INTRODUCTION
The incidence of keratinocyte carcinoma (KC), which consists of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), has been increasing worldwide.1-2 Reporting to cancer registries is not required for these tumors but in 2012, an estimated 5.4 million cases were diagnosed in the United States.1 In addition, the incidence of melanoma and melanoma in situ has been increasing significantly.3 These disturbing trends warrant further investigation into risk factors influencing skin cancer pathogenesis.
Multiple treatments are available for skin cancer but Mohs micrographic surgery (MMS) has repeatedly demonstrated the highest cure rates and best cosmetic results.4-6 This is achieved by histologically analyzing tissue margins during the procedure to ensure complete tumor resection while minimizing excision of healthy tissue. The cost-effectiveness of MMS is also comparable to traditional excision.7-10 MMS is typically indicated for skin cancers on facial areas as these locations are at greatest risk for recurrence and are of high cosmetic value.
The majority of MMS procedures are performed on head and neck tumors. Yet, a limited number of studies have described distributions of head and neck MMS. The data in this study offers a detailed analysis of facial MMS procedures from a single practice in the DC metropolitan area, which demonstrates an incredibly consistent pattern every year. This study aims to establish that there are persistent patterns in the anatomical locations of MMS procedures. By demonstrating that there are consistent patterns in this surgical technique, we can compare and contrast various trends and regional demographics to investigate factors affecting skin cancer prevalence.
Multiple treatments are available for skin cancer but Mohs micrographic surgery (MMS) has repeatedly demonstrated the highest cure rates and best cosmetic results.4-6 This is achieved by histologically analyzing tissue margins during the procedure to ensure complete tumor resection while minimizing excision of healthy tissue. The cost-effectiveness of MMS is also comparable to traditional excision.7-10 MMS is typically indicated for skin cancers on facial areas as these locations are at greatest risk for recurrence and are of high cosmetic value.
The majority of MMS procedures are performed on head and neck tumors. Yet, a limited number of studies have described distributions of head and neck MMS. The data in this study offers a detailed analysis of facial MMS procedures from a single practice in the DC metropolitan area, which demonstrates an incredibly consistent pattern every year. This study aims to establish that there are persistent patterns in the anatomical locations of MMS procedures. By demonstrating that there are consistent patterns in this surgical technique, we can compare and contrast various trends and regional demographics to investigate factors affecting skin cancer prevalence.
MATERIALS AND METHODS
Patient Characteristics
A retrospective chart review was performed on all patients treated with MMS at a private practice in Chevy Chase, Maryland from January 1, 2014, through December 31, 2019. Chevy Chase is a suburban region of the DC metropolitan area with a population density of 3,987 people per square mile. Citizen demographics are primarily Caucasian (84.9%), highly educated (85.5% with a bachelor’s degree or higher), and an income per capita of 97,282 (in 2018 dollars).11 The climate can be described as a humid subtropical (Köppen climate classification Cfa) with hot humid summers and cold to mild winters. Cases of MMS were identified through accessing surgical data records. All procedures were performed in office by Mohs surgeon
A retrospective chart review was performed on all patients treated with MMS at a private practice in Chevy Chase, Maryland from January 1, 2014, through December 31, 2019. Chevy Chase is a suburban region of the DC metropolitan area with a population density of 3,987 people per square mile. Citizen demographics are primarily Caucasian (84.9%), highly educated (85.5% with a bachelor’s degree or higher), and an income per capita of 97,282 (in 2018 dollars).11 The climate can be described as a humid subtropical (Köppen climate classification Cfa) with hot humid summers and cold to mild winters. Cases of MMS were identified through accessing surgical data records. All procedures were performed in office by Mohs surgeon
