Mohs surgery histopathology concordance in Australia

Abstract

An Australian Mohs surgeon is capable of correctly identifying and interpreting histopathology in non-melanoma skin cancers, and this compares favourably to an overseas study.

Mohs Micrographic Surgery Concordance Between Mohs Surgeons and Dermatopathologists

“…This retrospective quality assurance study of diagnostic concordance between MMS surgeons and a trained dermatopathologist in frozen section interpretation showed a high overall rate of agreement (99.4%). These results are consistent with previous studies carried out in the United States and Australia …”

“…A similar study by Tan and colleagues evaluated concordance between a MMS surgeon and a dermatopathologist in the correct identification of NMSC on frozen sections and marking its location on a Mohs map. A dermatopathologist randomly selected and reviewed 99 archival MMS slides from a private dermatologic surgery practice in Australia.…”

“…This process ensures precise identification of tumor and consequent resection during the stages of MMS. Few studies in the literature have compared the histopathology expertise of MMS surgeons in the assessment of Mohs sections with that of pathologists with special training in dermatopathology …”

Reliability of diagnosis from Mohs slides: interpersonal and intrapersonal agreement on basal cell carcinoma presence and histological subtype

“…Previous studies show high interpersonal agreement between Mohs surgeons and pathologists (95–99%) on BCC presence . These studies overestimate the reliability of diagnosis from Mohs slides because they report concordance rates instead of κ values.…”

“…1,2 Previous studies show high interpersonal agreement between Mohs surgeons and pathologists (95-99%) on BCC presence. [17][18][19][20][21][22] These studies overestimate the reliability of diagnosis from Mohs slides because they report concordance rates instead of j values. In contrast to these studies, we oversampled difficult Mohs slides, which resulted in an underestimated level of agreement.…”