Microscopically controlled surgery in the treatment of carcinoma of the scalp

Complete microscopic control of the excision of carcinomas of the scalp is of special benefit, because, in this location, there is an unusual tendency for outgrowths to extend for considerable distances beyond the clinically apparent borders of the neoplasms. Microscopic control is achieved through layer-by-layer excision of cancerous tissue and the use of frozen sections for systematic microscopic scanning of the undersurface of each layer. The reliability of this technique is demonstrated by the treatment results obtained in a series of 576 basal cell carcinomas. The cure rate for the 444 patients who were observed for five years or longer was 98.9%. In a series of 131 patients with squamous cell carcinomas, the cure rate for the 83 patients who were observed for five years or more was 98.8%. Conservation of maximal amounts of normal tissue is an added benefit of the microscopic control technique.