What is the recommended management protocol for a patient diagnosed with superficial BCC?

For a patient diagnosed with superficial basal cell carcinoma (BCC), the recommended management protocol primarily involves surgical excision with clear margins to ensure complete removal and minimize recurrence risk NICE CKS. This approach is considered the gold standard in UK clinical practice due to its high cure rates and histological confirmation of clearance NICE CKS.

Alternatively, for low-risk, well-defined superficial BCCs, non-surgical treatments such as topical therapies (e.g., imiquimod or 5-fluorouracil) or photodynamic therapy may be considered, especially when surgery is contraindicated or the lesion is in a cosmetically sensitive area NICE CKS. These options offer effective local control with good cosmetic outcomes but require patient adherence and monitoring for response and recurrence NICE CKS.

Recent European guidelines and emerging literature emphasize a tailored approach, highlighting that multifocal or larger superficial BCCs may benefit from combined medical and surgical management to optimize outcomes Trakatelli et al. 2014Ran Zhu et al. 2025. Specifically, Ran Zhu et al. (2025) suggest that integrating topical treatments with limited surgery can reduce morbidity while maintaining efficacy in multifocal superficial BCC cases.

Follow-up should be individualized based on risk factors, lesion characteristics, and treatment modality, with regular skin examinations to detect recurrence or new lesions early NICE CKS. Patient education on sun protection and skin self-examination is also critical to reduce future skin cancer risk NICE CKS.