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Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer (complete circumferential peripheral and deep margin assessment - CCPDMA) using frozen section histology. [1] CCPDMA or Mohs surgery allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.
As the CCPDMA surgery is frequently performed using frozen section pathology, immediate reporting of positive surgical margin is made, and the tumor can be completely removed in the same day. Traditional pathology processing is called "bread loafing", and only allows for the partial examination of the surgical margin.
Appropriate use criteria (AUC), sometimes referred to as appropriateness criteria (AC), specify when it is appropriate to perform a medical procedure or service. An "appropriate" procedure is one for which the expected health benefits exceed the expected health risks by a wide margin.
Frederic Edward Mohs (March 1, 1910 – July 2, 2002) was an American physician and general surgeon who developed the Mohs micrographic surgery (MMS) technique in 1938 to remove skin cancer lesions while still a medical student at the University of Wisconsin–Madison.
This can be by simple excision if the cancer is small; otherwise, Mohs surgery is generally recommended. [2] Other options include electrodesiccation and curettage , cryosurgery , topical chemotherapy , photodynamic therapy , laser surgery or the use of imiquimod , a topical immune-activating medication. [ 12 ]
The American College of Mohs Surgery (abbreviated as ACMS) is a membership-based organization of surgeons who are fellowship-trained (FACMS) in Mohs surgery, a technique that removes skin cancer in stages, one tissue layer at a time. The ACMS is the oldest and largest professional membership organization for Mohs surgeons. [2]
Surgical oncology is the branch of surgery applied to oncology; it focuses on the surgical management of tumors, especially cancerous tumors.. As one of several modalities in the management of cancer, the specialty of surgical oncology has evolved in steps similar to medical oncology (pharmacotherapy for cancer), which grew out of hematology, and radiation oncology, which grew out of radiology.
A round dull instrument of varying sizes (1 mm to 6 mm) is used to scrape off the cancer down to the dermis. [2] [3] [4] The scraping is then paused while an electrosurgical device like a hyfrecator is used next. Electrocoagulation (electrodesiccation) is performed over the raw surgical ulcer to denature a layer of the dermis and the curette is ...