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Skin biopsy "bread-loafing" technique has high error probability

In a retrospective study, researchers found skin biopsies processed through the “bread-loafing” technique were not reliable in detecting accurate margins.

Data collection included 1,000 cases of Mohs surgery, from which margins on skin biopsies were compared with margins on the first stage of Mohs micrographic surgery (MMS).

In biopsies that showed only deep margin involvement, a lateral margin was seen in 32% of the first stages of MMS, according to the researchers. Contrarily, a deep margin was seen on 14% of the first stages of MMS in the biopsies that showed only lateral margin involvement.

Among the biopsies that showed clear margins, a margin was seen in 30% of the cases on the first stage of MMS.

“The value of these studies comes into play when the dermatologist’s evaluation and decision-making might be altered by pathology reports that comment on margins,” the researchers wrote. “We would encourage dermatologists not to ask their dermatopathologists for a margin on biopsied nonmelanoma skin cancers and not to rely on such margins for further management of such lesions.”

Disclosure: The authors have no relevant financial disclosures.