Why Mohs?: The Gold Standard Explained
Key Reassurances
- Mohs examines 100% of the margin. Standard pathology examines ~0.1%
- Cure rates exceed 99% for primary BCC
- Maximum tissue preservation means the smallest possible wound
- You leave knowing the cancer is gone, not hoping
What Makes Mohs Different
Standard excision removes the tumor with a margin of healthy tissue, then sends it to a pathology lab where approximately 0.1% of the margin is examined in cross-section (bread-loaf technique). This means 99.9% of the margin is never actually looked at.
Mohs surgery is fundamentally different: the surgeon acts as both surgeon and pathologist, mapping and examining 100% of the surgical margin. If cancer remains at any point on the margin, only that specific area is re-excised. This process repeats until every edge is confirmed clear.
Treatment Comparison
How does Mohs compare to other skin cancer treatments?
| Treatment | Cure Rate (BCC) | Margin Check | Tissue Spared | Best For |
|---|---|---|---|---|
| Mohs Surgery | >99% | 100% of margin | Maximum | High-risk, facial, recurrent tumors |
| Standard Excision | ~95% | ~0.1% (bread-loaf) | Moderate | Low-risk trunk/extremity tumors |
| C&E (scrape & burn) | ~90–95% | None (clinical only) | N/A | Superficial, low-risk only |
| Radiation | ~90% | None | N/A | Non-surgical candidates |
| Topical (5-FU, imiquimod) | ~80–90% | None | N/A | Superficial BCC/AK only |
The Key Message
When you leave the Mohs surgery clinic, you leave knowing. Not hoping. That the cancer is completely gone. That certainty, combined with maximum tissue preservation, is why Mohs is the gold standard for high-risk skin cancers.
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About This Article
Author: Dr. Yehonatan Kaplan, M.D., Fellow ACMS
Last Medical Review:
Audience: Patients
Clinic: Kaplan Clinic · DermUnbound Research Program