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. 2009 Jan;60(1):94-8.
doi: 10.1016/j.jaad.2008.09.061.

Mohs micrographic surgery histopathology concordance

Kavita Mariwalla  1 , Sumaira Z Aasi, Earl J Glusac, David J Leffell
Affiliations

Mohs micrographic surgery histopathology concordance

Kavita Mariwalla et al. J Am Acad Dermatol. 2009 Jan.

Abstract

Background: The low recurrence rate and tissue-sparing benefit associated with Mohs micrographic surgery (MMS) requires accurate interpretation of frozen sections by the MMS surgeon.

Objective: We sought to assess concordance between dermatopathologists and MMS surgeons when reporting cutaneous malignancy in the MMS setting.

Methods: This study is a retrospective analysis of 1156 slides submitted during 10 years as part of a pre-existing randomized, blinded, quality assurance protocol. Slides were read by one of 5 dermatopathologists and represent cases from 3 MMS surgeons and 5 MMS fellows. Agreement or disagreement was recorded.

Results: Of the 1156 slides, 32 slides (2.8%) were disparate. Aside from differences regarding intraepidermal neoplasia, the concordance rate was 99.7%.

Limitations: This study represents data collected at a single institution in the United States alone.

Conclusion: There was statistically significant concordance between MMS surgeons and dermatopathologists in frozen section interpretation in the MMS setting. Discordance was primarily related to the interpretation of in situ malignancy.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Quality assurance form used as part of the quality assurance protocol in the Section of Dermatologic Surgery and Cutaneous Oncology at the Yale School of Medicine. Note the binary nature of the quality assurance form which precludes descriptive annotations by the slide interpreter however allows the pathologist and MMS surgeon to note resolution of any discrepancy under “Pathologist’s comments.”
Figure 2
Figure 2
1,156 slides were analyzed in an ongoing quality assurance program. Of the total number of slides, only three were considered to be truly discordant. Of the 32 slides in disagreement, 29 slides were in discordance simply due to the binary nature of the quality assurance sheet and thus were excluded from the discordant analysis.
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References

    1. American Cancer Society. Cancer Facts & Figures 2007. [Accessed February 11, 2007]. Available at: http://www.cancer.org/downloads/STT/CAFF2007PWSecured.pdf.
    1. Christenson LJ, Borrowman TA, Vachon CM, Tollefson MM, Otley CC, Weaver AL, et al. Incidence of basal cell and squamous cell carcinomas in a population younger than 40 years. JAMA. 2005;294:681–90. - PubMed
    1. Rowe DE, Carroll RJ, Day CL. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip: implications for treatment modality selection. J Am Acad Dermatol. 1992;26:976–90. - PubMed
    1. McGovern TW, Leffell DJ. Mohs Surgery: the informed view. Arch Dermatol. 1999;135:1255–9. - PubMed
    1. Mohs FE. Chemosurgery. Clinics in Plastic Surgery. 1980;7:349–60. - PubMed

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