Non-Invasive Tools for Improving Diagnosis of Non-Melanoma Skin Cancer: A Review

Abstract

Background Non-melanoma skin cancers (NMSC) are the most common cancers diagnosed in the western world . The need for surgical treatment of such lesions is on the increase. The fact that the majority of such lesions appear on aesthetically sensitive areas of head and neck means that a non-invasive method of diagnosis has the potential to both eliminate the need for tissue biopsy, as well as act as an adjunct to surgery to ensure minimal healthy tissue is sacrificed. MethodsA review of all literature using databases of Pubmed and Medline was carried out. All the titles and abstracts of all articles found were searched and relevant articles were selected. A further review of all the references mentioned in the selected studies was carried out and all relevant articles were added to the database. All selected articles were reviewed and categorised into groups based on the technique or the technology being investigated. ResultsThe minimally-invasive techniques currently under use or under investigation are: dermoscopy, high frequency ultrasound (HFUS), optical coherence tomography (OCT), and confocal microscopy including both fluorescence confocal scanning microscopy (FCSM) and reflectance confocal microscopy (RCM) ConclusionsBased on this review RCM is the only device that has shown any promise in delivering a non-invasive real-time in vivo image of the skin and its structures that is comparable in resolution to histology, has reasonable inter-operator reliability, and therefore has the potential for use in conjunction to surgery. To date, trials in its use however have been limited. Neville JA, Welch E, Leffell DJ. Management of nonmelanomaskin cancer in 2007. Nat Clin Pract Oncol 2007;4:462–9