A systematic review of the incidence of basal cell carcinoma with perineural invasion: conventional pathology versus Mohs micrographic surgery

Arch Dermatol Res. 2023 Mar;315(2):127-132. doi: 10.1007/s00403-022-02354-y. Epub 2022 Apr 25.


Incidence of basal cell carcinoma (BCC) with perineural invasion (PNI) ranges from 0.178 to 10% depending upon whether conventional pathology (formalin fixed, paraffin embedded) or Mohs micrographic surgery (MMS) (frozen sections) is used. To determine the incidence of BCC with PNI determined by conventional pathology versus MMS. A review of PubMed and EMBASE databases, from their inception to December 18th, 2020, identified articles that determined the incidence of BCC with PNI using conventional pathology or MMS. The general (average) incidence of BCC with PNI as determined by studies that used conventional histopathology and MMS was 0.85 and 2.51%, respectively. The observed incidence of BCC with PNI was not significantly higher using MMS compared to conventional pathology (p = 0.82).

Keywords: Basal cell carcinoma; Nonmelanoma skin cancer; Perineural invasion; Perineural spread.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Carcinoma, Basal Cell* / epidemiology
  • Carcinoma, Basal Cell* / pathology
  • Carcinoma, Basal Cell* / surgery
  • Humans
  • Incidence
  • Mohs Surgery
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Skin Neoplasms* / epidemiology
  • Skin Neoplasms* / pathology
  • Skin Neoplasms* / surgery