
Mohs Surgery
Mohs surgery, also known as Mohs Micrographic Surgery, is a specialized and highly effective procedure for the removal of skin cancer. Named after surgeon Frederic Mohs, who invented the Mohs Surgery Technique, Mohs surgery involves removing the tumor, examining 100% of the surgical margin under the microscope, and continuing the process until the cancer is completely excised. Mohs Surgery is widely regarded as the gold standard for the treatment of most types of skin cancer, especially when they occur in sensitive or visible areas on the body.
1. Precision
Mohs Surgery is precision surgery. The Mohs technique allows the surgeon to remove cancerous tissue while sparing as much healthy tissue as possible. This makes it ideal for treating skin cancers on cosmetically or functionally sensitive areas like the face or hands.
3. High Cure Rates and Low Recurrence Rates
Mohs Surgery has the highest success rate of all treatments for skin cancer - up to 99%- particularly for basal cell carcinoma and squamous cell carcinoma, the most common types of skin cancer.
Mohs Surgery is also used for recurrent skin cancers, certain types of melanoma, and other, less common, skin cancers. By ensuring complete cancer removal during the surgery, the chance of the cancer growing back is virtually eliminated.
2. Staged Excision and Microscopic Examination
The procedure involves removing the cancerous tissue in layers. After a layer is removed, it is examined under the microscope. This process is repeated until no cancer cells are detected in the examined tissue.
During a Mohs procedure, the Mohs surgeon completes a microscopic examination of 100% of the surgical margins. Other skin cancer treatments blindly estimate the amount of tissue to treat, which can result in the unnecessary removal of healthy skin tissue and tumor regrowth if any cancer is missed.
4. Immediate and On-Site Analysis
5. Tissue Sparing
The microscopic analysis of the tissue is done immediately and on-site, which means, in most cases, the surgery and the reconstruction can be completed in one visit.
By minimizing the amount of healthy tissue loss, the Mohs surgeon can maximize the functional and cosmetic outcome of the surgery, for which they have received extensive specialized surgical training.
6. Expert-level Care to Optimize Outcomes
Mohs surgeons are specialized dermatologists. To become a board-certified Mohs surgeon and Fellow of the American College of Mohs Surgery (FACMS), specialized training (fellowship) is required.
During this fellowship, rigorous training in cutaneous oncology, pathology, skin cancer surgery, and complex reconstructive surgery is completed. To prove their competency, candidates need to successfully complete a minimum of 500 Mohs cases under the supervision of an experienced Mohs surgeon, followed by an examination by the American College of Mohs Surgery.
This specialized training is necessary to ensure the high cancer cure rates and excellent cosmetic outcomes seen with Mohs surgery. As a result, Mohs surgeons complete more cutaneous reconstructions in cosmetically and functionally sensitive sites than any other medical specialty, as supported by Medicare trends.
DOI: 10.1097/DSS.0000000000003787