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  • Title: Mohs micrographic surgery concordance between Mohs surgeons and dermatopathologists.
    Author: Semkova K, Mallipeddi R, Robson A, Palamaras I.
    Journal: Dermatol Surg; 2013 Nov; 39(11):1648-52. PubMed ID: 24581313.
    Abstract:
    BACKGROUND: Mohs micrographic surgery (MMS) is the preferred treatment modality for high-risk nonmelanoma skin cancer because of the high cure rates and tissue-sparing effect. Its outcome is highly dependent on the expertise and accuracy of the Mohs surgeon in the interpretation of frozen sections. OBJECTIVE: This retrospective study evaluated the level of concordance between Mohs surgeons and dermatopathologists in reading histology slides from MMS procedures. METHODS AND MATERIALS: A Mohs surgeon read 170 randomly selected slides for a quality assurance audit during excision, and then a dermatopathologist blindly read them at a separate time. Absence or presence of tumour and the final diagnosis were recorded on a standardized form. RESULTS: An overall concordance of 99.4% was demonstrated. True discordance was recorded in only one of 170 cases. Intraepidermal atypia was the most challenging scenario for Mohs surgeons. CONCLUSIONS: The high rate of agreement in this study confirms that adequately trained MMS surgeons have sufficient expertise and training for accurate and precise frozen sections interpretation.
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