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PubMed This is a summary of 16 peer-reviewed journal articles Updated
Dermatology · Basal Cell Carcinoma

Building Your Care Team and Preparing for Your Visit

At a Glance

For basal cell carcinoma, a general dermatologist often coordinates care. Higher-risk or complex tumors may need a Mohs surgeon or specialists in eye reconstruction, radiation, or cancer medicines. Bring your pathology report, pre-biopsy photos, medication list, and treatment history to the visit.

Navigating a Basal Cell Carcinoma (BCC) diagnosis often involves coordinating with different specialists. Because BCC can vary from a simple surface spot to a tumor requiring specialized surgery, building the right team is essential for ensuring the highest cure rate and the best functional and cosmetic outcome [1][2].

The General Dermatologist

For most patients, a general dermatologist is the cornerstone of the care team. They typically perform the initial biopsy, confirm the diagnosis, and assess the risk level [3].

  • What they do: Treat straightforward, lower-risk BCCs using methods like excision, C&E (scrape and burn), or topical creams [1].
  • When they refer out: If a tumor is on a high-risk area (like the face), is large, shows aggressive features on pathology, or has recurred, they may refer you to a specialized surgeon [4][5].

The Margin-Control Specialist: The Mohs Surgeon

A Mohs surgeon is a dermatologist who has undergone additional training to remove skin cancer in stages, checking 100% of the margins under a microscope during the procedure to ensure clearance while sparing healthy tissue [6].

  • Credentials to ask about: You can ask if the surgeon is fellowship-trained (e.g., through an ACGME-accredited program in Micrographic Surgery and Dermatologic Oncology or an equivalent certification body) and what their experience is with tumors in your specific anatomic location [7].
  • When to ask if Mohs is appropriate:
    1. The tumor is in the H-Zone (eyes, nose, lips, ears, genitalia, hands, or feet) [5].
    2. The pathology report shows an aggressive subtype (Infiltrative, Micronodular, or Morpheaform) [4].
    3. The cancer has recurred after a previous treatment, or you have a suppressed immune system [5].

Expanding the Team for Complex Cases

For routine BCC, a tumor board or medical oncologist is not necessary. However, in complex situations, other specialists are brought in:

  • Oculoplastic Surgeon: If a BCC is near the eyelid or eye socket, an oculoplastic specialist may assist with reconstruction to protect your vision [8][9].
  • Radiation Oncologist: Recommended if you are not a candidate for surgery, or as an adjuvant treatment for tumors with extensive nerve or bone involvement [10][11].
  • Medical Oncologist: Essential for locally advanced or metastatic BCC where systemic medications (like Hedgehog inhibitors) are needed [12][13].

Preparing for Your First Consultation

Your first specialist visit is your opportunity to ensure the plan matches your goals. Being organized can significantly improve the quality of your care.

What to Bring:

  1. The Pathology Report: This is the most critical document; it tells the surgeon exactly what they are treating [3].
  2. Photos: If you have a photo of the spot before the biopsy, bring it. Once a biopsy heals, it can be hard to see the original “footprint” of the tumor [14][15].
  3. Medication List: Include all prescribed medications, over-the-counter drugs, and supplements. Safety Note: Never stop taking aspirin, prescribed anticoagulants (blood thinners), or other medicines without explicit instructions from your prescribing clinician and surgical team [3].
  4. Treatment History: If you have had radiation or surgery in that same spot before, the doctor needs to know, as scar tissue can alter the surgical approach [3][16].

Vetting Your Team:
Don’t be afraid to ask about the surgeon’s experience and their plan for reconstructing the wound. High-volume experience with your specific type of tumor and anatomy is an excellent indicator of a quality surgical team [7].

Common questions in this guide

Who usually manages basal cell carcinoma treatment?
A general dermatologist often starts by confirming the biopsy diagnosis, assessing risk, and treating straightforward basal cell carcinomas. They may refer you to a Mohs surgeon or another specialist when the tumor is in a high-risk location, has aggressive features, has returned, or involves more complex care.
When might Mohs surgery be recommended for BCC?
Mohs surgery may be considered when BCC is near the eyes, nose, lips, ears, hands, feet, or genitals; has an aggressive subtype; has come back after treatment; or occurs in someone with a suppressed immune system. The surgeon removes the cancer in stages and checks the edges under a microscope while trying to preserve healthy tissue.
What should I bring to my first basal cell carcinoma appointment?
Bring your complete pathology report, any photo of the spot before the biopsy, a list of every prescription, over-the-counter medicine, and supplement, and details about earlier surgery or radiation in the same area. These records help the team understand the tumor and plan treatment.
Should I stop aspirin or blood thinners before BCC surgery?
Do not stop aspirin, prescribed blood thinners, or other medicines on your own. Ask the clinician who prescribed them and the surgical team for specific instructions before the procedure.
What specialists might be involved in complex basal cell carcinoma?
An oculoplastic surgeon may help rebuild tissue near the eyelid or eye socket, while a radiation oncologist may be involved when surgery is not possible or the tumor affects nerves or bone. A medical oncologist may help when BCC has grown extensively nearby or spread to distant sites and treatment with body-wide medicines, such as Hedgehog inhibitors, is needed.

Questions For You

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Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Are you a fellowship-trained Mohs surgeon, or what is your specific experience with margin-controlled surgery for this area?
  2. 2.Who will be performing my reconstruction after the cancer is removed—you, or will we need to coordinate with a plastic or oculoplastic specialist?
  3. 3.Given my pathology results, why is the proposed treatment the most appropriate for my specific subtype and location?
  4. 4.Do you recommend my pathology slides be reviewed by a specialist dermatopathologist before we proceed with surgery?
  5. 5.Should I bring my pre-biopsy photos to the consultation?

References

References (16)
  1. 1

    Basal Cell and Cutaneous Squamous Cell Carcinomas: Diagnosis and Treatment.

    Firnhaber JM

    American family physician 2020; (102(6)):339-346.

    PMID: 32931212
  2. 2

    Nonsurgical Options for the Treatment of Basal Cell Carcinoma.

    Paoli J, Gyllencreutz JD, Fougelberg J, et al.

    Dermatology practical & conceptual 2019; (9(2)):75-81 doi:10.5826/dpc.0902a01.

    PMID: 31106008
  3. 3

    How Perfectly Do Biopsy Request Forms and Pathology Reports Adhere to Guidelines in Basal Cell Carcinoma? A Retrospective Analysis of 851 Cases.

    Altınöz Güney C, Koç HA, Çınar E

    Journal of cutaneous pathology 2026; (53(6)):524-531 doi:10.1111/cup.70094.

    PMID: 41844232
  4. 4

    Patient Indications for Mohs Micrographic Surgery: A Systematic Review.

    Murray C, Sivajohanathan D, Hanna TP, et al.

    Journal of cutaneous medicine and surgery 2019; (23(1)):75-90 doi:10.1177/1203475418786208.

    PMID: 30033747
  5. 5

    European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma-update 2023.

    Peris K, Fargnoli MC, Kaufmann R, et al.

    European journal of cancer (Oxford, England : 1990) 2023; (192()):113254 doi:10.1016/j.ejca.2023.113254.

    PMID: 37604067
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    Mohs Micrographic Surgery.

    Wong E, Axibal E, Brown M

    Facial plastic surgery clinics of North America 2019; (27(1)):15-34 doi:10.1016/j.fsc.2018.08.002.

    PMID: 30420068
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    Micrographic dermatologic surgery (MDS) diplomates: a demographic evaluation and comparison of Medicare case volume.

    Walocko FM, Memon R, Kwasny MJ

    Archives of dermatological research 2022; (314(2)):213-216 doi:10.1007/s00403-022-02329-z.

    PMID: 35133478
  8. 8

    Recurrence of periocular basal cell carcinoma and squamous cell carcinoma after Mohs micrographic surgery: a retrospective cohort study.

    Weesie F, Naus NC, Vasilic D, et al.

    The British journal of dermatology 2019; (180(5)):1176-1182 doi:10.1111/bjd.17516.

    PMID: 30536656
  9. 9

    Current Basal and Squamous Cell Skin Cancer Management.

    Mendez BM, Thornton JF

    Plastic and reconstructive surgery 2018; (142(3)):373e-387e doi:10.1097/PRS.0000000000004696.

    PMID: 30148788
  10. 10

    Definitive and Postoperative Radiation Therapy for Basal and Squamous Cell Cancers of the Skin: Executive Summary of an American Society for Radiation Oncology Clinical Practice Guideline.

    Likhacheva A, Awan M, Barker CA, et al.

    Practical radiation oncology 2020; (10(1)):8-20 doi:10.1016/j.prro.2019.10.014.

    PMID: 31831330
  11. 11

    Approaches to Perineural, Lymphovascular, and Single-Cell Disease.

    Collins MK, Behshad R, Maloney M, Pugliano-Mauro M

    Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2019; (45 Suppl 2()):S118-S128 doi:10.1097/DSS.0000000000002259.

    PMID: 31764297
  12. 12

    Managing Advanced Basal Cell Carcinoma: A Guide for the Dermatology Clinician.

    Burshtein J, Schlesinger T

    The Journal of clinical and aesthetic dermatology 2025; (18(3)):21-27.

    PMID: 40135179
  13. 13

    Advanced basal cell carcinoma: What dermatologists need to know about treatment.

    Wilson M, Johnson RP, Senft SC, et al.

    Journal of the American Academy of Dermatology 2022; (86(6S)):S14-S24 doi:10.1016/j.jaad.2022.03.022.

    PMID: 35577406
  14. 14

    Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management.

    Marzuka AG, Book SE

    The Yale journal of biology and medicine 2015; (88(2)):167-79.

    PMID: 26029015
  15. 15

    Correlation of dermoscopic and histopathological features in basal cell carcinoma using computerized image analysis.

    Kaya G, Ataman K, Güleşçi S, Yabaci Tak A

    Frontiers in medicine 2025; (12()):1581601 doi:10.3389/fmed.2025.1581601.

    PMID: 40370729
  16. 16

    Periocular Basal Cell Carcinoma Predictors for Recurrence and Infiltration of the Orbit.

    Furdova A, Lukacko P

    The Journal of craniofacial surgery 2017; (28(1)):e84-e87 doi:10.1097/SCS.0000000000003242.

    PMID: 27906855

This page explains how to assemble a basal cell carcinoma care team and prepare for a dermatology visit for educational purposes only; it does not replace medical advice. Ask your clinicians before changing medicines or choosing treatment.