Basal cell carcinoma involoving the skin of breast a rare site

Basal cell carcinoma [BCC] is the most common and least lethal form of all cancers. The estimated lifetime risk of BCC in the white population is 33-39% in men and 23-28% in women. It occurs most frequently in people over 50 years of age and almost twice as often in men as in women. Up to 85% of BCCs are found in the head and neck region, but the lesions occasionally occur in unusual and routinely photoprotected locations. These include breast, vulva, scrotum, earlobe and middle ear. With such an atypical presentation of BCC, a keen and skeptical eye for diagnosis is required. No population-based epidemiologic studies to assess the incidence of BCC have been done in Pakistan. However, some scattered data can be found in local medical literature, which shows the highest frequency in 51-60 years age group with a male preponderance. We report a case of non healing ulcerated lesion over breast that was being treated for 5 years unsuccessfully. On skin biopsy, it came out to be BCC. As far as we have searched, it is the first report of such a case in Pakistani literature