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In Reply.—Dr Byers' letter highlights the fact that there is some confusion about how pathologists orient tissue for frozen-section determination. The traditional technique, which we would describe as perpendicular to the surgical surface and the one used by Byers and his colleagues, is a sampling process. Typically, this orientation would sample 0.1% of the actual margin. Even if multiple additional sections were made, the percentage would only be increased slightly. The orientation described by Frederick Mohs and the one we applied is parallel to the surgical margin and if properly performed, examines 100% of the surgical margin. This is 1,000 times more thorough.
Using this approach, I think, we learned something new about the growth patterns of epidermoid carcinoma. This tumor has fingerlike extensions that can be detected by parallel histologic sectioning. Using this technique, this microscopic spread can be detected, traced, and excised. This will ultimately reduce the
DAVIDSON TM. The Biology of Head and Neck Cancer-Reply. Arch Otolaryngol. 1984;110(7):485. doi:10.1001/archotol.1984.00800330067017
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