Mohs Surgery-facts

Mohs Surgery-facts
Skin Cancer-facts
patient Information

 Mohs surgery has been shown to be a highly effective treatment for certain types of skin cancer, with a cure rate of up to 99% for certain tumours.
  • Mohs surgery is particularly useful for treating the more aggressive types of BCC
  • Due to the fact that the Mohs procedure is micrographically controlled, it provides the most precise method for removal of the cancerous tissue, while sparing the greatest amount of healthy tissue. For this reason, Mohs surgery may result in a significantly smaller surgical defect as compared to other methods of skin cancer treatment.
  • The Mohs procedure is recommended for skin cancer removal in anatomic areas where maximum preservation of healthy tissue is desirable for cosmetic and functional purposes.
  • It may also be indicated for lesions that have recurred following prior treatment, or for lesions which have the greatest likelihood of recurrence.

History of Mohs Surgery
The Mohs surgical technique was developed in the 1930’s by Dr. Frederic Mohs, a general surgeon at the University of Wisconsin. This important development occurred while he was studying various injectable irritants to evaluate the in vivo inflammatory response in transplantable rat cancers and normal tissue. In the course of this study, Dr. Mohs noted that injected 20% zinc chloride solution inadvertently caused tissue necrosis in tumor and normal tissue. Further, he found that microscopic examination of this necrotic tissue showed well-preserved tumor and cell histology, the same as if the tissue had been excised and immersed in a fixative solution. This discovery formed the basis for a method by which cancers could be excised under complete microscopic control. This fixed tissue technique was utilized for over a decade, with Dr. Mohs being its pioneer, advocate, and lone practitioner. Long-term follow-up of his patients was carefully documented and gave further testimony to the effectiveness of this treatment. In 1953 a revolutionary breakthrough occurred while filming the removal of an eyelid carcinoma for educational purposes. An involved margin in the first level caused a delay in filming, this development necessitating utilization of horizontal frozen sections for the second and third levels. This fresh tissue technique worked so well that Dr. Mohs continued to use it for most eyelid cancers. He also found the technique useful for small and medium sized cancers at other sites, and subsequently continued to use the fresh tissue technique for multiple other skin cancers.

In 1969 Dr. Mohs reported the use of the fresh tissue technique for sixty-six basal cell carcinomas and for squamous cell carcinomas of the eyelid, with five-year cure rates of 100%. A corroborating series of data was instrumental in convincing the medical community of the validity of the fresh tissue technique, which had not yet largely replaced the fixed tissue technique. It is now well-established that the five-year cure rates using fresh tissue technique are equivalent to that of the fixed tissue technique. The fixed tissue technique is still recommended by some Mohs surgeons, however, for selected tumours.

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