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Rapid lump examination shows promise in speeding up Mohs micrographic surgery
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Rapid lump examination enabled fast detection of residual basal cell carcinoma during Mohs micrographic surgery, according to published study results.
Researchers conducted a pilot study of 22 facial basal cell carcinomas (BCCs) excised from 19 patients (53% men; mean age, 68 years) of various subtypes by rapid lump examination and stand fresh frozen section examination. The two techniques were used to evaluate the differences in the actual surgical margins. Freshly excised tissue stained with toluidine blue and imaged with a stereomicroscope before being subdivided into sections suitable for processing into fresh frozen section were used for rapid lump examination.
Hemotoxylin and eosin were used to stain fresh frozen sections, which were evaluated with light microscopy.
Rapid lump examination had a final sensitivity of 83.8%, specificity of 94%, positive predictive value of 83.8% and negative predictive value of 94% when fresh frozen section was used as the gold standard for detection of residual BCC.
“The present pilot study shows that [rapid lump examination] is a promising technique to speed up [Mohs micrographic surgery] and could therefore be a helpful solution to handle the skin cancer epidemic,” the researchers concluded. “Its staining procedure of only 75 seconds enables fast detection of residual BCC in freshly excised tissue, whereas the preparation of traditional [fresh frozen section] usually takes 30 to 45 minutes.
“The diagnostic accuracy of [rapid lump examination] as observed in this study is promising, but it also highlights the need for future research and further refinement of the technique.” – by Bruce Thiel
Disclosure: The microscope used in the study was on loan from Leica Microsystems. The researchers report no relevant financial disclosures.
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