Mohs Micrographic Surgery
We perform Mohs micrographic surgery in our office. Mohs surgery has the highest cure rate for treating basal cell carcinomas, squamous cell carcinomas, and most other skin cancer types. The procedure is performed in stages, including laboratory work while the patient waits. Sometimes removal of cancer and repair of the resultant defect, are performed on different days. For instance, if the repair is conducted by another physician, or if 'retention' sutures are used to stretch the skin overnight, which can significantly decrease the scar length.
Many people don't know that Frederick Mohs, who pioneered the surgery named after him, routinely performed and actually preferred the technique for melanoma. Mohs surgery may be used to treat melanoma on areas requiring maximum tissue preservation, such as the face, scalp, ears, genitals, or digits. The procedure can completely remove the melanoma while sparing as much normal skin around the tumor as possible. Studies show survival and recurrence rates after Mohs surgery are equal or better to traditional surgery. Dr. Hines is one of only several physicians in Washington State fellowship trained to perform Mohs surgery on melanoma. We can use this technique to remove melanoma in-situ (thin melanomas) and also invasive melanoma depending on the clinical circumstances. Mohs on melanoma is facilitated by use of rapid immunostaining using MART-1 (melanoma-associated antigen recognized by T-cells), which highlights melanoma cells making them easy to see under the microscope (see photo below).