Talk:Basal-cell carcinoma

Additions

I got the number of 800,000 cases in the US per year from the Skin Cancer Foundation website, http://www.skincancer.org/basal/index.php Carax 02:56, 3 October 2005 (UTC)

I have added new information about imiquimod (Aldara). Philiphughesmd 02:59, 26 January 2006 (UTC)

I have added information about the new treatment using petty spurge,somebody please extend it.Fufu Fang 19:29, 1 May 2006 (UTC)

I wanted to add an external link to a derm site with some excellent images of BCC. Basal Cell Carcinoma (BCC) Just wanted to run this by the discussion group first. Burrills99 14:13, 23 January 2007 (UTC)

This edit

The edit linked in this section heading is non-neutral, and reversion was appropriate pending discussion (and determination of consensus) here. I would favor better citation of the data in the article and claims in general. --Scray (talk) 01:38, 26 February 2009 (UTC)

The NCCN guideline (http://www.nccn.org/professionals/physician_gls/PDF/nmsc.pdf) summarizes the discussion here well. Page 6 define peripheral margin control pathology methods, and page 7 issue the guideline for low risk and high risk basal cell cancer. Most other clinical guidelines quoted follow similar recommendation, with slight variation on the size of the tumor considered (i.e. greater than 6 mm vs. greater than 2 cm). Leaving the discussion of peripheral control method from this discussion simply because Mohs surgery is one of the method is not acceptable. --Northerncedar (talk) 15:18, 26 February 2009 (UTC)

Dr. Cooper's argument that frozen section has no use in treatment due to "inability to distinguish between melanoma and basal cell cancer", as posted on talk page to an admin has no relevance here. Once the tumor is diagnosed as either melanoma or basal cell cancer - frozen section is simply used to determine margin, and not for definitive diagnosis.--Northerncedar (talk) 15:18, 26 February 2009 (UTC)

Dr. Cooper's assertion that dermatoscopy is worthless for deep margin is correct. As a clinical tool, it only aids the surgeon in determining the accurate clinical margin, to which he will add the correct surgical margin. Not using a tool is simply like saying you don't need to wear glasses if you are doing surgery.--Northerncedar (talk) 15:18, 26 February 2009 (UTC)

Dr. Cooper's lack of insight into pathology and histology sectioning is reflected in his argument that ALL sections are examined by a pathologist, therefore all margins are examined. This is the basis for his lack of understanding of the content of his deletion. We REALLY need the insight of a pathologist or dermatopathologist here - as I can not walk Dr. Cooper through our pathology lab so he can see how wax embedded sections are processed and read. --Northerncedar (talk) 15:18, 26 February 2009 (UTC)

In supporting his last edit here, Dr. Cooper stated that "frozen section is rarely used in the excision of basal cell cancer". This is simply false from both the stand point that Mohs frozen section is used routinely in the US, and frozen section using other methods of margin control are being done routinely by plastic surgeons in association with a pathologist at surgical centers throughout the world (http://www.ima.org.il/imaj/ar08may-4.pdf). A conscientious plastic surgeon will either have Mohs surgery done first prior to his reconstruction, or to do it in a surgical center where frozen section is available for margin determination on facial cases, or recurrent cases.--Northerncedar (talk) 23:44, 26 February 2009 (UTC)

When making a decision on this case, one should relook at Dr.Cooper's previous deletions and edits (and compare it to the version immediately before it), to see his style of confrontation and refusal to engage in discussion on the talk pages (since April 2008).--Northerncedar (talk) 15:52, 26 February 2009 (UTC)

The images here are from the referenced page of peripheral margin control method mentioned by the NCCN which includes Mohs surgery.--Northerncedar These methods are called ccpdma - complete circumferential peripheral and deep margin assessment by the NCCN. The diagrams show several CCPDMA methods, one of which is Mohs sectioning. Bread loafing, and modified bread loafing are also illustrated. Most CCPDMA are done with frozen section, as the surgical margins are narrower and more likely to result in positive margins. "Slow MOHs" is a misused term by some surgeons applying standard breadloafing with fixed tissue methods to make it sounds like they are using a CCPDMA technique. While some real Mohs surgeon use fixed histology and delayed reading for melanomas - many such "slow mohs" are not true CCPDMA methods(talk) 20:06, 26 February 2009 (UTC)

Protection

Following recent edit warring, I have now protected the page for a week. I would recommend to the editors in question that they try to find common ground, and seek informal mediation if needed. JFW | T@lk 21:05, 26 February 2009 (UTC)

Editprotected

I request that the gallery section be removed, as the gallery violates WP:IG. It does not appear to be part of the current edit war. Yellowweasel (talk) 20:57, 2 March 2009 (UTC)

I agree, and I removed it. It also violates WP:EWGROSS. Shii (tock) 07:27, 3 March 2009 (UTC)