Determining whether a suspicious spot on the skin is a so-called basal cell carcinoma – the most common form of skin cancer – can in many cases be done just as well with a skin scan, instead of taking and examining a piece of tissue.
This is apparent from research by Maastricht UMC+, the outcome of which was published on Monday in The Lancet Oncologythe international scientific journal in the field of cancer.
The outcome of diagnosing skin cancer (basal cell carcinoma) via a scan was no worse than via tissue sampling, according to a year and a half of research into more than five hundred patients with a suspicious spot on the skin. They were referred to Maastricht UMC+, Catharina Hospital in Eindhoven or Zuyderland Medical Center in Heerlen for this.
In one half, tissue was taken with a type of knife (a biopsy), which was then examined under a microscope. In the other half, the dermatologist made an OCT (optical coherence tomography) scan of the suspicious spot using a mobile scanning device – laptop-sized. One year after treatment, it was checked whether there was a difference in the clinical outcome: the number of recurrence of tumors. After the diagnosis of basal cell carcinoma, patients from both groups received regular treatment and the suspicious spot was removed.
In the scanned group of patients, the researchers checked the diagnosis to be sure by also taking tissue from these patients. What turned out? Of the 225 basal cell carcinomas discovered, 192 had also come to light through the scan. In short: 85.3 percent of the scan diagnoses were correct.
Provide a more patient-friendly answer
The research, conducted by dermatologist and skin cancer expert Klara Mosterd of Maastricht UMC+, represents an important step towards more patient-friendly and cheaper skin cancer care, according to the specialist. . As a dermatologist, you want to provide a definitive answer as quickly and as patient-friendly as possible. A biopsy is painful and does not immediately give a result, unlike the OCT scan. So I am pleased that our research shows that in many cases the scan could replace tissue sampling,” she says in a press release from the MUMC+.
Our research shows that the scan could replace tissue sampling in many cases
Scanning the suspicious spot in one group of patients was only done with ‘very high certainty of the diagnosis’. This was the case in 65.5 percent of the cases, whereby the dermatologist immediately discussed the treatment with the patient during the first consultation. ‘If the basal cell carcinoma was suitable for treatment with an ointment, it was prescribed immediately. If surgery was necessary, it was immediately scheduled.
In the group of patients from whom tissue was taken (biopsy), the results were known after one to two weeks, so that the treatment could only be discussed or started during a follow-up consultation. ‘In both groups, the proportion that had no recurrence of the skin cancer after one year was not significantly different. In addition, about 10 percent of the costs could be saved in the diagnosis and treatment process via OCT scan. In short: diagnostics via a scan is faster, costs less and is no less effective from a medical point of view,’ according to the UMCM+.
Diagnosis established in 1 in 5 Dutch people
Skin cancer is the most common form of cancer. Currently, one in five Dutch people is diagnosed with basal cell carcinoma. According to specialist Mosterd, there is therefore a need for an ‘efficient care path’ for this common form of skin cancer. “Less tissue removal and therefore one less consultation, in addition to cost savings, provides extra capacity for dermatologists. This is essential to cope with the increased demand for skin cancer care. From now on we can start working on a protocol and the preconditions for rolling out the OCT scan in daily practice. Although this will still take a few years, we have now taken a crucial step.”
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