Mohs surgery has come to be accepted as the single most effective technique for removing Basal Cell Carcinomas and Squamous Cell Carcinomas (BCCs and SCCs), the two most common skin cancers. It accomplishes the nifty trick of sparing the greatest amount of healthy tissue while also most completely expunging cancer cells; cure rates for BCC and SCC are an unparalleled 98 percent or higher with Mohs, significantly better than the rates for standard excision or any other accepted method.
Skin biopsies most often are done to diagnose skin cancer, which may be suspected when an abnormal area of skin has changed color, shape , size, or appearance or has not healed after an injury. Skin cancers are the most common type of cancers. Early diagnosis of a suspicious skin lesion and skin biopsy can help identify skin cancers and lead to early treatment.
Squamous cell carcinomas detected at an early stage and removed promptly are almost always curable and cause minimal damage. However, left untreated, they eventually penetrate the underlying tissues and can become disfiguring. A small percentage even metastasize to local lymph nodes, distant tissues, and organs and can become fatal. Therefore, any suspicious growth should be seen by a physician without delay. A tissue sample (biopsy) will be examined under a microscope to arrive at a diagnosis. If tumor cells are present, treatment is required. There are several effective ways to eradicate squamous cell carcinoma. The choice of treatment is based on the tumor’s type, size, location, and depth of penetration, as well as the patient's age and general health. A local anesthetic is used during most surgical procedures. Pain or discomfort is usually minimal, and there is rarely much pain afterwards.
Surgical Excision is where we use a scalpel to remove a growth, along with a surrounding border of apparently normal skin as a safety margin. The wound around the surgical site is then closed with sutures. The excised tissue specimen is then sent to the laboratory for microscopic examination to verify that all cancerous cells have been removed. A repeat excision may be necessary on a subsequent occasion if evidence of skin cancer is found in the specimen. The accepted cure rate for primary tumors with this technique is about 92 percent. This rate drops to 77 percent for recurrent squamous cell carcinomas.
Curettage is the process of scraping skin with a spoon-shaped instrument (curette) to remove skin tissue. Electrosurgery is the burning of skin tissue with an electric current that runs through a metal instrument or needle. Electrosurgery may be done after curettage to control bleeding and destroy any remaining cancer cells. The wound is then covered with an antibiotic dressing. The skin is numbed with a local anesthetic before the procedure. Curettage and electrosurgery may be repeated once or twice or may be combined with other procedures, such as cryosurgery. Treatment with curettage and electrosurgery for skin cancer has a cure rate of nearly 99 out of 100 for basal cell cancer that is less than 1 cm (0.4 in.) wide. The cure rate is about 84 out of 100 if the cancer is larger than 2 cm (0.8 in.) wide.1 This procedure is most effective on new skin cancers.