Marc D. Brown, M.D.,
President, American Society for Dermatologic Surgery
Mohs surgery was named in honor of Dr. Frederic Mohs, who developed the basic technique over 50 years ago. Since Dr. Mohs first described the surgical procedure, many technical improvements and refinements have contributed to making it a safe and highly effective means of treating skin cancers including basal cell cancers, squamous cell cancers, and melanoma.
Mohs surgery technique
The main difference between Mohs surgery and other methods of removing skin cancers is meticulous microscopic control where the surgeon also functions as the pathologist reading the slides.
As the skin cancer is surgically removed, it is mapped by the Mohs surgeon so its exact location can be pinpointed. Every layer of tissue removed is inspected under the microscope for evidence of cancer cells at both the peripheral and deep margins.
If any skin cancer cells are seen, the Mohs surgeon continues to remove and examine sequential tissue layers. The Mohs surgeon is able to locate the cancer cells based on this meticulous mapping technique. When no further skin cancer cells are identified, the Mohs surgeon can be confident that the entire base and sides are tumor free.
In addition to ensuring total removal of the cancer cells, this technique also preserves as much normal, healthy skin as possible. Mohs surgery is indicated for skin cancers that are located in high-risk areas such as the head and neck; skin cancers that are large, aggressive, and difficult to treat with other therapies; or recurrent cancers.
Mohs micrographic surgery is performed in an outpatient setting under local anesthesia and is very safe and very well-tolerated. Since tissue is only removed until the cancer is no longer present, the Mohs surgery minimizes the size of the surgical wound and should reduce the size and appearance of the final surgical scar.