Harvard Health Letter

What is Mohs micrographic surgery

Mohs surgery is the best way to make sure that a skin cancer is completely removed.

Mohs micrographic surgery is the usual first choice for treating high-risk squamous cell and basal cell skin cancers (and sometimes melanoma) because it offers the best chance of a cure and the best possible cosmetic result. When used to treat a first skin cancer, cure rates five years after Mohs surgery are 97% for squamous cell carcinoma (SCC) and 99% for basal cell carcinoma (BCC)—higher than any other treatment approach. The procedure allows a physician to track down the cancer to its roots and remove it without taking more tissue than is absolutely necessary.

Mohs surgeons have specialized skills and training in dermatology, dermatological surgery, pathology, and the Mohs technique.

Removing risky skin cancers

BCC and SCC can grow downward and outward, like the roots of a plant, and may extend further than is visible at the surface. Clinicians consider skin cancers on the central part of face, temple area, and ears to be high-risk because they have the potential to cause disfiguring damage to an eye or ear, the lips, the nose, or the forehead. Skin cancers can also invade tissues such as cartilage, bone, blood vessels, and nerves, which increases risk in certain areas of the head and neck and also the feet and hands. Risk also rises if the tumor is particularly aggressive, has recurred, or is large (greater than 0.2–0.4 inch in high risk areas of the head or face or greater than 0.75 inch for other areas).

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