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Difference between SCC and SCC in Situ

Rague
Posts: 3340
Joined: Aug 2009

I recently was DX'd with SCC which was  eccised with clean margins.  The same day that was done, there was also a punch done on arm  which came back BCC.  When I went back to have the BCC excissed, the surgeon saw a 'spot' on other cheek she wanted checked.  Path is that it is SCC in Situ.

So what is the difference in SCC and SCC In Situ?

(I'm a 4 yr IBC (Inflammatory Breast Cancer) survivor.  Path . says that my BCC  and SCC is not IBC related.)

Winyan - The Power Within

Susan<

Alexandra's picture
Alexandra
Posts: 1246
Joined: Jul 2012

I've just noticed that your post is rather old, so you probably found the answer by now.

Here's a link to the page explaining BCC, SCC and SCC in situ http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skin-cancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell

BCC and SCC are skin cancer; SCC in situ is pre-cancer non-invasive skin condition.

jalind's picture
jalind
Posts: 2
Joined: Dec 2011

Susan,

I'm a skin cancer disaster area. That your BCC and SCC isn't IBC related is no surprise to me. The difference between SCC and SCC in situ is whether or not it has progressed beyond the epidermis into the underlying dermis and perhaps beyond that. In situ is Latin meaning "in the original site or location" and is used in medical and legal jargon. There was a time when SCC in situ was considered a "pre-cancer" because it hadn't progressed to the TNM staging definition of Stage I yet. In reality, characterizing it as a "pre-cancer" is a misnomer. A true "pre-cancer" would be an actinic keratosis that had not yet become SCC. Make no mistake, it's cancer, even if it's still in situ.

The oncology community has been shifting to classifying an in situ SCC lesion as Stage 0 to truly call it what it is. You will see the vestiges of older skin cancer documents labeling it a "pre-cancer" which is unfortunate as people tend not to take it as seriously as they should. SCC, if it isn't dealt with and is ignored, will become invasive and it will metastasize, typically through the lymphatic system, albeit usually not as aggressively as melanoma will. Thus, dealing with it promptly as soon as it appears -- while it's in situ -- is important.

As you've already found SCC and apparently BCC you are a known risk for skin cancer appearing elsewhere, including recurrence at or very near where it was found this time. Learn how to do self-exams to watch for skin lesions appearing, and have routine visits for a full body check with a good dermatologist that deals with skin cancers. A good one can spot stuff that you might miss or may not think is a lesion to be concerned about. The typical SCC and BCC photos you see on the internet are the horrid basket cases. Note that BCC metastasizing is exceptionally rare, and most variants are slow growing, but it will eventually invade underlying skin and other tissue structures in its immediate vicinity. Dealing with BCC lesions as they're found minimizes the depth and breadth of excision required, and the time needed for the site to heal. Modern cosmetic surgical techniques are very good. Permanent disfigurement is generally not an issue in all but the extreme cases. I've had numerous lesions removed and people do not notice the surgical sites unless I stretch the skin just right and point out the very faint scar line.

Best wishes
John

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