Do I Need MOHS Sugery?
- Asked by treeguy in South Carolina
- 1 year ago
One month ago had basal cell on cheek but close to nose removed, leaving maybe 8-10mm now healing scar, the tumor was maybe 4 mm. They cut it out and used heat to seal off, no stiches. Then I get biopsy report and someone hand wrote on it MOHS yet if you read it does not clearly say why, nothing about margins etc? My wife had one removed same day on back and the biospy reads exactly the same but no MOHS mentioned. Called doctor and person at front says due to margins but not stated on it.
Do I need Mohs
There are several reasons in which Mohs' surgery is indicated. For tumors on the face that are >1cm in diameter, for aggressive tumors (i.e. infiltrative basal cell carcinoma, sclerotic basal cell carcinoma, or morpheaform basal cell carcinoma), and for tumors on or near the eyelid, nose, lips, and ears, Mohs' is the treatment method of choice. That does not mean that Mohs' has to be done, but it usually preferred. Of any surgical method, Mohs' Surgery removes the least amount of normal (non-cancerous) skin and has the highest cure rate of any treatment (over 99% for non-recurrent, untreated tumors). For recurrent or large tumors (>2cm) on the body, Mohs' should be considered.
Mohs surgery appropriate for facial skin cancers and particular anatomic locations
Mohs surgery is the right treatment for your skin cancer. The location of your tumor is mid face (mask area) and near your nose. Mohs surgery allows your skin cancer to be treated with precise margin control and the lowest rate of recurrence, all the while preserving normal healthy skin.
MOHS is typically recommended for facial skin cancers. They can be equally effectively remove by an experienced plastic surgeon and reconstructed at the same time.
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MOHS is ok
This is an anatomical area of concern for skin cancer. It can spread deeply along the sulcus between the nose and the cheek. MOHS will lead to a clear diagnosis and will get better outcome in cosmesis and margin safety. It is characterized by look all the margins during the surgery with total control of the tumor spread pattern.
Mohs and BCC...
If I understand correctly, a biopsy was done on this area and Mohs surgery was recommended to you, but you were not given an explanation why? If that is correct, the region you had your basal cell occur is one where tissue is at a premium. In those cases, Mohs surgery is recommended to limit the amount of "normal" tissue that is taken and give you the best chance of cure. In most cases, the dermatologist can close these defects themselves, but if you are concerned with the appearance of the scar, they may consult with a facial plastic surgeon to "close" the defect. As others have stated below, because the back, torso and legs are not such cosmetically sensitive areas, they often do not require the precise control of margins as lesions on the face do.
Best of luck with your closure and thanks for your question!
High risk areas deserve Mohs
The location where your BCC was excised usually is one where a biopy confirms the diagnosis and Mohs is recommended. The risk is not that the cancer is more dangerous but is in an areas where margins can be difficult and there is greater risk of recurrence. Of course on the face were tissue is at a premium and closures can be more complicated the ACMS(American College of Mohs Surgery) recommends Mohs in order to achieve maximum cure, spare as much healthy tissue as possible and allow for optimal cosmetic results. On the trunk and on most areas off the face Mohs is not indicated for a first time, well demarcated BCC or SCC smaller than 1 cm in size.
To Mohs or not to Mohs
Mohs surgery is performed on areas where it is important to conserve tissue, such as the face/hands/feet/groin. It is a tissue sparing technique in which the surgeon can follow the tumor and make sure the margins are clear, reconstruction is done to the area usually on the same day. It sounds as though you had a biopsy, and your dermatologist wishes for you to have Mohs micrographic surgery and your wife to have an excison (the back not beeing a tissue sparing area). The best thing to do is to sit down and speak to your dermatologist about the plans for your basal cell, and ask any questions you may have.
Mohs surgey is a method of skin cancer removal
It sounds like you had a cheek basal cell carcinoma biopsied, and there is a plan for definitive tumor removal with Mohs surgery. Its important that you follow up with the physician that did the biopsy, because this doctor needs to communicate the plan to you.
Mohs surgery and subsequent reconstruction is an effective way to remove skin cancers from regions of the face where skin is a precious resource- the nose, cheek, eyelids etc.
Mohs procedures typically are not necessary for regions like the back, legs etc where there is a lot of skin to reconstruct the defect with.
Do I need Mohs surgery
Mohs is recommended for specific areas where the smallest amount of skin should be removed and preserved, like the face, ears, nose, hands, and feet. Mohs isn't needed usually on the arms, legs, or torso because a larger excision can be done and just stitched up. I'm unsure if you mean you HAD Mohs done, or are now scheduled for Mohs and don't know why. If you have questions, call and ask to speak directly to the physician, or at least the nurse. I love my front office staff, but they don't necessarily know the true medical answers or purposes for things.