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26 Years Old - BCC Right Next to Eye. Mohs Best Option? (photo)

I was just diagnosed with a BCC last Friday just below and to the left of my left eye. Picture is after biopsy. There is no way to determine how extensive it will be based on the biopsy? Can they tell anything at all from the biopsy? I have read that for some - once a MOHS surgeon started cutting there wasn't any cancer present? Is this a possibility? It has been there for about 3 years. I have 3 consults set up but my mind is flooded with questions before then. Thanks in advance.

Doctor Answers (8)

Mohs IS the best option for you

+1

Receiving a cancer diagnosis at any age can be overwhelming and I'm sorry you have to go through this at age 26.  The upsides to Mohs surgery are 1) the cancer will be removed it its entirety on the day you have surgery 2) the absolute smallest scar will result from this treatment vs any other 3) no healthy tissue will be wasted in the process. 

There is always a chance that the surgeon will get it all on the first stage but the initial biopsy alone will not tell us how deep or wide it is.  Do go for your consults and do make certain you see a fellowship trained Mohs surgeon who is a member of the American College of Mohs Surgery.  Good luck. 


Seattle Dermatologist
4.5 out of 5 stars 11 reviews

Mohs surgery for biospy proven basal cell carcinomas on the face and sensitive areas

+1

A skin biopsy can tell you what the diagnosis is, but often will not tell you how extensive your skin cancer is. Mohs surgery is the most precise and effective method for treating skin cancer today. It is a minimally invasive procedure that spares healthy tissue and has an over 99% cure rate for primary (i.e. never before treated) basal cell carcinoma skin cancers. Occasionally, a skin biopsy can remove the entire cancer. However without checking to make sure all the cancer roots have been removed, the cancer can come right back. Although there are a number of treatment options out there, the fact that your cancer is on the face and close to the eye, as well as the fact that you are your (basal cell carcinoma is not that common in people age 25-34), I would recommend the Mohs surgery procedure. You are welcome to look at the attached video for more information about Mohs.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

MOHS and skin canacer.

+1

MOHS surgery is the best option for treating skin cancer of the eyelids. The MOHS surgeon will remove just enough tissue to completely clear the area of skin cancer. This technique leaves the  maximal amount of normal  tissue for reconstruction and has the highest success rate for complete cancer removal. 

Adam J. Cohen, MD
Skokie Oculoplastic Surgeon
3.5 out of 5 stars 12 reviews

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Mohs surgery is the treatment of choice for skin cancers

+1

Unfortunately, the information a biopsy can provide is limited to a diagnosis. You must have a definitive procedure to remove the remaining skin cancer that may be invisible to the eye, yet still be present in the tissue examined under a microscope. Mohs surgery is the most tissue sparing procedure in cancer treatment armamentarium. Smaller wounds typically result in smaller and/or simpler reconstructions. In the end, your reconstruction will depend on what the final defect will look like. Keep in mind, if left untreated, the cancer will continue to grow both wide and deep, destroying everything in its way: skin, muscle, bone, and so on. It can be absolutely devastating.

Take your time selecting a surgeon. If you want to learn more, go to www *dot* skincancermohssurgery *dot* org to learn more about your cancer and Mohs surgery.

Larisa Ravitskiy, MD
Columbus Dermatologist

BCC on face

+1

Sorry that you have a BCC.  We have had many patients in their 20's and Mohs followed by plastic surgery reconstruction is by far the best option

Sam Naficy, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 141 reviews

Mohs excision is the BEST option for removal of a facial skin cancer - results in smaller wounds and lowest recurrence rates.

+1

Mohs excision is the BEST option for removal of a facial skin cancer. You will do very well to followup with a fellowship trained Mohs surgeon (almost all are dermatologists). There is no question that you should undergo another procedure to ensure that your skin cancer is completely removed. Mohs will result in the smallest possible wound with complete removal of the skin cancer and low, low rates of reappearance of skin cancer down the road in that spot. Your reconstruction will either be performed by your Dermatologist or you might be referred to a Facial Plastic Surgeon depending upon a discussion between you and your Dermatologist.

Thank you for your question.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 37 reviews

Mohs surgery and BCCs

+1

The problem with BCCs is that they have roots. What happens is that while a site may look small on the surface, underneath it can be growing deeper or wider, due to the roots of the cancer. I have been doing Mohs surgery for about 25 years now and I can say with certainty that there is no way to look at someone and tell you how big or wide or how many levels will need to be done. Most often on the face on someone young like you, it won't have had time to grow that deep and wide underneath, but there is no way to know that without cutting some tissue out, making slides, and reviewing them. The purpose of Mohs is to remove the smallest amount of tissue possible and close the site in the cleanest way possible. There is no way that if the biopsy has shown that you have a BCC and it extends to the margins (this will be stated on the biopsy report) that there would be no cancer there - so yes, you have cancer and yes, you need Mohs. Go to your consultations with as many questions as you have and pick the surgeon you are most comfortable with.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.5 out of 5 stars 8 reviews

MOHs

+1

MOHs is a tissue sparin technique and is your best option

if you want the best of both worlds, pre arrange good plastic surgeon

For closure.

Best of luck

Peter Malouf, DO
Dallas Dermatologist
5.0 out of 5 stars 74 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.