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Updated: Apr 26, 2026
Establishment of a Clinic-based Biorepository
Published on: May 29, 2017
Reliability of skin biopsies in determining accurate tumor margins: a retrospective study after Mohs micrographic
Cynthia Lynn Koslosky1, Abdel Kader El Tal, Benjamin Workman
1*Department of Dermatology, Wayne State University, Dearborn, Michigan; †Department of Dermatology, American University of Beirut, Beirut, Lebanon; ‡Department of Internal Medicine, Clinical Research Institute at the Faculty of Medicine, American University of Beirut, New York, New York; §Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Background:
Skin biopsy reports of basal cell carcinoma and squamous cell carcinoma are often accompanied by comments on the margins. A physician's management can be influenced by such reports, particularly when the margins are reported as clear and no further interventions are pursued.
Objective:
To retrospectively review pathology margins on Mohs micrographic surgery (MMS) cases performed at a University Center and to compare biopsy margins with the Mohs margins found on the first stage.
Materials And Methods:
Data collection of 1,000 cases of Mohs surgery was obtained regarding margins on skin biopsy and compared with margins on the first stage of MMS.
Results:
Overall, of the biopsies that showed only deep margin involvement, a lateral margin was seen on 32% of the first stages of MMS. Conversely, of the biopsies that showed only lateral margin involvement, a deep margin was seen on 14% of the first stages of MMS. Of the biopsies that showed clear margins, a margin was seen in 30% of the cases on the first stage of MMS.
Conclusion:
Skin biopsies processed through the "bread-loafing" technique are not reliable in detecting accurate margins, and therefore, a biopsy report should not include margin involvement within it.
