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Mohs micrographic surgery (MMS) has a long track record of achieving the highest cure rate and the best tissue conservation for basal cell carcinoma (BCC). Most supporting data have come from retrospective studies. In this prospective comparison study from the Netherlands, primary and recurrent BCCs were randomized to treatment by standard excision or by MMS.
Investigators treated 397 primary BCCs that were larger than 1 cm in diameter or of an aggressive histologic subtype and located in centrofacial or ear regions, and 201 recurrent similar BCCs. With either technique, 3-mm margins were employed. Patients were followed for 18 to 30 months. After two standard excisions, any positive margins were treated by MMS.
Of 199 primary BCCs treated by…