Mohs Micrographic Surgery is most physicians’ treatment of choice for the more difficult carcinomas of the skin.
Named after Dr. Frederick Mohs, this procedure is the most modern, accurate and specialized treatment for the total removal of skin cancer. In this state-of-the-art treatment, the Mohs physician serves as both surgeon and pathologist.
It employs the precision and accuracy of a microscope to trace and ensure removal of skin cancer down to its roots.
Mohs Micrographic Surgery is the only skin cancer treatment that provides complete microscopic examination of all the tissues surgically removed, as well as detailed graphic mapping for orientation purposes – hence the term micrographic surgery.
Mohs surgery ensures that all the diseased tissue (and only the diseased tissue) is removed, minimizing the cosmetic impact.
The Mohs process includes a specific sequence of surgery and pathological investigation. Mohs surgeons examine the removed tissue for evidence of cancer cells. Once the visible tumor is removed, Mohs surgeons trace the paths of the tumor using two key tools:
• A map of the surgical site
• A microscope
Once the obvious tumor is removed, Mohs surgeons:
• Remove an additional, thin layer of tissue from the tumor site.
• Create a “map” or drawing of the removed tissue to be used as a guide to the precise location of any remaining cancer cells.
• Microscopically examine the removed tissue thoroughly to check for evidence of remaining cancer cells.
If any of the sections contain cancer cells, Mohs surgeons:
• Return to the specific area of residual tumor as indicated by the map.
• Remove another thin layer of tissue only from the specific area where cancer cells were detected.
• Microscopically examine the newly removed tissue for additional cancer cells.
If microscopic analysis still shows evidence of disease, the process continues, layer by layer, until the cancer is completely gone.
Mohs micrographic surgery is used primarily to treat basal and squamous cell carcinomas, but can also be used to treat less common tumors, including melanoma.
Mohs Micrographic Surgery is exceptionally effective in cases such as:
*Tumors in high-risk areas (eyes, nose, ears, lips etc.)
*Tumors with ill-defined borders
*Large cancers (greater than 2cm)
*cancers with aggressive history (e.g. sclerosing)
The advantage of Mohs Surgery:
*Cure rate: Mohs Surgery has the highest cure rate of any comparable procedures (99%).
*Low impact: the Mohs technique has the lowest functional and cosmetic morbidity of any procedure.
*Convenience: the one-day outpatient procedure uses local anesthesia in a comfortable, easily accessible facility.
*Economy: Mohs surgery is highly cost-effective compared to other surgical options.
The surgery is done only by specialists that were trained in the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO), the only organization that oversees post-graduate fellowship training and regulates the requirements for comprehensive training in this specialty.