Mohs Micrographic Surgery (MMS)

MOHS MICROGRAPHIC SURGERY (MMS)

Named for its inventor, Dr Frederick Mohs, it was first established in the 1930s but has only been widely practiced since the 1960s, when the process was modernised by Dr Perry Robins of New York. Mohs Micrographic Surgery is considered the gold standard in the treatment of certain skin cancers including basal cell carcinoma and squamous cell carcinoma. These are contiguous tumours and the two most common skin cancers in Australia.

Mohs surgery is a unique staged procedure that involves your doctor performing both the surgery and the pathology. Your Dermatologist (if qualified to perform Mohs Micrographic Surgery) will first remove the lesion as close as possible to its margins and then examine that section under the microscope. If cancer cells are seen at any of the edges, your Dermatologist will then remove a further layer of tissue, but only where it is needed. This process is repeated until all of the cancer has been removed.

Overall, 70% of patients will be clear on the first stage. Once clear, your Dermatologist will then repair the wound that has been left by removal of the cancer. As only the minimum amount of healthy tissue has been removed using the Mohs procedure, there is a better chance that the wound will be able to be closed as a straight line (primary closure) giving a more cosmetically pleasing scar. If this isn’t possible, your Dermatologist may use a local flap or a graft. Occasionally they may work in combination with an oculoplastic or plastic surgeon.

Whilst standard excision with a wide surgical margin is a perfectly acceptable treatment option, there are certain circumstances in which Mohs surgery is best. For instance, in the removal of basal cell carcinoma and squamous cell carcinoma in cosmetically and functionally important areas such as the eyes, nose, lips, ears, scalp, fingers, toes or genitals. It is also useful for rapidly growing tumours that have indistinct edges, or have recurred after previous treatment.

Overall Mohs surgery offers the highest cure rate, up to 99% for a primary skin cancer and 94% for a skin cancer that has recurred after previous treatment. It is precise, allowing same day results with close to 100% of the margins examined, compared to standard excision where only 1% of the tumour is examined under the microscope. It is convenient and cost effective, performed in the day surgery suites of the adjacent hospital, requiring only local anaesthetic.

Dermatologist, Dr Andrew Freeman, who consults from The Skin Centre, is currently the only practitioner on the Gold Coast offering Mohs Micrographic Surgery. This service can be accessed with or without a referral, but Dr Freeman requires a pre-surgical consultation with his patients prior to the Mohs Micrographic Surgery, for planning.

Please contact The Skin Centre on (07) 5597 7170 to make an appointment with Dr Freeman or email reception@skincentre.com.au