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Diagnosis and prognosis of Skin Cancer
If cancer is suspected, a diagnosis is made following a skin biopsy. Depending on the severity of the skin lesion, a biopsy can be conducted by scraping surface cells, by using a narrow punch to extract a larger tissue sample, or by excising a section of skin and surrounding tissue with a scalpel.
Once nonmelanoma skin cancer has been diagnosed, its stage is determined to indicate how far the cancer has progressed. Stage 0 skin cancer is also called squamous cell carcinoma in situ, or Bowen disease, and is confined to the epidermis. Stage I cancers are 2 cm (approximately 3/4 inch) or less in size; stage II, more than 2 cm. Neither has spread beyond the skin. Stage III cancers have spread to deeper layers of the skin, underlying tissues, or nearby lymph nodes. Stage IV cancers have spread to other parts of the body such as the muscles, bones, lungs, nerves, or brain.
Very few cases of nonmelanoma spread to other tissues before they are detected and removed. Basal cell carcinomas rarely spread to surrounding tissues, and five-year survival rates approach 100 percent when these cancers are detected early, as most are. A small percentage of basal cell carcinomas spread to nearby lymph nodes and surrounding tissues; the five-year survival rate in these cases is very low. Squamous cell carcinomas also have an extremely high five-year survival rate when detected early, but the rate drops considerably if the cancer has spread.
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