Mohs Micrographic Surgery at Boston Medical Center
Who will be performing my surgery at Boston Medical Center?
Kavitha Reddy M.D., Director of Dermatologic Surgery, specializes in skin cancer treatment and in cosmetic and procedural dermatology. She is board-certified in Dermatology, and certified in Procedural Dermatology by the ACGME, and in Dermatologic Surgery and Mohs Micrographic Surgery by the American College of Mohs Surgery.
Dr. Reddy conducts research on cutting edge laser and light therapies at the Harvard University and Massachusetts Institute of Technology David H. Koch Institute for Integrative Cancer Research. She has conducted many clinical trials using lasers and other medical devices for the treatment of medical and cosmetic skin conditions including sun damage, skin cancer, skin aging, skin discoloration, vascular birthmarks, and tattoo removal. She has received an American Society for Dermatologic Surgery Cutting Edge Research Grant, as well as grants from the American Skin Association, and Aid for Cancer Research. She has been honored as a member of the Alpha Omega Alpha National Medical Honor Society.
Dr. Reddy serves as a workgroup member for the American Society for Dermatologic Surgery, and editor for the Journal of Investigative Dermatology Connector. She has helped lead community organizations including the American Academy of Dermatology Camp Discovery Program, Harvard University Project Health Program, and Boston Public Health Commission Youth to Health Careers Program.
What is Mohs Micrographic Surgery?
Mohs micrographic surgery is a specialized technique for removal of skin cancers. Mohs surgery is unique because it allows the surgeon to map and remove not just the visible parts of a skin cancer, but also the roots that can only be seen under the microscope. When used to treat basal cell carcinoma and squamous cell carcinoma, Mohs has the highest cure rate of any treatment. This technique also allows the Mohs surgeon to spare normal skin to minimize scarring.
How is Mohs Micrographic Surgery done?
Mohs micrographic surgery is done in stages. After the site is cleaned and anesthetized, the Mohs surgeon will remove the visible portion of the tumor together with a very small margin of normal skin. The tissue is then processed in the laboratory and viewed under the microscope by the Mohs Surgeon. In approximately one hour the surgeon will have determined whether the tumor is completely removed or whether it is necessary to remove additional tissue. The Mohs surgeon is able to carefully map out the area where the tumor remains and will only remove additional skin in the areas where the margin shows tumor. This process is repeated as many times as necessary to ensure that the tumor is completely removed.
After the tumor is removed, how will the area be repaired?
Once the margins are clear the surgeon will determine which repair will give the optimal and functional cosmetic outcome to restore normal architecture and function. In some cases the best repair is a simple straight line while in other cases the best repair may require shifting and re-draping skin (flaps) or borrowing skin from a distant site such as the skin over the collar-bone or the skin fold in front of the ear (grafts). Often stitches are required to create the repair that will ultimately give the best appearance once the site is healed.
Treatment Cure Rates
Clinical studies demonstrate that Mohs micrographic surgery provides five-year cure rates of approximately 99% for primary basal cell carcinomas, and 96% for recurrent basal cell carcinoma. Cure rates for squamous cell carcinoma are approximately 97%.These cure rates are significantly higher than with other methods of tumor removal or destruction.
When is Mohs micrographic surgery preferred to other treatments?
- Tumors on the face
- Tumors on other body sites that may be difficult to repair if too much tissue is removed.
- Recurrent (previously treated) tumors
- Large tumors or tumors without clearly defined edges
- Tumor that appear aggressive under the microscope