Understanding the Differences: Basal Cell Carcinoma versus Squamous Cell Carcinoma - Key Facts to Remember
Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) are the two most prevalent types of non-melanoma skin cancer. Each has distinct symptoms, causes, means of diagnosis, and treatment options.
Common Symptoms
Basal Cell Carcinoma (BCC)
BCC often presents as pearly or waxy bumps on the skin, sometimes with visible blood vessels. It may also appear as a flat, flesh-colored or brown scar-like lesion. BCC is typically slow-growing and rarely metastasizes, commonly occurring on the face, neck, and trunk.
Squamous Cell Carcinoma (SCC)
SCC usually appears as rough, scaly red patches that may crust or bleed. Open sores that fail to heal, wart-like growths, thickened skin or raised growths with central depressions are also common signs of SCC. This type of skin cancer grows faster and has a higher risk of metastasizing compared to BCC, and is more likely to develop on hands, arms, scalp, ears, and areas with sun exposure or chronic wounds.
Causes
Both BCC and SCC are primarily caused by cumulative ultraviolet (UV) radiation exposure from the sun or tanning beds. Fair-skinned individuals are at a higher risk. BCC arises from basal cells in the lower epidermis, while SCC arises from squamous cells in the middle and outer epidermis layers. SCC can also develop on scars, chronic wounds, inflamed areas, and in association with HPV infection, especially Bowen’s disease, a form of SCC in situ.
Diagnosis
Doctors diagnose both BCC and SCC through visual and clinical examination. A biopsy is often required for confirmation. For BCC, histopathology shows nests of basaloid cells with peripheral palisading and sometimes pigmentation or stromal changes. For SCC, a full-thickness biopsy is necessary to assess depth and extent. SCC can be graded by differentiation and invasion, with possible perineural spread. Fine Needle Aspiration biopsy may be used for suspicious lymph node involvement in SCC cases.
Treatment Options
Basal Cell Carcinoma
Surgical excision is the most common treatment for BCC. Mohs micrographic surgery is used for facial or recurrent lesions. Less aggressive lesions may be treated with topical therapies, cryotherapy, or photodynamic therapy. Radiation therapy is used in some cases.
Squamous Cell Carcinoma
Surgical excision is the primary treatment for SCC. Mohs surgery is preferred for high-risk or facial lesions. Radiation therapy is used for inoperable tumors or residual disease. Invasive SCC with metastasis may require additional systemic therapies.
Summary Table
| Feature | Basal Cell Carcinoma (BCC) | Squamous Cell Carcinoma (SCC) | |-------------------------|------------------------------------------------|--------------------------------------------------------| | Origin | Basal cells (lower epidermis) | Squamous cells (middle and outer epidermis) | | Common Appearance | Pearly, waxy bumps, sometimes pigmented | Rough, scaly red patches, open sores, wart-like growths| | Growth Rate | Slow | Faster and more aggressive | | Metastasis Risk | Very low | Higher risk | | Common Locations | Face, neck, trunk | Hands, arms, scalp, ears, scars, chronic wounds | | Main Cause | Chronic UV exposure | Chronic UV exposure, HPV infection, scars | | Diagnosis | Clinical exam, biopsy for histopathology | Full-thickness biopsy, possible FNA for lymph nodes | | Treatment | Surgical excision, Mohs surgery, topical therapy| Surgical excision, Mohs surgery, radiation if needed |
Both cancers have high cure rates if detected early, with SCC typically requiring more aggressive management due to its higher potential for metastasis. Other treatment options for BCC include light therapy, cryosurgery, topical medications, and radiation. People with a history of basal cell carcinoma may have a higher risk of developing squamous cell carcinoma later in life.
Non-melanoma skin cancer is a type of skin cancer that does not begin in melanocytes. Common treatment options for squamous cell carcinoma include surgical removal of skin growths, cryosurgery, laser surgery, electrosurgery, light therapy, topical medications, and radiation. Diagnosis of basal or squamous cell carcinoma involves a physical exam by a doctor and questions about any symptoms a person is experiencing.
Basal and squamous cell carcinomas are caused by long-term exposure to UV rays, which may come from spending time outdoors in the sun or from using tanning beds. Basal and squamous cell carcinomas do not turn into each other, but a history of basal cell carcinoma can increase the risk of developing squamous cell carcinoma. Use of indoor tanning beds can increase a person's chance of developing basal cell carcinoma.
- Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), two prevalent types of non-melanoma skin cancer, primarily occur due to long-term ultraviolet (UV) radiation exposure.
- Pigmented, pearly or waxy bumps on the skin can be indicative of Basal Cell Carcinoma (BCC), while rough, scaly red patches or open sores that fail to heal may signal Squamous Cell Carcinoma (SCC).
- In addition to skin cancer, other skin conditions under the umbrella of medical-conditions, such as skin-care issues, can be diagnosed through clinical examinations and biopsies for histopathology or full-thickness biopsies.
- Both BCC and SCC share the common treatment options of surgical excision, light therapy, cryosurgery, and radiation, but Mohs micrographic surgery is preferred for high-risk or facial lesions, and for SCC with suspicious lymph node involvement.
