Mohs Surgery for Melanoma

Posted on: March 27th, 2023 by Our Team

At Phoenix Surgical Dermatology Group, we are proud to offer state-of-the-art technology for skin cancer treatment. In addition, we are one of the only clinics in Arizona that utilizes immunohistochemical staining to treat melanoma.

Mohs micrographic surgery (MMS) is a specialized surgical technique that has become a standard of care for treating melanoma, a type of skin cancer that can be deadly if not caught and treated early. One key aspect of MMS is using MART-1 (Melanoma Antigen Recognized by T-cells 1) immunohistochemical staining, which helps identify and target cancerous cells during surgery. In this blog article, we will discuss the importance of MMS for melanoma and how MART-1 staining plays a crucial role in this treatment.

Melanoma is a type of skin cancer that arises from pigment-producing cells called melanocytes. It is one of the most aggressive forms of skin cancer and can spread quickly to other parts of the body if not caught and treated early. Melanoma is the leading cause of death from skin disease, and it is estimated that over 100,000 new cases of melanoma are diagnosed each year in the United States alone.

Traditionally, melanoma has been treated with wide excision, a surgical procedure in which the cancerous lesion is removed along with a margin of surrounding healthy tissue. This approach has been practiced for early-stage melanoma. Still, it has been associated with higher recurrence rates because it does not check 100% of the margin. As a result, MMS has shown an overall survival benefit for melanoma, including thin and barely invasive lesions.

MMS was developed in the 1930s by Dr. Frederic Mohs. It is a specialized surgical technique that allows for the precise removal of melanoma while minimizing the loss of healthy tissue. It involves the removal of small layers of tissue, which are then examined under a microscope to determine if any cancer cells remain. This process is repeated until all cancerous cells have been removed. The key is that 100% of the margin is evaluated, compared to local excision, where only less than 1% is evaluated.

One key aspect of MMS is the use of MART-1 staining, which helps to identify cancerous cells during surgery. MART-1 is a protein expressed on the surface of melanoma cells but not on normal skin cells. By using an immunohistochemical stain that targets MART-1, surgeons can differentiate between cancerous and normal cells and ensure that all cancerous cells are removed during surgery.

There are several benefits to using MMS for the treatment of melanoma. First and foremost, it allows for the precise removal of cancerous cells, which can be especially important for more advanced cases of melanoma. By removing thin layers of tissue and examining them under a microscope, surgeons can ensure that all cancerous cells have been removed and that the margins are clear. This can help to reduce the risk of melanoma recurring after surgery.

In addition to its precision, MMS is also less invasive than traditional wide excision surgery. Because it involves the removal of thin layers of the tissue rather than a large chunk of skin, MMS can result in more minor scars and a faster recovery time. This can be especially important for melanoma on visible areas of the body, such as the face, where scarring can be more noticeable.

Another benefit of MMS is that it allows for the preservation of healthy tissue. By removing thin layers of tissue and examining them under a microscope, surgeons can identify and remove cancerous cells while leaving as much healthy tissue intact as possible. This can help to reduce the risk of complications and improve the cosmetic outcome of surgery.

Overall, MMS is a highly effective treatment for melanoma, and MART-1 staining is an essential aspect of this treatment. It allows for the precise identification and removal of cancerous cells, which results in an overall survival benefit. Phoenix Surgical Dermatology Group is proud to be one of the only clinics to offer Mohs for melanoma.