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Small (2mm) excision margins for nodular BCCs have been proven to provide adequate clearance in previous studies. We aim to evaluate the outcome of these small excision margins for the different subtypes of BCC treated with staged excision and reconstruction in Aintree.

All BCCs excised over a 1 year period (Jan 1st to Dec 31st 2014) with a 2mm margin were retrospectively audited for location of lesion, histological subtypes, margin clearance and evidence of recurrence. Exclusions were lesions which were excised with greater margins, or non-BCC histology.

85 periocular BCCs were excised with 2mm margins during the study period, 4 of which were recurrent from previous excisions. Proportionally, 67 (79%) were nodular and 18 (21%) were a more aggressive subtype. Margins were clear in 55 (65%), clear but close (<1mm) in 18 (21%), and involved in 12 (14%). Of the involved/clear but close cases, 6 (20%) were of non-nodular subtype.
Clear but close and involved margins underwent further excision at involved margins before reconstruction. Patients were followed up for a mean of 3.7 years, with no recurrence observed.

Previous studies have shown 2mm margins can be used safely in nodular BCCs. Our study shows that 2mm margins may be used safely even in more aggressive histological subtypes.