MOHs Surgery Vs Surgical Excision for Non-face BCC While Pregnant?

I had a biopsy done for a 6.6mm mole on the right side of my abdomen and it came back as basal cell carcinoma. I am four months pregnant and trying to schedule and appointment for surgery in the next few weeks. Even though the mole was not on my face, I would like to have a MOH's surgery done instead a regular surgical excision (since the MOS's procedure seems to give a higher cure rate). Is my decision correct? Is the recovery harder after MOHs because I am pregnant? Thank you.

Doctor Answers 3

Mohs during pregnancy

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Your age may determine whether Mohs is appropriate for you or not.  Patients who are under the age of 40 are considered young, and those patients do often qualify for Mohs surgery because the risk of recurrence is greater for them.  While the abdomen is not considered a high-risk location, if the sub-type of basal cell carcinoma is infiltrative or if the tumor is recurrent (ie, it has been treated previously), you also may qualify for Mohs. 

Best of luck with your surgery and your pregnancy. 

Standard surgical excision should be fine

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A 6.6 mm BCC on the abdomen does not meet appropriate use criteria for Mohs surgery.  A standard surgical excision is the appropriate treatment.  Both offer very high cure rates.   If the procedure is done under local anesthesia, your pregnancy should not be a major issue.  I am a fellowship-trained Mohs surgeon and a strong believer in the procedure, but your situation is not an appropriate use for Mohs.  

In an ideal world, we would do Mohs for every skin cancer because of its high cure rates; unfortunately, we do not live in this world.  There are many pressures from outside sources including the government and insurance companies.  These pressures require ethical Mohs surgeons to use the procedure in appropriate situations. 

Brent Spencer, MD
Frisco Dermatologic Surgeon

Basal Cell on Abdomen

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Many insurance plans will not cover Mohs on the abdomen unless the basal cell is recurrent. The reason is that you will have a very high cure rate either way.

Being four months pregnant is not an issue. Minor surgical procedures under local anesthesia are well tolerated during pregnancy.

Being pregnant, I am sure your doctor and nurses will give you extra TLC. Take care.

T. Wayne Day, MD
Nashville Dermatologic Surgeon

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