Katarina Kesty1, Omar P Sangueza1, Barry Leshin2, John G Albertini3. 1. Wake Forest Department of Dermatology, Wake Forest Baptist Health, Winston-Salem, NC. 2. The Skin Surgery Center, Winston-Salem, NC; Wake Forest Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health, Winston-Salem, NC. 3. The Skin Surgery Center, Winston-Salem, NC; Wake Forest Department of Plastic and Reconstructive Surgery, Wake Forest Baptist Health, Winston-Salem, NC. Electronic address: john.albertini@skinsurgerycenter.net.
Abstract
BACKGROUND: The success of Mohs micrographic surgery depends on the surgeon's ability to correctly interpret intraoperative frozen sections. OBJECTIVE: This retrospective study analyzed the rate of concordance between Mohs surgeons and dermatopathologists in reading slides from Mohs surgery cases. METHODS: A dermatopathologist reviewed all the frozen sections and the corresponding Mohs map for every 30th Mohs case at a practice employing 6 different Mohs surgeons from 2001-2017. Cases in which the dermatopathologist and the Mohs surgeon disagreed on the interpretation were noted. RESULTS: The concordance rate between Mohs surgeons and dermatopathologists was 99.79%. The three discordant cases included one case each of squamous cell carcinoma, superficial basal cell carcinoma, and hypertrophic squamous cell carcinoma in situ. LIMITATIONS: This analysis is limited to fellowship-trained Mohs surgeons and therefore may not be applicable to all physicians who perform Mohs. CONCLUSIONS: Fellowship-trained Mohs surgeons show very high concordance with board-certified dermatopathologists in the accurate and precise interpretation of histology slides in the setting of Mohs micrographic surgery.
BACKGROUND: The success of Mohs micrographic surgery depends on the surgeon's ability to correctly interpret intraoperative frozen sections. OBJECTIVE: This retrospective study analyzed the rate of concordance between Mohs surgeons and dermatopathologists in reading slides from Mohs surgery cases. METHODS: A dermatopathologist reviewed all the frozen sections and the corresponding Mohs map for every 30th Mohs case at a practice employing 6 different Mohs surgeons from 2001-2017. Cases in which the dermatopathologist and the Mohs surgeon disagreed on the interpretation were noted. RESULTS: The concordance rate between Mohs surgeons and dermatopathologists was 99.79%. The three discordant cases included one case each of squamous cell carcinoma, superficial basal cell carcinoma, and hypertrophic squamous cell carcinoma in situ. LIMITATIONS: This analysis is limited to fellowship-trained Mohs surgeons and therefore may not be applicable to all physicians who perform Mohs. CONCLUSIONS: Fellowship-trained Mohs surgeons show very high concordance with board-certified dermatopathologists in the accurate and precise interpretation of histology slides in the setting of Mohs micrographic surgery.
Authors: Madison J Hill; Karl M Hoegler; Albert E Zhou; Chloe R Snow; Amor Khachemoune Journal: Arch Dermatol Res Date: 2022-04-25 Impact factor: 3.017