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Mohs vs. Excision


What is Mohs surgery?

MOHs surgery is a specialized surgical procedure to remove basal and squamous cell lesions. It is reserved for cancer removal in areas that are near important features and provides the most cosmetically acceptable scars. Mohs is the least invasive and most effective treatment for non-melanoma skin cancers. Reported five – year cure rates are 98% or greater for common non-melanoma skin cancers. The high success rate is due to the fact that the excised tissue is examined by the surgeon, under a microscope during surgery, and not after the tumor has been removed. This eliminates the possibility of the tumor being only partially removed.

What is surgical excision?

Excision is surgery to remove the entire skin cancer and a margin of healthy tissue to remove any cancer cells that may have spread to the surrounding tissue. Surgical excision is generally an office procedure or can be performed as an outpatient with local anesthetic.

Surgical excision is surgery for all kinds of skin cancer, melanoma and non-melanoma. With a skilled and experienced surgeon such as Dr. Joseph Sedrak, you can expect good medical and cosmetic results.

However, a tumor that is large (0.8 mm) or ulcerated is indicative of potential metastasis (spreading) to the nearby lymph nodes. In that case, a sentinel node biopsy will be performed to and determine if the cancer has spread. Many times, the entire tumor will be removed along with the lymph node biopsy in one procedure, but when the tumor is small and not ulcerated no lymph node biopsy is usually necessary.

Which is better Mohs or surgical excision?

The most obvious difference between Mohs surgery and routine excisional surgery is that Mohs is done in stages while you wait for lab results, which are obtained immediately on site, rather than the tissue sample being sent to a lab for results days later.

As you can imagine, all of this takes time. If you need several rounds, it may take several hours. But the time spent is worth it. The Mohs process examines 100 percent of the tissue margins under the microscope, whereas in standard surgical excision only 1 percent of the margins are examined microscopically. Mohs surgery also conserves the greatest amount of healthy tissue, giving you the smallest scar possible. The procedure is cost-effective because the cancer removal, microscopic evaluation and, in most cases, wound reconstruction are all done in one visit, and the cure rate is over 98 percent.

For small or superficial low-risk BCCs and SCCs on the abdomen, chest, back, arms and legs, standard treatments such as surgical excision, cryosurgery (freezing), curettage and electrodesiccation (scraping and burning), photodynamic therapy and topical medications may provide adequate therapy.

Mohs surgery is on the rise, for good reasons: It has the lowest recurrence rates, highest cure rates and best cosmetic results of any skin cancer treatment.

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