The Medical College of Georgia
1004 Chafee Ave
Augusta, GA 30912
We read with interest the article by Bentkover et al1 regarding excision of head and neck basal cell carcinomas with a rapid, cross-sectional, frozen-section technique. While we are sympathetic toward the ongoing issue of medical and surgical costs, we respectfully submit 2 points of consideration.
The rapid, cross-sectional, frozen-section technique is a novel approach for the treatment of basal cell carcinoma with cost in mind; however, this method does not account for the entirety of the surgical section. Complete histologic confirmation of both lateral and deep margins cannot be completely evaluated by such representative samples with this cross-sectional technique. Complex anatomic regions with characteristically higher recurrence rates such as the nose, canthi, and ears necessitate Mohs micrographic surgery.2 Recurrences in such complex areas can be associated with significant morbidity.
Lane JE, Peterson CM, Ratz JL. Modified Mohs Technique for Basal Cell Carcinomas of the Head and Neck. Arch Facial Plast Surg. 2003;5(1):116. doi: