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Since the 1980s, the most successful procedure for removing nonmelanoma skin cancers has been Mohs Micrographic Surgery. The Mohs technique was originated by Dr. Frederick Mohs, a general surgeon from Wisconsin during the 1930s. Since then it has been modified to the procedure that was started in the 1980s and continues today. The goal is to completely eradicate and remove non-melanoma skin cancers, while at the same time, minimizing the amount of normal tissue that must be sacrificed.
With typical surgical excisions, the pathologist “breadloafs” or slices the specimen vertically, like a loaf of bread. Using this technique, the pathologist is only sampling the margins of the tissue, so only 1 percent of the specimen is being examined. With Mohs surgery, 100 percent of the specimen is examined, which explains why Mohs surgery results in much higher cure rates than other forms of surgery.
Mohs Surgery: Advantages
In addition to its high cure rate, Mohs surgery provides several other advantages for people with skin cancer:
- Compared to traditional surgery, the precision of Mohs surgery usually causes less scarring, which leads to better cosmetic and functional outcomes.
- It requires no general anesthesia, which permits its use for people who may not be able to tolerate traditional surgery.
- Because it is so safe, it can be used for elderly people or in patients too fragile to undergo other forms of surgery.
- The procedure can often be performed in a office-based surgical suite, minimizing hospital time for patients.
- Because it uses microscopic examination of each layer of tissue to trace the edges of the cancer, Mohs surgery can more accurately eliminate diseased tissue and lessen the chance of recurrence.
Mohs Surgery: How It Works
Mohs surgery involves the systematic removal and microscopic analysis of thin layers of tissue at the tumor site until the last traces of the cancer have been eliminated. The immediate and complete microscopic examination and evaluation of excised tissue is what differentiates Mohs surgery from other cancer removal procedures. Cancerous tissue is removed with minimal normal tissue sacrifice, minimizing both post-operative wound size and the chance of recurrence.
Mohs surgery is most commonly used for basal and squamous cell carcinomas. Cancers that have recurred are often treated using this technique because the precision of Mohs surgery is ideal for the elimination of cancers in cosmetically and functionally critical areas such as on the head, neck, hands, and feet.