Basal cell carcinoma: A comparison of shave biopsy versus punch biopsy techniques in subtype diagnosis

Background: There are two standard ways to obtain tissue for histologic classification of a clinically suspected basal cell carcinoma: shave and punch biopsy. However, information on the value of each method is limited. Objective: The purpose of this study was to identify accuracy rates of two standard biopsy techniques in diagnosing subtypes of basal cell carcinoma. Methods: A total of 86 cases were identified that had received either a punch or a shave biopsy with subsequent total excision of tumor. The biopsy specimens and excisions were compared for histologic correlation. Results: Analysis of specimens from punch and shave biopsies produced equivalent diagnostic accuracy rates: 80.7% and 75.9%, respectively. There was no statistically significant tendency to overcall or undercall any particular tumor subtype on the basis of the type of biopsy procedure used. Conclusion: For histologic classification of basal cell carcinoma, there is an approximately 80% accuracy rate with both the shave and the punch biopsy. Therefore either biopsy technique is appropriate.