There are no large RCTs comparing surgical excision with a predetermined margin with any other intervention for BCC, despite the fact that this modality is probably the most frequent treatment. There are, however large case series, which demonstrate excellent "success" rates for this modality.23
Mohs' micrographic surgery is a technique whereby 100% of the surgical margin is examined by mapping horizontal frozen sections from successive excision layers until clearance is achieved. No RCTs have investigated the margin of excision that would be effective in the removal of BCC by surgical excision with predetermined margins. Proxy measures based on Mohs' micrographic surgical margins required to remove BCCs and histopathological studies of excised specimens have suggested that for small nodular or superficial BCC, a 4 mm margin of normal skin will clear 95% of tumours.18,24 Larger margins are required for tumours greater than 20 mm and for morphoeic tumours.18
Was this article helpful?