral, and management considerations for these types of cancers. […] Communication is essential in establishing referral networks and professional partnerships to facilitate the seamless coordination of care for patients with non-melanoma skin cancers.

• #48

  https://www.accc-cancer.org/home/learn/cancer-types/skin-cancer/advanced-non-melanoma-skin-cancers/advanced-nmsc-practices

  This publication maps out effective practices in multidisciplinary cSCC management. […] One of the most important things that health care providers can do for patients with non-melanoma skin cancer is coordinate treatment. Multidisciplinary teams in non-melanoma skin cancer care can help determine the best care plan for each patient and improve the quality of care.

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