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Skin cancer stages

Making an educated treatment decision begins with the stage, or progression, of the disease. The stage of skin cancer is one of the most important factors in evaluating treatment options.

Staging may depend on the type of cancer. For non-melanoma skin cancers that have a low likelihood of spreading, like basal cell or squamous cell carcinomas, the staging process may not be necessary. Melanomas are more likely to spread quickly, so the skin cancer staging process becomes a very useful tool when it comes time to plan for treatment:

  • Non-melanoma skin cancers: Basal cell carcinomas rarely spread and may not be staged. The chance that squamous cell carcinomas will spread is slightly higher and may be staged using the American Joint Committee on Cancer (AJCC) TNM System.
  • Melanoma: Melanomas are more aggressive and likely to spread. This type of skin cancer is usually staged by the AJCC TNM system or the Clark levels. Read more about the melanoma skin cancer stages.

Video: Cancer Staging

Cancer Staging

Basal cell carcinoma stages

There are certain features that are considered to make the cancer at higher risk for spreading or recurrence, and these may also be used to stage basal cell carcinomas. These include:

  • Greater than 2 mm in thickness
  • Invasion into the lower dermis or subcutis layers of the skin
  • Invasion into the tiny nerves in the skin
  • Location on the ear or on a hair-bearing lip

After the TNM components and risk factors have been established, the cancer is given a stage. For basal cell carcinoma staging, the factors are grouped and labeled 0 to 4. The characteristics and stages of basal cell carcinoma are:

  • Stage 0 basal cell carcinoma: Also called carcinoma in situ, cancer discovered in this stage is only present in the epidermis (upper layer of the skin) and has not spread deeper to the dermis.
  • Stage I basal cell carcinoma: The cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.
  • Stage II basal cell carcinoma: The cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with 2 or more high-risk features.
  • Stage III basal cell carcinoma: The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.
  • Stage IV basal cell carcinoma: The cancer can be any size and has spread (metastasized) to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.

We're here to guide you through the cancer journey

We understand you may be feeling overwhelmed with questions and concerns about your type of cancer and what it all means. We're here to help guide you through the process.

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