There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Margins for Excising Ocular Basal Cell Carcinoma
- The necessary margins for excising an ocular basal cell carcinoma from the nose are still a topic of discussion among researchers and medical professionals.
- A study published in 2015 1 suggests that traditional surgical treatment of non-melanoma skin cancer includes excision with adjacent surgical margins, with some authors favoring a clinical excision margin of 4mm for basal cell carcinoma.
- However, another study from 2020 2 found that basal cell carcinomas less than 6 mm had a clearance rate of 96% with 3-mm margins, and that nodular BCCs less than 6 mm may be cleared with 3-mm margins instead of the current 4-mm margin recommendation.
- A 2021 study 3 found that 2-3 mm excision margins can yield enough safety in facial BCCs, with recurrence rates comparable to those reported after wider margins.
- An earlier study from 1999 4 reported successful treatment of peri-ocular basal cell carcinomas using a 2 mm margin with delayed repair, with no recurrences after an average follow-up period of 36 months.
- Another study from 2018 5 used Optical Coherence Tomography (OCT) to define the margins of BCCs before micrographic surgery, and found that OCT may help to better define the microscopic dimensions of BCCs and reduce the number of stages of MMS.
Specific Margins for the Nose
- The 2021 study 3 found that the nose was the predominantly affected area, with 95 cases, and that 2-3 mm excision margins can yield enough safety in facial BCCs.
- The 1999 study 4 also reported successful treatment of peri-ocular basal cell carcinomas, which includes the nose, using a 2 mm margin with delayed repair.
- The 2018 study 5 used OCT to define the margins of BCCs before micrographic surgery, but did not specifically focus on the nose.
- The 2020 study 2 found that 3-mm margins were sufficient for nodular BCCs less than 6 mm, but did not specifically address the nose.
- The 2015 study 1 discussed the challenges of applying traditional surgical margins to eyelid tumors, including those on the nose, due to anatomic and functional reasons.