Skin Cancer

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Mohs Micrographic Surgery

How It Works

This procedure was first developed in the 1930s by Dr. Frederick Mohs, a professor of surgery at the University of Wisconsin. Mohs micrographic surgery is distinct from routine surgical excision. Standard surgical excision allows for delayed examination of approximately 1% of tissue margins. Since only a small percentage of margins are evaluated, residual tumor may be missed. If more cancer cells are found to remain during delayed pathologic examination, a second surgical procedure will be required at a later date.

Mohs surgeons are dermatologists who have performed additional fellowship training to become experts in Mohs micrographic surgery. Fellowship-trained Mohs surgeons are highly skilled in all aspects of this technique, including surgical removal of the tumor, pathologic examination of the tissue, and advanced reconstruction techniques of the skin. Dr. Whitney Tope is Mohs fellowship-trained and a member of the American College of Mohs Micrographic Surgery and Cutaneous Oncology (ACMMSCO). This official national organization maintains the high level of training and quality of care of this sub-specialty.

Mohs Micrographic Surgery

Mohs micrographic surgery is a highly specialized, state-of-the-art technique used for the treatment of complex skin cancers. Mohs micrographic surgery (MMS) was created by Dr. Fred Mohs when he was a medical student over fifty years ago. It is a meticulous and precise surgical technique used for removing skin cancers. This procedure has gained wide acceptance for skin cancer treatment in the last 25 years. The name “micrographic” comes from “micro”, indicating the use of a microscope to examine tissue, and “graphic”, indicating that a detailed map or drawing of the tumor is made during the treatment. With the Mohs technique, surgically removed tissue is carefully mapped, color-coded, and thoroughly examined microscopically by the surgeon on the same day of surgery. During this process, 100% of tissue margins are evaluated to ensure that the tumor is completely removed prior to repair of the skin defect. Mohs micrographic surgery therefore results in the highest cure rate for complex skin cancers while minimizing the removal of normal tissue.

About Dr. Tope

After medical school, Dr. Tope completed a general internal medicine internship at the University of Washington in Seattle, then returned to Duke University for his dermatology residency training (1992). Dr. Tope’s training continued with fellowships in Advanced Dermatologic Surgery at Oregon Health & Science University in Portland and in Clinical and Research Laser studies at Harvard Medical School’s Wellman Center for Photomedicine.