Mohs micrographic surgery concordance between Mohs surgeons and dermatopathologists
Kristina Semkova1, Raj Mallipeddi, Alistair Robson
1Department of Dermatology and Venereology, Medical University-Sofia, Sofia, Bulgaria.
Summary
Mohs micrographic surgery (MMS) surgeons demonstrate high accuracy in interpreting frozen sections, with 99.4% concordance with dermatopathologists. This confirms their expertise in diagnosing skin cancer during Mohs surgery.
Area of Science:
- Dermatology
- Surgical Pathology
- Oncology
Background:
- Mohs micrographic surgery (MMS) is a leading treatment for high-risk nonmelanoma skin cancer, valued for high cure rates and tissue preservation.
- Accurate interpretation of frozen sections by Mohs surgeons is critical for successful MMS outcomes.
Purpose of the Study:
- To evaluate the concordance between Mohs surgeons and dermatopathologists in interpreting histology slides from MMS procedures.
- To assess the diagnostic accuracy of Mohs surgeons in frozen section analysis.
Main Methods:
- A retrospective study involving 170 randomly selected histology slides from MMS procedures.
- One Mohs surgeon initially reviewed slides for quality assurance during excision.
- A dermatopathologist subsequently performed a blinded review of the same slides.
Main Results:
- An overall concordance rate of 99.4% was observed between Mohs surgeons and dermatopathologists.
- True diagnostic disagreement occurred in only one out of 170 cases.
- Intraepidermal atypia presented the most significant diagnostic challenge for Mohs surgeons.
Conclusions:
- The high concordance rate validates the expertise of trained Mohs surgeons in interpreting frozen sections.
- Adequately trained Mohs surgeons possess the necessary skills for precise frozen section analysis during MMS.
