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Infiltrative BCC


Hi all,
My dermatologist told me I have an aggressive subtype of BCC which is “infiltrative.” Does anyone have any experience with this? The lesion was a pearly pink smooth bump on the top of my nose. I decided to proceed with Mohs surgery... which will be in a few weeks. I feel like I am too young (28 yo female) for radiation therapy.

Thanks for any insight and thoughts...
The image is my “spot” location after the shave biopsy. It healed nicely.

  1. Hi , I'm so sorry to hear about your infiltrative BCC diagnosis. We have a lot of content on radiation therapy and Mohs if you want to read up on it a bit before having undergoing treatments. What type of treatment did your dermatologist suggest/push for? We have members who have had all types of treatments so the experience can definitely vary from person to person. Radiation therapy works especially well for the treatment of the face, lips, ears, scalp, neck, hands, arms, and legs. However, Mohs works very well for melanoma and non-melanoma including high-risk basal cell. High-risk BCC or SCC is likely to recur, so Mohs surgery is usually the first choice of treatment for this.

    About Mohs Surgery:
    Mohs Surgery Advice:
    About Radiation Therapy:
    Radiation Therapy Considerations:

    Please keep us posted on how you're doing and which treatment you decided on. Sending positive and healthy wishes your way! -Warmly, Sidney, moderator

    1. Hi Sidney! Thanks for responding, I appreciate your thoughts and information. I plan to move forward with Mohs on May 4th followed by reconstruction (skin graft or flap, not sure what they will choose). I will also be meeting with a radiologist on the 21st (soon!) to talk about SRT as a "secondary" treatment if needed (if the margins of the BCC are not clear). I think it's better to do the surgery because if it ever comes back, it will be better to do radiation vs. to do radiation as the primary treatment modality and then it comes back since they do not recommend doing radiation on a previously irradiated area (from what I've read).
      I am hopeful because my reconstruction surgeon does good work and he is very experienced. I am OK with a scar... not a disfigurement.
      I never thought this would happen to me esp. at my age. I am a perfectionist and have always obsessed over my skin (acne, facial features, etc.). Those days are over. I am tired of feeling sad and scared about this surgeries, and I must change my perspective 😀 -the links you sent me were very helpful!

      1. I wanted to jump in here and thank you for sharing your journey with our community with us. Hope that May 4 goes really well for you. Please keep us updated. Scott moderator

    2. Hi Hannah,

      I'm really sorry to hear of your infiltrative BCC on the tip of your nose. Firstly, I want to say - brace yourself for a longish journey, but there will be an end to it!

      Two years ago I had the same diagnosis, also the tip of my nose. They took off a piece that was 28mm across down to the cartilage. At the time, no plastic surgeon was available and because of the size, the dermatologist doing the procedure didn't feel confident doing a skin flap. As the piece was too large to take from e.g. behind my ear, he took the graft skin from my clavicle, which is the best you can do if not using skin from your face, but it does look slightly different. The graft has healed well, but I'm left with an irregularly shaped, different coloured and textured piece of skin covering my nose tip.

      This morning I discussed possible revision surgery with a plastic surgeon. He confirmed a skin flap would have given a better result and said he could take off the graft and do a local skin flap. I would have to go private as the NHS (I live in the UK) would not pay for this. An alternative would be medical tattooing, which I'd never heard of, but which I'm now looking into.

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