Predictors of Local Invasion in Infiltrative Basal Cell Carcinoma: Tumour Budding Outperforms the WHO Subtyping

Authors

  • Maria Teresa Fernandez-Figueras Department of Pathology, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallés, Barcelona, Spain; Affiliation Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain https://orcid.org/0000-0002-2366-7110
  • Noelia Perez-Muñoz Department of Pathology, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallés, Barcelona, Spain; Affiliation Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
  • Luis Puig Affiliation Department of Dermatology, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Affiliation Universitat Autònoma de Barcelona, Barcelona, Spain https://orcid.org/0000-0001-6083-0952
  • Rodolfo Posada-Caez Department of Pathology, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallés, Barcelona, Spain
  • Rosa Ballester Victoria Department of Pathology, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallés, Barcelona, Spain
  • Martha Henriquez Affiliation Universitat Internacional de Catalunya, Sant Cugat del Vallés, Barcelona, Spain
  • Eva Musulen Department of Pathology, Hospital Universitari General de Catalunya, Grupo Quironsalud, Sant Cugat del Vallés, Barcelona, Spain; Affiliation Institut de Recerca contra la Leucèmia Josep Carreras https://orcid.org/0000-0002-9667-6464

DOI:

https://doi.org/10.2340/actadv.v104.40172

Keywords:

Basal cell carcinoma, Tumor budding, risk assesment, treatment, World Health Organization, classification

Abstract

Tumour budding (TB) correlates with increased local invasion in various neoplasms. Certain basal cell carcinomas (BCCs) exhibit local aggressiveness. Detecting adverse prognostic factors in partial biopsies could aid in identifying cases with heightened local risk. The absolute number of TB (≤ 3 tumour cells) in excision specimens of 271 infiltrative BCCs (0: absent; 1: 1–2 foci; 2: ≥ 3 foci; 3: ≥ 10 foci), the histopathological subtype and depth of infiltration, perineural invasion, and other histological features were evaluated. A significant correlation was found between TB and both depth of infiltration (rho 0.445, p < 0.001) and perineural invasion (p = 0.009). In the multivariate analysis of depth and perineural invasion (multiple regression, stepwise), TB was identified as a significant covariate together with diameter, inflammation, and perineural invasion for the former, and depth for the latter. Conversely, no correlation existed between the WHO histological subtypes (infiltrating, sclerosing, and micronodular), and depth of infiltration or perineural invasion. This study demonstrates the value of TB as a biomarker for local invasiveness in BCC. In routine practice, a count of ≥ 3 TB foci in lesions incompletely excised or with narrow tumour-free surgical margins would be a straightforward and reproducible method to guide BCC treatment.

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Author Biography

Luis Puig, Affiliation Department of Dermatology, IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Affiliation Universitat Autònoma de Barcelona, Barcelona, Spain

Department of Dermatology

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Published

2024-07-02

How to Cite

Fernandez-Figueras, M. T., Perez-Muñoz, N., Puig, L., Posada-Caez, R., Ballester Victoria, R., Henriquez, M., & Musulen, E. (2024). Predictors of Local Invasion in Infiltrative Basal Cell Carcinoma: Tumour Budding Outperforms the WHO Subtyping. Acta Dermato-Venereologica, 104, adv40172. https://doi.org/10.2340/actadv.v104.40172

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