Excision for nonmelanoma skin cancer

Surgery Overview

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Excision is the removal of a skin cancer along with some of the healthy skin tissue around it (margin). For this procedure, a local anesthetic is used to numb the area.

After the cancerous area is removed, the incision is closed with stitches. If the incision is large, sometimes a skin graft or flap is required. Reconstructive surgery may be necessary if the excision surgery creates a scar.

Standard excision is different from Mohs micrographic surgery. In Mohs surgery, the skin cancer is removed one layer at a time. Each layer is checked under a microscope right away. By doing Mohs surgery, the surgeon can cut away all the cancer cells and spare as much healthy skin as possible.

What To Expect After Surgery

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Recovery from skin cancer surgery varies depending on the site and how much skin is removed.

Why It Is Done

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Standard excision works well to remove basal cell and squamous cell carcinomas. But Mohs surgery works better for some skin cancer in places (such as the face) where it is important to save as much skin as possible.

How Well It Works

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Standard excision treatment for basal cell carcinoma less than wide has cure rates as high as 95 out of 100 people, when done with margins.¹ When standard excision is used to treat squamous cell carcinoma, about 92 out of 100 people are cured. In most cases, Mohs micrographic surgery has cure rates that are a little higher than excision cure rates.²

Risks

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Risks of using excision to remove skin cancers include the following:

• The wound may bleed, cause pain, or become infected.
• Scarring may occur.
• A skin graft may not heal.
• All cancer cells may not be removed, leaving a margin that has cancer cells.

What To Think About

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The edges (margins) of the skin where a skin cancer was removed will be examined in a lab by a pathologist to see whether any cancer cells still remain outside the area of skin that was removed. It is extremely important that the entire skin cancer be removed to reduce the risk of recurrence.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

References

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Citations

1. Carucci JA, Leffell DJ (2008). Basal cell carcinoma. In K Wolff et al., eds., Fitzpatrick's Dermatology in General Medicine, 7th ed., vol. 1, pp. 1036–1042. New York: McGraw-Hill Medical.

2. Green A, Chong AH (2007). Squamous cell carcinoma of the skin (non-metastatic), search date January 2007. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Credits

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Author	Bets Davis, MFA
Editor	Maria Essig
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer	Alexander H. Murray, MD, FRCPC - Dermatology
Last Updated	October 14, 2008