How Fast Does Basal Cell Carcinoma Grow?

From what I have read, basal cell carcinoma (BCC) tends to be slow growing. What exactly does that mean? I am 43 years old and have a BCC located just below my nose and scheduled for Mohs surgery on Tuesday. I have had the BCC for at least 5 years, probably longer. My surgeon tells me that there is no way to know how much tissue will be removed until surgery. Immediately following the Mohs surgery, I will see a plastic surgeon to repair the wound. My bcc is pink slightly elevated with a rolled border and a crusted indentation in the center. When i went to the dermatologist, he knew right away just from looking at it that it was a BCC, biopsy confirmed. Do they grow at a certain rate? I just want to be prepared. Any information will be helpful.

Doctor Answers 17

Basal cell carcinoma growth rate difficult to generalize

Well, typically BCCs grow very slowly, but there are occasions when they grow fast.

If a person's immune system is compromised (i.e. from medications or generic disorders), BCC can grow faster. If the cancer has been there for 5 years, typically it's bigger than a dime, but again it's hard to say.

Each person's BCC grow as different rates. I'm a Mohs surgeon and have seen thousands of BCCs.

Seattle Dermatologist

Growth rate of BCC

Basal cell skin cancers vary in their growth rates - typically no faster than 2-3 mm over 2-3 months. Local destruction and invasion is what we worry about with BCC, as metastasis of this tumor is very rare. It is common for patients to present with these growths that appear to have been present for years, apparently unchanged. The visible portion of the tumor, however, does not always give an accurate picture of the entire size of the tumor. It may be the "tip of the iceberg" so to speak. Sounds like you are getting the appropriate skin-sparing procedure, Mohs surgery.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 5 reviews

There's no predefined rate of growth

There's no clear cut answer to your question - how fast does basal cell cancer grow? In some people, it appears rather abruptly and grows quickly. In others, such as yourself, it may start out as a smaller cancer or pre-cancer (actinic keratosis) and grow slowly.

The important fact is that it will keep growing until it is removed, so be sure to have it taken it. Often times what is seen by the naked eye is just the tip of the iceberg. The sooner you get that out, the less damage there will be. Hopefully in the past 5 years your cancer has not spread too much to the surrounding area.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

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Basal Cell Carcinomas can grow slowly or quickly, but usually only locally.

Thank you for your question.

Basal Cell Carcinoma (BCC) is the most common type of skin cancer and is due to recurrent sun exposure, but not related to the number of sunburns (although that definitely does contribute). A BCC tends to grow like the "roots of a tree". Usually it is slow growth, but what you see on the surface may not represent the entire tumor. The tumor can easily be growing underneath the skin and spreading, but you might not see most of it, and that's why you won't know how big the area taken out will be until the actual surgery.

To specifically answer your question, most BCCs will grow very slowly - usually only showing about 4-5mm of growth, plus or minus, every 6 months or so. But, it may be growing quicker underneath and that's what should be the main concern, especially in areas around the eyes, nose, and ears. You have had the BCC for 5 or more years, so it is very possible that a large area of tissue might have to be removed; only the surgery will tell.

I wish you the best of luck!

Don Mehrabi, MD
Beverly Hills Dermatologist
5.0 out of 5 stars 1 review

Basal Cell Carcinoma (BCC) Growth Rate

Basal cell carcinomas (BCCs) are considered "slow" growing tumors when compared to other skin cancers.   They are locally destructive tumors.  However, please keep in mind that the rate of growth and the amount of tissue damage from a BCC will vary from individual to individual depending on multiple factors.    

The benefit of Mohs surgery is that this procedure will be able to pinpoint  and remove the visible portions of the BCC as well as the roots of the BCC so that the surgical site will be clear of carcinoma.  After the margins are clear of carcinoma, the surgical defect can be safely reconstructed.  

Kenneth W. Neal, MD
Arlington Dermatologic Surgeon
4.2 out of 5 stars 5 reviews

How fast does basal cell carcinoma grow

Basal cell carcinoma (BCC) tends to grow slowly and invade locally and usually do not kill people the way squamous cell carcinoma and melanoma can (these can spread thru the blood stream called metastasis which BCC does not).  But it's difficult to generalize about how fast they grow--they can grow slowly or quickly.  There are some aggressive BCC's which can invade deeply and into the nerves which can create functional problems (especially if it involves the eye, nose, mouth, or ears).  What you see on the surface may just be the tip of the iceberg which is why it's important to map out the extent of the tumor with Mohs micrographic surgery.  If you've already had the lesion for 5 years, then waiting a little longer probably won't make much difference.  For new suspicious lesions, it's best to get it looked at by a dermatologist or Mohs surgeon.  It's typical to have to wait a few weeks to months to get the results of the biopsy and then get scheduled for surgery.

M. Christine Lee, MD
Walnut Creek Dermatologic Surgeon
4.3 out of 5 stars 16 reviews

Varies on Type, Immunity, Location

    As a rule basal cell carcinomas grow slowly. However, do not tell this to anyone with an aggressive  "rodent ulcer". This type of basal cell can erode the skin fairly rapidly, causing a deep excavation in what a few months earlier was only a small bump. In fact, on occasion, when badly neglected,  the rodent ulcer can penetrate through bone.

   Every year the American Academy of Dermatology devotes its first two days to brief (10 minute) presentations. Invariably, a few cases of this sort of tumor is presented. Unbelievably, some of the victims design bags or cloths to place over their heads when going out in public ( usually at night). The photographs the presenter displays will demonstrate ulcerations with brain matter protruding. 

   However, the vast majority of basal cell carcinomas grow slowly, sometimes very slowly. For instance, the cystic type of basal cell carcinoma may dwell on the face for decades without arousing its recipient's attention. I remember a lady in her 40's, with a cystic BCC telling me that "I've had that my whole life".  The superficial multi-centric basal cell is also a very slow growing type. This is often misdiagnosed as a patch of psoriasis or eczema. If you have a similar spot like this, which does not respond to steroid creams, you and your physician should be suspicious of this lesion. 

   The speed with which a basal cell carcinoma grows depends on other factors than its classification. The underlying stroma is important. Where the dermis is tight firm, there is more resistance. The BCC will grow slower. In fact, most experts feel that there is a strong interplay between the epidermis and the dermis in the development of a basal cell carcinoma: that it is not an entirely epidermal lesion.

   Immunity is another factor in the growth of a basal cell carcinoma, although not as strong a factor as in the squamous cell carcinoma. 

   Of course, the earlier that you seek treatment the better off you will be. Smaller scar, easier procedure, less anxiety etc.  If you have a new lesion which fails to heal after a month or two, you should consult with a dermatologist, or lacking one, your family physician. 

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist
4.7 out of 5 stars 14 reviews

Basal Cell Carcinoma Growth

Basal cell carcinoma is the most commonly occurring type of skin cancer. When compared to other types of skin cancers, BCC is a relatively slower growing family of malignant tumors. BCCs are usually caused by cumulative UV exposure. Common types of BCCs include:
  • Nodular
  • Micronodular
  • Morpheaform/sclerosing
  • Pigmented
  • Superficial
  • Infiltrative

There are other types of BCCs, but the above are amongst the most common variants. Each type, along with location determine risk of recurrence and metastasis. There are certain types of BCCs that are faster growing.

Brian Feinstein, DO
Delray Beach Dermatologist

Do I need Mohs?

The simple answer is, why put off for tomorrow what should have been done yesterday? Find a surgeon that you trust and has a lot of experience. The longer you wait, the larger the tumor and the larger the scar will be.

Robert S. Bader, MD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Basal Cell Carcinoma Growth Pattern

Basal Cell Carcinomas tend to be a slow growing skin cancer with little risk of metastasis to other body sites; however, the skin cancer does slowly and insidiously grow, destroying the normal healthy tissue. The reason that basal cell carcinomas are treated is because of this slow growth where the healthy tissue is replaced or infiltrated by the skin cancer and because these tumors can spread along nerves, blood vessels, cartilage, etc and be difficult to remove. The fact that you know the tumor has been there for at least 5 years would suggest that it is probably going to be larger than how it appears to you. In other words, the cancer has continued to grow during the five years before you saw the dermatologist. The best option for treating the skin cancer is through Mohs surgery which will give you the highest cure rate and preserve the greatest amount of healthy tissue for reconstrution.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.