Mohs Micrographic Surgery
With more than 1.3 million new skin cancers diagnosed in the United States each year, treatments have evolved to provide potentially higher cure rates and improved cosmetic results. Mohs surgery at our Thousand Oaks practice represents a significant advance in the treatment of skin cancer.
Watch a news story about Mohs surgery featuring Dr. Kaufman
Mohs micrographic surgery is a complex, specialized technique for the treatment of difficult or recurrent skin cancers. This procedure differs from all other types of surgical procedure in that one person acts as surgeon and pathologist and 100% of the surgical margins are examined microscopically. As a result, according to the scientific literature, cure rates frequently are higher and healthy tissue surrounding the skin cancer is preserved.
To learn more about Mohs surgery in Southern California, click here to request a consultation with one of our providers. Or you can call The Center for Dermatology Care at (805) 497-1694 and one of our helpful staff members will schedule your appointment.
Before & After Photos
To view our real patient results of mohs micrographic surgery, visit our photo gallery.
Mohs Surgery Training
First described in the 1930's by Dr. Frederic Mohs, the procedure was modified in the 1970's by doctors at the University of California, San Francisco. With changes in the procedure and increases in the incidence of skin cancer, the procedure has become one of the fastest growing medical treatments in recent years.
The American College of Mohs Surgery (ACMS) was founded by Dr. Mohs in 1967 to promote research, education and training of skin cancer and reconstructive surgery. Members of the College have completed one to two year fellowships in Mohs surgery, including training in reconstructive surgery, Mohs surgery and dermatopathology. By seeking out members of the College, patients are assured that their surgeon has the training and experience necessary to perform Mohs surgery and subsequent reconstruction.
Dr. Kaufman completed a fellowship in Mohs micrographic surgery and Dermatologic Surgery at the University of California, San Francisco, under the direction of Drs. Roy Grekin and Richard Glogau. Dr. Kaufman has been a Fellow of the American College of Mohs Surgery since 1998 and is currently a member of the Board of Directors of that institution. Dr. Kaufman is one of only a handful of doctors who are ACMS fellowship-trained in Mohs Surgery practicing in Ventura County.
The Mohs Procedure
The Mohs procedure is performed under local anesthesia. A very narrow piece of tissue is taken from the periphery of the visible skin cancer. The specimen is carefully removed, mapped and processed so that 100% of the surgical margins are evaluated for residual tumor. If any cancer is noted under the microscope, another thin margin is removed from the involved area and processed again. This is repeated stage by stage until the roots of the skin cancer are traced out completely. Once cleared of tumor, the surgical defect is reconstructed using side-to-side repairs, flaps, grafts or allowing the wound to heal by itself.
Mohs Surgery vs. Standard Surgical Excision
Cure rates for Mohs micrographic surgery depend upon the type of cancer being treated and whether the cancer has previously been treated, but for most instances cure rates for Mohs surgery tend to be higher than other forms of cancer treatment available. For basal cell carcinoma not previously treated the cure rate is approximately 98.5-99%. For recurrent basal cell carcinomas and primary squamous cell carcinomas the cure rates are approximately 95%. Mohs micrographic surgery is also useful for most other types of skin cancers, including lentigo maligna, lentigo maligna melanoma, microcystic adnexal carcinoma, and dermatofibrosarcoma protuberans.
Aside from superior cure rates another advantage of the procedure is the preservation of healthy tissue surrounding the skin cancer. This is accomplished by starting with narrower margins than are recommended for standard surgical excision of skin cancers. Mohs surgery can begin with narrower margins for most skin cancers because of the meticulous tracing out of the roots of the skin cancer that is part of the procedure. By preserving surrounding healthy tissue the resultant surgical defect should be as small as possible and still assure complete cancer removal. Small surgical defects mean that smaller or simpler repairs can be performed and therefore helps to minimize scarring and improve final cosmetic result.
The main disadvantage to patients compared to standard surgical excision is the time commitment involved. Patients need to plan to be at the office most of the day, since the number of stages needed to trace out the skin cancer varies case by case. Most will leave by early afternoon, but the small time commitment is considered by most to be a minor sacrifice in exchange for potentially higher cure rates and smaller surgical wounds for repair.
For more information about Mohs micrographic surgery visit the Mohs Surgery Patient Education website by the American College of Mohs Surgery.
