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British Association of Dermatologists ( BAD ) National Audit on Non‐Melanoma Skin Cancer Excision 2016 in collaboration with the Royal College of Pathologists
Author(s) -
Keith D. J.,
Bray A. P.,
Brain A.,
Mohd Mustapa M. F.,
Barrett H. E.,
Lane S.,
Emmerich M.,
Jakes A.,
Barrett P. D.,
de Berker D. A. R.
Publication year - 2020
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.14034
Subject(s) - medicine , histopathology , audit , basal cell carcinoma , skin cancer , basal cell , dermatology , stage (stratigraphy) , complication , surgery , cancer , pathology , paleontology , management , economics , biology
Summary Background We conducted a re‐audit of the surgical practice of UK dermatologists for the treatment of nonmelanoma skin cancer and examined changes with reference to our previous audit in 2014. The audit was supplemented by a detailed assessment of completeness of the histopathology reports for each tumour. Methods UK dermatologists collected data on 10 consecutive nonmicrographic excisions for basal cell carcinoma ( BCC ) and 5 for squamous cell carcinoma ( SCC ). Data were collected on site, preoperative diagnosis, histological diagnosis, proximity to previous scars, and histological deep and peripheral margins. Results In total, 222 responses were received from 135 centres, reporting on 3290 excisions. Excisions from the head and neck accounted for 56.7% of cases. Tumour diameter (mean ± SD ) was 11.4 ± SD 7.1 mm (maximum size 100 mm) and 97% of cases were primary excisions. BCC s and SCC s respectively accounted for 65.7% and 26.8% of total cases. Of the suspected BCC s and SCC s, 95.8% and 80.4%, respectively, were confirmed histologically. All margins for any tumour were clear in 97.0% of cases, and complication rate in the audit was < 1%. Of the 2864 histology reports evaluated, only 706 (24.6%) contained all core data items; 95% of these were structure (synoptic) reports. Commonly omitted items were level of invasion, risk and T stage, which were absent from 35.7%, 64.2% and 44.1% of reports, respectively. Conclusions Diagnostic accuracy and complete excision rates remain high. Complication rates may be under‐reported owing to lack of follow‐up. Histopathology reporting has a greater chance of being complete if reports are generated on a field‐based platform (synoptic reporting).