Mohs Micrographic Outpatient Surgery for Skin Cancer

State of the Art Treatment for Skin Cancer Micrographically Controlled Excision or Mohs Surgery is the technical name for the procedure to treat your skin cancer.

Dr. Frederick Mohs developed this technique in the 1940’s.  Skin cancers are the most common malignant tumors in fair-skinned Americans.  Although some types of skin cancers, such as malignant melanoma, can be very serious problems, the typical skin cancer does not often pose a major threat to a patient’s overall health.  This is partly because a typical skin cancer is easy for your doctor to see,so that it can be safely and effectively treated by a variety of simple techniques.

However, some cancers, particularly large or recurrent ones, can spread in the skin in ways that make them more difficult to see with the eye, and simple techniques risk leaving cancer cells behind.  Fortunately, our doctors have been trained to predict which cancers are likely to spread in that way. 

Mohs  Surgery Procedures

Mohs micrographic surgery is a minor surgical procedure and special method of removing skin cancers using local anesthesia. Mohs is a very precise technique whereby small layers of skin are sequentially removed and immediately examined under the microscope until the samples indicate that the skin cancer is completely removed. If more cancer cells are seen under the microscope after the first stage, another skin layer is removed and again examined. Each skin layer that is removed is called a “level”. Once the skin cancer has been completely removed, it is referred to as “clear” and no additional levels are taken. By removing only tissue where cancer is known to be present, the technique combines a very high cure rate while ensuring that the maximum amount of healthy tissue is kept intact. Once the cancer has been entirely removed, the skin defect will be surgically repaired.

Mohs is a very specialized technique because the entire edge and undersurface of each skin cancer layer is carefully examined under the microscope for the presence of very small cancer cells. With traditional surgery, only about 1% to 3% of the tumor margins are actually examined, thereby increasing the chances that some cancer cells would be missed and left behind. Mohs allows for examination of 100% of the tumor margins, thereby reducing the chance that tumor cells will be left behind. Clinical studies conducted at various national and international medical institutions demonstrate that with a cure rate of 95% to 99%, Mohs surgery has the highest cure rate for basal cell and squamous cell carcinomas.

In order for Mohs surgery to be approved by your insurance company, specific criteria must be met. For example, the location of the cancer, its size, and previous therapies are all taken into consideration.