WHAT ARE THE DIFFERENCES?
| MOHS SURGERY | WIDE EXCISION | |
|---|---|---|
| Normal skin to be cut out | 1-2 mm margin | 4-6mm margin |
| Margin examination technique | 100% margin peripheral and deep en face margin examination *Circle of excised tissue with peripheral 100% “pie tin” specimen removed.  | 1-2% margin of vertical section evaluated -Bread loaf sampling (random pieces of bread are examined)  |
| Intraoperative microscopic examination | Yes, Mostly 30-45 minutes pathologic report. *Mohs surgeon cut and read pathologic slides themselves, allow for precise mapping the tumor. *Our Mohs surgeon is also a Dermatopathologist. | May be Generally pathological report come 7-10 days after operation. *Some surgeons send the remove tissue for frozen section, 30-45 minutes waiting time, but pathologic slides were read by other pathologist not the surgeon. |
| Indication | High risk area Moderate risk * Size> 1cm Low-risk area * Size>2 cm Recurrence tumor | High risk area-if Mohs surgery is not available. Moderate risk area *Size<1 cm Low risk area *Size< 2cm |
| Operating time | At least 4hr *Depend on number of stages to clear the tumor.Most of the cases are complete within one day | At least 1 hr *Depend on tumor size, location and wound closure technique. |
| Type of anesthesia | Mostly local anesthesia | Mostly local anesthesia |
| Recurrence rate | Lowest BCC:2.1-5.2% SCC: 3% | Higher BCC: 0.8-17.4% SCC: 8% |
| Cost | More expensive | Cheaper |
National Comprehensive Cancer Network Clinical Practice Guideline in Oncology 2024 (NCCN guideline)
