History of Infiltrative BCC, but Deem Won't Biopsy New Lump?

I had a BCC taken off my ear in October, results showed it was an aggressive 'intfiltrative' type. It was a waxy pearly lump with multiple thread veins visible. I now have two new (much smaller) waxy wart like lumps on my forehead, but my dermatologist only glanced at them briefly (did not use bright light or magnification) and said, they look fine, nothing to worry about. Well, that's what they said about the lump on my ear! Should I insist on biopsies? I have history of indoor tanning.

Doctor Answers 4

To biopsy or not when there is a history of skin cancer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Without seeing the lesions, it's difficult to say whether they should be biopsied.  It's understandable that you'd be concerned, but having a history of skin cancer means every lesion should be removed.  Might the lesions on the forehead be sebaceous hyperplasia or milia?  Ask your dermtologist what he or she thinks the lesions might be if not a skin cancer.  Magnification is not required to assess all skin lesions.  If you don't feel confident, and you don't want a biopsy, find a dermatologist who will do the biopsy.  Good luck!

New York Dermatologist

To Biopsy or Not To Biopsy

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I understand your concerns given your prior history of skin cancer. I think your best option is to discuss your concerns with your dermatologist. If you feel you cannot discuss your concerns with your current dermatologist or you feel that he/she is not adequately listening or examining you, find a different dermatologist. You need to have confidence that your doctor is carefully examining you and will listen to your concerns and will give you answers as to why a particular lesion needs to be biopsied or not. Good luck.

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

History of BCC, but derm won't biopsy new site

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

This is a bit tough to answer. I don't like to do unnecessary biopsies on people either - it can create scarring - but my ultimate goal is obviously to provide good care to my patients. Did you derm give you any idea of what the small bumps on your forehead might be? From your description I'm guessing maybe milia? I know to patients many things look exactly the same, and they just aren't to a trained eye, but I realize that's not reassuring in this sense especially given your past. My suggestion is the following: 1. ask your derm what he/she presumes the bumps are and why he/she isn't recommending a biopsy, 2. you keep an eye on those spots and if they grow, change, etc. you go back and ask to have them removed and sent to a lab for verification.

You might also like...

Mole removal on the forehead with a history of skin cancer

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

At times, it is adequate to defer the decision to a board certified specialist.  However, if you feel strongly about the bumps and would rest more peacefully if they were biopsied, then by all means it is worthwhile doing so. 

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 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.