Mohs Micrographic Surgery
MMS is a special state-of-the-art procedure that is a gold standard of skin cancer treatment. Skin cancers removed by MMS have the lowest rate of recurrence (approximately 1%) as compared to skin cancer removed by regular surgery (10-15%).
Mohs surgeon removes the skin cancer excising as little of healthy uninvolved skin as possible (Stage I). Excised tissue is immediately examined under the microscope by the Mohs surgeon for presence of any residual cancer cells. Tissue specimen is prepared and placed on a slide in such a way that examination of the entire (100%) edge of the cut is possible. For comparison, only 5% of the edge gets examined when a regular, non-Mohs, specimen is sent to an off-premises histopathology lab.
If the Mohs surgeon notes that the skin cancer cells are still present at the margin, more tissue is removed (Stage II). During the procedure meticulous mapping and using of special stains allows for precise correlation between the specimen under the microscope and the patient on operating table. Even if the cancer cells are spreading under the skin, the mapping allows to track them down. Sometimes the cancer is completely removed at the first step, but often 2 or more stages are required to clear some of the more aggressive tumors. Hence, the procedure may take anywhere from 40 minutes to few hours.
Mohs surgery combines the highest cure rate with the best cosmetic result. It is indicated for carcinomas on the face, hands, and genitals, for large or aggressive tumors, for tumors that recur after other treatments, or tumors arising within the scar. Mohs surgeons such as Dr. Shirin, receive additional special training. Dr. Shirin is proud to be a Fellow of the American Society for Mohs Surgery (ASMS). ASMS membership requires extensive Mohs surgery experience and annual proficiency and quality review.