No sign of basel cell cancer after biopsy. Would the pathology repot be able to tell how deep it is?

I have had a large reddish limp with blood vessels showing around it for over 3 yrs. Had some type of biopsy done. A lot of pus came out and the pathology report came back stating they found invasive basel cell cancer. My cheek is healing nicely now. Nothing shows on my face now, but a hole and I am wondering if the report can tell how deep the cancer is and should I have another biopsy to see if the cancer is gone scheduled for Mohs in 3 weeks. Do not want to do the procedure if the cancer is gone.

Doctor Answers 3

Treatment of basal cell skin cancer with Mohs surgery

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Your biopsy was to confirm if the spot is cancer or not, it is not a treatment by itself. Often after a biopy the surface heals up well and the cancer is hidden under the surface of the biopsy site. If the cancer is on your face, Mohs is the most appropriate and cost effective way of treating it with the highest cure rate and best cosmetic result.

Mohs surgery after biopsy

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The biopsy is a diagnostic procedure, and not a treatment for skin cancer. While some pathologists will comment on the type of basal cell seen, regardless of the type, further treatment with Mohs surgery is important to make sure that the deep and peripheral margins are clear of tumor. While it may seem like the site is healing well and the cancer is gone, it is impossible to know for sure without further work. Fortunately Mohs surgery can evaluate the margins microscopically, give you the highest cure rate and smallest scar possible.

Mary Alice Mina, MD
Atlanta Dermatologic Surgeon

Biopsy of basal cell carcinoma

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The biopsy is meant only to diagnose the skin cancer but not to treat it.  The most common treatments for a skin cancer in this area include Mohs micrographic surgery and radiation therapy.  I am not given the subtype of basal cell carcinoma, which sometimes pushes this decision, often towards Mohs surgery.  Nevertheless, the use of a biopsy alone to determine whether or not a skin cancer persists is not ideal as the variable of sampling error exists.  It sounds like you have a solid plan to take care of this skin cancer and ensure that it is treated.

Joshua E. Lane, MD, MBA
Columbus Dermatologic Surgeon

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