Patients who have been diagnosed with skin cancer may be recommended Mohs micrographic surgery as a treatment. It is considered the most effective treatment against skin cancer today, as recent studies show high success in achieving a cure rate for the three most common skin cancers: basal cell carcinoma, squamous cell carcinoma, and melanoma.
One of the goals of this treatment is to remove skin cancer without harming healthy tissue as much as possible. This article discusses the procedure to help patients understand it and its mechanisms and provides insight into why it is a preferred choice for many individuals diagnosed with skin cancer.
What is Mohs Micrographic Surgery?
Mohs surgery, named after its inventor Dr. Frederic Mohs, is a precise surgical technique primarily used to treat skin cancer. Unlike traditional excisional surgery, Mohs surgery involves the systematic removal and examination of thin layers of tissue around the cancerous growth until only cancer-free tissue remains. This process allows for the complete removal of cancer cells while preserving as much healthy tissue as possible, leading to superior cosmetic and functional outcomes.
How is it Performed?
This cutting-edge skin cancer treatment is performed by a dermatologist trained in Mohs surgery, known as a Mohs surgeon.
Here’s an overview of how the procedure is performed:
- Initial Examination – The Mohs surgeon begins by examining the visible tumor and mapping out the area to be treated, identifying the boundaries of the cancer, and planning the surgical procedure.
- Local Anesthesia – Before the surgery begins, local anesthesia is administered to the patient to numb the area to be treated.
- Tumor Removal – The surgeon then removes the visible tumor along with a thin layer of surrounding tissue. This tissue is immediately processed and examined under a microscope in an on-site laboratory.
- Microscopic Analysis – The excised tissue is carefully examined under a microscope by the surgeon. The goal is to assess if any cancer cells remain at the edges of the removed tissue. This step is crucial for ensuring complete removal of the cancerous cells while preserving healthy tissue.
- Layer-By-Layer Removal – If cancer cells are still present at the edges, the surgeon will proceed to remove another layer of tissue from the specific area where the cancer cells are detected. This process is repeated until no cancerous cells are visible under the microscope. This meticulous approach ensures the complete removal of cancerous tissue while sparing healthy tissue.
- Tissue Reconstruction – Once the cancer is completely removed, the surgeon discusses options for wound closure and reconstruction. Depending on the size and location of the excision, reconstructive techniques such as suturing the wound closed, using skin grafts, or other specialized methods may be employed.
- Post-Operative Care – After the surgery, the provider gives instructions for wound care and a follow-up appointment to the patient to ensure proper healing and monitoring of the surgical site.
How Does Mohs Surgery Achieve a Cure for Skin Cancer?
In one recent study, Mohs surgery has shown impressive 5-year cure rates for non-melanoma skin cancers, especially basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Here are some examples: primary BCC has a 99% cure rate, while recurrent BCC has a 94.4% cure rate. Similarly, primary SCC boasts a cure rate of 92-99%, with recurrent SCC close behind at 90%.
The key to the surgery’s success lies in its ability to precisely identify and remove cancerous tissue while preserving surrounding healthy tissue. By systematically examining tissue samples during the procedure, the surgeon can accurately determine the extent of the cancer and ensure its complete removal. This minimizes the likelihood of cancer recurrence and reduces the need for additional treatments.
Mohs Surgery is Usually Recommended for the Following Skin Cancers:
- High-Risk Areas – It’s often chosen for skin cancers located in sensitive or critical areas like the face, scalp, hands, feet, genitals, or around the eyes.
- Recurrent Tumors – When skin cancers return after previous treatments, the Mohs procedure offers a high success rate by meticulously eliminating cancer cells while preserving healthy tissue.
- Large Tumors – Mohs surgery is particularly effective for large or aggressive tumors. It allows precise examination of margins, minimizing tissue removal and scarring.
- Aggressive Subtypes – Some aggressive skin cancer subtypes, like infiltrative basal cell carcinoma or sclerosing squamous cell carcinoma, may require Mohs surgery for complete removal due to their tendency for deep invasion and recurrence.
- Uncertain Borders – When tumor borders are unclear, Mohs surgery’s microscopic examination ensures precise margin assessment, ensuring complete removal is achieved.
Top-Rated Mohs Surgeon in Miami, FL
Dr. T.J. Giuffrida is our board-certified dermatologist who is fellowship trained in Mohs surgery at the Dermatology and Skin Cancer Center. Dr. Giuffrida is one of the few dermatologists trained in this state-of-the-art skin cancer treatment. Our practice takes in only a limited number of patients to allow us to give the time and dedication each patient deserves.
To get the best in skin cancer treatments, consult skin cancer expert, Dr. Giuffrida. Call our office today at (305) 461-2000 or schedule an appointment using our convenient online form.
