Dr Todd Schlesinger: Tissue-Sparing Mohs Surgery Is Highly Accurate

Todd Schlesinger, MD, FAAD, director, Dermatology and Laser Center of Charleston and Clinical Research Center of the Carolinas, explains the process of Mohs surgery for removing skin cancers and preserving healthy surrounding tissue.

Transcript

What is Mohs surgery and how is it utilized for patients with skin cancers?

The whole point of Mohs surgery is to remove a skin cancer, with the smallest amount of normal skin and the highest chance of cure and the lowest chance of recurrence. Mohs surgery has a set of appropriate-use criteria, and most dermatologists will be aware of those criteria. In a nutshell, we're talking tumors that are in sensitive areas of the body: the central part of the face, the ears, the temples, the scalp, the nose, the lips, fingers, genital areas, things like that. We're looking where we want to spare tissue, and we want to remove the cancer with the smallest amount of normal skin around it.

The other big important piece of Mohs surgery is the way that pathology slides are processed. The key is that they're processed so that way 100% of the surgical margin is examined in 1 plane. As you slice through the specimen, you can see all the way around the edges and you can see the center at the same time—that’s what you see when you do the first layer of Mohs. This is a micrographic, highly controlled type of surgery with a high cure rate.

The other important point is that the surgeon is also the pathologist, so the same person is removing the tissue and seeing what's going on clinically with a patient and the tumor bed. They're also reading the slides and comparing those, too, and that comparison that's done by that 1 person improves the accuracy tremendously over traditional surgery.

Mohs surgery is a highly accurate, microscopically controlled surgery that can help our patients get clear of tumors with the lowest chance of recurrence.