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Additional review of Mohs slides to optimize Mohs micrographic surgery
Author(s) -
Lee C.B.,
Graafland B.,
Koljenović S.,
Neumann H.A.M.,
Nasserinejad K.,
Nijsten T.E.C.,
Bos R.R.,
Munte K.
Publication year - 2015
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.13750
Subject(s) - erasmus+ , rotterdam study , medicine , library science , art , art history , computer science , surgery , prospective cohort study , the renaissance
Summary Background One significant risk factor for recurrence after Mohs surgery is misinterpretation of slides. Objectives To determine how often pathologists detected incompletely excised basal cell carcinoma ( BCC ) on Mohs slides and to determine risk factors for incompletely excised BCC s. Methods This retrospective study included 1653 BCC s treated with Mohs surgery in a university hospital between 2007 and 2011. For routine quality assurance, all slides were additionally reviewed by a pathologist within 1 week of the procedure. For this study, all cases that had divergent interpretations were re‐evaluated by a Mohs surgeon and a pathologist. Mixed‐effects logistic regression models with Mohs surgeon effects as random effects were used to determine risk factors for incompletely excised BCC . Results Incompletely excised BCC s were detected in 31 cases (2%), in which defects > 20 mm in diameter were an independent risk factor (odds ratio 3·58, 95% confidence interval 1·55–8·28). Other studied variables (i.e. aggressive subtype, previously treated BCC , location on nose and > 2 Mohs stages) did not affect the risk of incompletely excised BCC s. Conclusions The additional review of Mohs slides might increase accurate interpretation, especially in large BCC s.