Surgery Overview

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 needed 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

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

Why It Is Done

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

Standard excision treatment for
basal cell carcinoma less than
20 mm (0.8 in.) wide has cure
rates as high as 95 out of 100 people, when done with
4 mm (0.2 in.) margins.footnote 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.footnote 2

Risks

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

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

Citations

  1. Carucci JA, et al. (2012). Basal cell carcinoma. In LA Goldman et al., eds., Fitzpatrick’s Dermatology in General Medicine, 8th ed., vol. 1, pp. 1294-1303. New York: McGraw-Hill.
  2. Green AC, McBride P (2014). Squamous cell carcinoma of the skin (non-metastatic). BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/1709/overview.html. Accessed October 2, 2014.

Credits

ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Amy McMichael, MD – Dermatology

Current as ofMay 3, 2017