Mohs Micrographic Surgery

Cheyenne Skin Clinic is one of the few facilities in the region able to offer Mohs Micrographic Surgery, a scientifically advanced method of removing skin cancer while saving as much healthy skin as possible. Our Mohs Micrographic Surgery Center is staffed by a team that includes a Mohs micrographic surgeon, Dr. Julie Neville; a trained nursing staff who will assist in Mohs surgery, respond to your concerns, help answer questions, and instruct you in wound care following your Mohs surgery; and laboratory histotechnicians who work in our on-site laboratory preparing the tissue slides which are examined by Dr. Neville under a microscope.

 

What is Mohs Micrographic Surgery?

A skin cancer that has been biopsied often resembles a “tip of an iceberg” with more tumor cells growing downward and outward into the skin, like roots of a tree. These “roots” are not visible with the naked eye, but can be seen under a microscope. Mohs micrographic surgery is a treatment for skin cancer in which cancerous cells are removed in stages, one tissue layer at a time. Once a tissue layer is removed, its edges are marked with specially colored dyes, and a map of the specimen is created. The tissue is then processed onto microscope slides by a trained Mohs surgery histotechnician in our on-site laboratory. These slides are carefully examined under the microscope by our Mohs surgeon so that any microscopic roots of the cancer can be precisely identified and mapped. When cancer cells are seen, an additional tissue layer is removed only in areas where the cancer cells are still present, leaving normal skin intact. This allows the Mohs surgeon to save as much normal healthy skin as possible The term “Mohs” refers to Dr. Frederic Mohs, Professor of Surgery at the University of Wisconsin, who developed this surgical technique in the early 1940s. The technique has undergone many refinements and has come to be known as “Mohs surgery” in honor of Dr. Mohs.

 

What are the Advantages of Mohs Micrographic Surgery?

Mohs micrographic surgery is safe, reliable, and has a significantly higher cure rate than any other available treatment, even when dealing with difficult cases and those that have failed other forms of treatment. In addition, Mohs surgery is a “tissue-sparing” technique, which allows for selective removal of cancerous tissue while preserving as much normal skin as possible. Mohs surgery is done as a same-day outpatient surgical procedure that eliminates the need for general anesthesia and hospital fees. Mohs surgery is performed by a physician who is both the surgeon and the pathologist and has received specialized training in this technique.

With standard skin cancer excision, only a portion of the removed tissue is sampled and examined microscopically by a pathologist to determine whether the cancer is completely removed. Mohs micrographic surgery allows for examination of the entire underside and edges of the tissue which results in a higher cure rate while minimizing the removal of normal tissue.

Because Mohs surgery is a highly specialized technique, not all skin cancers require this treatment. Skin cancers that have “come back” after previous treatment, a tumor with microscopic features suggesting it may be aggressive or have extensive roots, and a skin cancer on the nose, eyelids, ears, fingers or other areas in which sparing of normal tissue is essential.

 

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