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Diagnosis of basal cell carcinoma is made through the following methods:

  • Medical history and general examination: The patients should consult the dermatologists for the initial evaluation of any progressive skin lesions to rule out the presence of malignancy. During the procedure, the patients undergo a comprehensive general examination to determine their overall health. The dermatologist inquires about the occurrence of the lesion, its progression, and other symptoms along with the lesions. The patients are also asked about the drugs they are taking as taking immunosuppressive drugs increases the risk of basal cell carcinoma. Enquiring prior treatment history is also important, as radiation therapy increases the risk of basal cell carcinoma.
  • Dermatological examination: Dermatologists perform a complete examination of not only the affected site of the skin but the complete body skin to look for any other lesions in other body areas. The lymph nodes under the skin in certain areas are also examined during the dermatological examination.
  • Dermoscopy: Dermoscopy, also known as dermatoscopy, is a technique to evaluate the spots of the skin in detail. It involves the use of a dermoscope, which is a specialized magnifying glass. The spots on the skin are analyzed under the light source with the assistance of magnifying glass. Sometimes, a thin layer of oil or alcohol may be used during the procedure. If required, the images of the spots may be taken for future comparison.
  • Magnetic resonance imaging: Magnetic resonance imaging diagnoses basal cell carcinoma, usually at stages III and IV. MRI involves using strong magnets and power radio waves that provide detailed 3D images of the body's organs. It assists in determining the spread of basal cell carcinoma to other organs.
  • Chest X-ray: Chest X-ray Is done to diagnose the spread of disease in the lungs. It is generally used in patients with pulmonary symptoms and basal cell carcinoma believed to have metastasized in other organs. However, this technique is not used in patients who underwent a PET scan.
  • CT scan: CT scan provides detailed images of various organs of the body by using X-rays from various angles. The images, in the form of slices, are combined and shown on the computer. The technique is used for the diagnosis of metastatic basal cell carcinoma.
  • PET scan: Rapidly dividing cells require a high amount of food. This phenomenon is used to determine the presence of rapidly dividing cells throughout the body through positron emission tomography. In this process, the radioactive derivative of the sugar is injected into the vessel. Once the sugar is transported to all the organs through blood, it is traced with a special camera. The camera provides images of the accumulation of radioactive sugars at different places in the body, indicating the presence of rapidly dividing cells at these places.
  • Skin biopsy: Skin biopsy is the process of obtaining a sample of abnormal skin tissues and examining it under the microscope for the presence of cancerous cells. There are several types of skin biopsy techniques, and the method chosen depends upon several factors, such as site, size, and type of tumor. The types of skin biopsy techniques include:
  • Punch biopsy: A round cutter-like tool removes the sample from deeper skin during this procedure. The tool is rotated on the skin until it reaches the required layer of the skin. The sample is taken, and the wound is closed with stitches.
  • Shave biopsy: Shave biopsy is used when a skin sample is required from the upper layers. A surgical blade is used to shave off the upper layer. The sample is collected, and topical medicines or wound cauterization stops the bleeding.
  • Excisional biopsy: If the entire skin tumor is removed during the biopsy, the procedure is known as an excisional biopsy.
  • Incisional biopsy: If a portion of the tumor is removed during the biopsy, the procedure is known as an incisional biopsy.
  • Lymph node biopsy: Lymph node biopsy is also conducted to determine if basal cell carcinoma has reached the lymph nodes. The biopsy procedure for lymph nodes includes fine needle aspiration and surgical biopsy.

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