Mohs micrographic surgery is named in honour of, Dr Frederic Mohs, the physician who developed the basic technique in the 1950s. You may hear it called Mohs surgery, chemosurgery, microscopically controlled excision or Mohs micrographic surgery. In the years since Dr Mohs pioneered the procedure, many improvements and refinements have contributed to making this surgery a safe and highly effective means of treating skin cancers.
Every layer of tissue removed is inspected under the microscope for evidence of cancer cells. As long as cancer cells remain anywhere within the specimen, the surgeon continues to remove and examine layers of tissue until no cancer cells are present. Because each layer is examined microscopically, dermatologists can be confident that all the cancer has been eradicated and that no tumour nests have been left behind. In addition, only the cancerous tissue is removed, saving as much normal skin as possible. Studies have shown that greater than 95% of all patients treated at the Skin & Cancer Foundation by Mohs surgery are cured of cancer.
Mohs surgery is now universally recognized as a precise method for treating skin cancers of the face and other cosmetically sensitive areas, because it can eliminate all the cancer cells while causing minimal damage to the surrounding normal skin. Mohs surgery is also ideal for the removal of recurrent skin cancers; tumours that reappear after previous treatment and can plague a patient repeatedly. While skin cancers are usually visible to the patient, individual cancer cells are microscopic and any cells left behind can cause the tumour to reappear.
The tumour may spread beyond its obvious external margins, with ‘nests’ of cells growing in unpredictable areas. With the Mohs technique, all tumour nests can be identified and removed with a high degree of accuracy, so that high cure rates are possible even when the tumour is recurrent.
A dermatologist is best trained to determine when this technique should be used rather than other procedures. Many dermatologists throughout Australia have been trained in skin cancer surgery. When patients require more extensive surgery, however, they are referred to a qualified Mohs surgeon. The period of training to be a qualified Mohs surgeon is a one-year fellowship, during which the dermatologist acquires extensive experience with all aspects of the technique.
The Skin and Cancer Foundation Australia has the largest Mohs surgery centre in the Southern Hemisphere. Click on the following link to view profiles of the surgeons undertaking this technique at our day surgeries: Mohs Surgeons