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After more than 20 years of personal experience with Mohs micrographic surgery as both consultant pathologist and as clinician engaged in followup care, I find that I strongly approve of this supremely logical approach to the management of most skin cancers with the specific exception of melanoma. My strongly positive bias is in no small part due to the wonderfully cooperative and productive association that I have had with two caring and skilled skin surgeons, Dr William B. Taylor, who was one of the first persons trained by Dr Fred Mohs, and Dr Neil A. Swanson, who has an uncanny skill for planning how to fill the substantial defects that he is frequently obliged to create.
My approval, however, goes well beyond appreciation for professional skills. Micrographic surgery has two singular and important benefits: first, an improved probability for tumor-free margins as compared with blind excision and/or field-limited radiotherapy, and