Frozen Sections vs Mohs Surgery: Understanding Their Similarities

Frozen Sections and Mohs Surgery: Understanding Their Similarities

When it comes to skin cancer treatment, two commonly employed techniques are frozen sections and Mohs. Both methods play vital roles in ensuring accurate tumor removal and minimizing healthy tissue damage.

Tissue Examination in Real-Time:
One significant similarity between frozen sections and Mohs is their reliance on real-time tissue examination. In frozen sections, a thin slice of tissue is frozen and examined by a Pathologist under a microscope while the patient is still in the operating room. This immediate analysis helps guide the surgeon in determining whether additional tissue removal is necessary to ensure complete excision. The Mohs procedure involves the removal of thin layers of tissue, which are examined under a microscope by a trained Mohs doctor.

Margin Assessment:
Both frozen sections and the Mohs procedure focus on assessing tumor margins to achieve complete removal. Frozen sections enable the surgeon to evaluate the extent of tumor involvement and determine if any remaining cancerous cells are present at the edges of the excised tissue. By examining the frozen section, the surgeon can accurately gauge if additional tissue needs to be removed ensuring that the tumor is entirely eradicated. The Mohs procedure also relies on examining tumor margins. The layers are analyzed until no cancerous cells are detected.

Minimization of Healthy Tissue Damage:
A shared goal of frozen sections and the Mohs procedure is to minimize the removal of healthy tissue surrounding the skin cancer. Both techniques employ meticulous precision to precisely identify and target cancerous cells, reducing the unnecessary excision of unaffected tissue. By preserving healthy tissue, both procedures aim to achieve optimal cosmetic and functional outcomes for the patient, particularly when treating skin cancer in delicate or cosmetically sensitive areas.

High Cure Rates:
Both frozen sections and Mohs surgery are known for their high cure rates in treating skin cancer. By allowing immediate assessment of tumor involvement and providing precise guidance during surgery, both methods maximize the chances of complete tumor removal. The real-time examination enables the surgeon to take additional tissue samples or layers, if necessary, to ensure all cancer cells are removed. This meticulous approach significantly contributes to the high success rates of frozen sections and the Mohs procedure in treating skin cancer.

Surgeon Expertise and Collaboration:
Both frozen sections and the Mohs procedure require specialized expertise and collaboration between various medical professionals. In frozen sections, pathologists play a crucial role in examining the tissue samples and providing immediate feedback to guide the surgical procedure. Similarly, the Mohs procedure involves close collaboration between the Mohs doctor, dermatopathologists, and assistants to ensure accurate interpretation of tissue samples and comprehensive tumor removal.
One of the concerns surrounding the Mohs procedure is its overutilization in cases where it may not be the most appropriate treatment option. While this procedure may be effective for certain types of skin cancer and specific locations, it may not be necessary for all cases. In some instances, less invasive treatments such as simple excision may suffice. The misuse of the Mohs procedure by performing it unnecessarily can lead to increased healthcare costs, longer patient wait times, and potential complications for patients. Because a separate pathologist is not involved there may be inadequate examination of margins, leading to incomplete tumor removal. Insufficient evaluation can result in the persistence or recurrence of cancer, compromising patient outcomes and necessitating additional procedures or treatments that would increase financial gain.
The Mohs procedure, being a complex and specialized procedure, can be financially lucrative for healthcare providers. Unfortunately, this financial potential can incentivize some practitioners to prioritize their own profits over the well-being of patients. This can manifest in the form of unnecessary tests, multiple stages of surgery when a single stage would suffice, or billing for services not rendered. Such exploitation can harm patients both financially and emotionally, eroding trust in the medical profession.
The Mohs procedure requires specific training and expertise to perform correctly. However, not all practitioners offering Mohs may have received comprehensive training or possess the necessary qualifications. In some cases, non-specialists or inadequately trained individuals may attempt to perform this procedure, leading to suboptimal outcomes or increased risks for patients. The lack of standardized training and oversight can contribute to the abuse of this specialized technique.

In conclusion, frozen sections and the Mohs procedure share several important similarities in their approach to skin cancer treatment. With real-time tissue examination, focus on margin assessment, minimization of healthy tissue damage, high cure rates, and reliance on expertise and collaboration, these techniques are powerful tools in the fight against skin cancer. If you or a loved one is diagnosed with skin cancer, give us call at Myers Plastic Surgery to determine the most suitable treatment approach. Remember, early detection and appropriate treatment are crucial for achieving successful outcomes in skin cancer management.