Fortunately, basal cell carcinomas rarely metastasize. 33 Reported sites of metastases include the lymph nodes, lungs, bone, skin and liver. The most important variable contributing to increased morbidity and mortality is the size of the primary tumor, and the most important factor contributing to the size of the tumor is patient neglect. 34 Final Comment Overall, basal cell carcinoma is easily treated when it is detected early. Thus, all skin sites must be examined carefully for both routine and atypical presentations of this malignancy.
Patient neglect allows tumors to grow, and the larger the tumor, the greater the patient's risk.
In an effort to reduce the incidence and mortality of skin cancer, the AAD and CDC have made several recommendations. First, patients should be informed that their physician should examine any sore that does not heal or any skin growth that is enlarging. Patients should also avoid using artificial tanning booths. Finally, patients should be instructed to perform skin self-examinations and to routinely see their physician for full cutaneous and mucocutaneous examinations. The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as representing the views of the Department of Defense, the Department of the Army or the Department of the Air Force.