Observations on the Critical Margin for the Complete Excision of Carcinoma of the Skin

How accurate is the visual assessment of basal carcinoma margins?

“…The 5-10 mm margin recommended by Beirne & Beirne (1959) was based on their experience with tumours treated by Mohs chemosurgery. Beirne & Beirne recorded the number of chemosurgical excisions required to reach a cancer free plane after the bulk of tumour was removed by curettage.…”

Morpheaform Basal‐Cell Epitheliomas

“…Current surgical recommendations call for margins of 2 to 5 mm of healthy tissue in excisions of basal‐cell epitheliomas 4–10 . Because of the high rates of recurrence in the morpheaform type of malignancy, 3 a series of them was studied to determine subclinical extensions beyond poorly delineated clinical borders to ascertain if the recommendations of margins of 2 to 5 mm of healthy tissue are valid.…”

Mohs' Surgery, Fresh‐Tissue Technique: Our Technique with a Review

“…Those with histopathologic features portraying aggressive behavior: morpheaform or sclerotic, multicentric, infiltrating, or basosquamous forms of basal‐cell carcinomas 19,29,37,67,68 …”

“…">Those found in sites reported to have a relatively high treatment failure rate, namely, the periorbital area, nasolabial fold, nose‐cheek angle, posterior ear sulcus, pinna, canal of the ear, and forehead, and those in scar tissue 2,21,36,58,63–66 Those with poorly delineated clinical borders 37 Those that are very large (greater than 2 cm) 19 Those with aggressive, infiltrative features, as denoted by history and physical examination 2,29 Those with histopathologic features portraying aggressive behavior: morpheaform or sclerotic, multicentric, infiltrating, or basosquamous forms of basal‐cell carcinomas 19,29,37,67,68 Those in areas where maximal preservation of uninvolved tissues is desirable, e.g., eyelid, nose, finger, penis 7 Squamous‐cell carcinoma with perineural invasion 25 …”

“…15 Bard Parker disposable blade (or No. 10 for large lesions) 8 is used to make a shallow incision around the periphery of the wound to include a 2‐ to 5‐mm margin of normal skin 35–37 . For recurrent lesions, the whole scar, graft, or flap is usually removed 35 .…”