What is Mohs surgery?
Mohs surgery (also known as Mohs micrographic surgery) is a method used to remove high-risk skin cancer. It’s very precise. Your surgeon cuts away (excises) the tumor in layers starting with the visible portion of the tumor and a margin of skin cells around it. Then, the sides and deep edges are examined under a microscope. If the skin cancer extends to any of the edges (margins) your surgeon will remove more tissue in the positive areas, and look at the new sample under a microscope. This process continues until all of the cancer is removed.
One of the advantages of Mohs surgery is that your surgeon only removes cancerous tissue. This means that your healthy tissue is spared, making Mohs a useful approach for skin cancers on your face, scalp, ear, hands, feet and genital areas.
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Why is it called Mohs surgery?
The procedure was developed by Frederic E Mohs, MD, in the 1930s and has since been refined. Originally, Dr. Mohs injected the tumor with a preserving chemical so that when removed (excised), he could inspect the tissue under a microscope. But the initial process of preparing fixed-tissue slides took several days, the use of chemicals to cauterize the tumor was controversial and the procedure was painful.
About 20 years passed before Dr. Mohs and his colleagues tried a new technique to remove carcinoma from an eyelid: the surgery could be done in one day using frozen fresh tissue in slide preparation.
Mohs surgery vs. excision: What’s the difference?
Excision is a procedure through which your surgeon removes the skin cancer and a margin of surrounding skin and the specimen is sent to pathology for processing and interpretation. In general, less than 1% of the margins are checked with wide local excision. . Mohs micrographic surgery involves excision with a smaller margin and the tissue is processed in such a way that your surgeon checks 100% of the deep and side (lateral) margins.
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What types of skin cancers are removed with Mohs surgery?
The Mohs surgery procedure treats the most common forms of skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Mohs surgery is also sometimes used to treat other skin cancers, including certain melanomas, dermatofibrosarcoma protuberans, microcystic adnexal carcinoma, sebaceous carcinoma and extramammary Paget disease, among others.
Where is Mohs surgery done?
Mohs surgery is done in a doctor’s office or outpatient surgical center. After each excision, you’ll wait in a waiting room or the operating room while your care team prepares slides of your tumor and your surgeon inspects those slides. If your provider finds tumor at any of the margins, you will be brought back in so your surgeon can remove another layer of tissue for further inspection. This process can take a while, so be sure to bring a book or electronic device to keep you occupied while you wait.
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How often are these procedures performed?
Mohs surgery is a very common treatment for high-risk skin cancer because it has a cure rate of up to 99%. This is the lowest recurrence rate of any other treatment for skin cancer.
