Abstract Number: 97

The role of Mohs surgery for incompletely excised BCC

A.M. Coe 1, B. De’Ambrosis1, P. Wilson2

Meeting: 2021 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Incompletely excised basal cell carcinoma (BCC) is considered high-risk for recurrence, with a large propor- tion of recurring tumours arising several years after ini- tial excision. Mohs micrographic surgery (MMS) as a procedure for primary and recurrent tumours has been well described in the literature. However, the role of MMS for incompletely excised lesions has remained rel- atively unexplored, with no randomised control trials to date.

An incompletely excised BCC is a common clinical scenar- io, with incidence estimated between 1.9% and 16%, and occurring 2.5 times more often on the nose or ear1. Micronodular, infiltrative and morpheic BCCs are threefold more likely to be incompletely excised versus nodular and superficial subtypes2. These aggressive lesions are thought to have recurrence of 17% when excised with standard surgical margins2. Residual tumour has been described in
69% of incompletely excised BCCs initially excised with standard margin control1, with positive lateral margins alone more common than deep involvement (66% versus
34% respectively)3.

A retrospective study will be presented assessing the role of Mohs micrographic surgery in incompletely excised BCC, with a minimum follow-up period of 5 years. To the presenter’s knowledge, this is the largest retrospective study to date examining cure rates of MMS for incom- pletely-excised BCC.

References

1. Palmer VM, Wilson PR. Incompletely excised basal cell carci- noma: residual tumor rates at Mohs re-excision. Dermatologic surgery: official publication for American Society for Dermato- logic Surgery [et al]. 2013;39(5):706–18.
2. Walker P, Hill D. Surgical treatment of basal cell carcinomas using standard postoperative histological assessment. The Aus- tralasian Journal of Dermatology. 2006;47(1):1–12.
3. Luz FB, Ferron C, Cardoso GP. Analysis of effectiveness of a sur- gical treatment algorithm for basal cell carcinoma. Anais brasi- leiros de dermatologia. 2016;91(6):726–31.