title: Mohs micrographic surgery concordance between Mohs surgeons and dermatopathologists.
abstract: BACKGROUND
  Mohs micrographic surgery (MMS) is the preferred treatment modality for high-risk nonmelanoma skin cancer because of the high cure rates and tissue-sparing effect. Its outcome is highly dependent on the expertise and accuracy of the Mohs surgeon in the interpretation of frozen sections.
  
  
  OBJECTIVE
  This retrospective study evaluated the level of concordance between Mohs surgeons and dermatopathologists in reading histology slides from MMS procedures.
  
  
  METHODS
  A Mohs surgeon read 170 randomly selected slides for a quality assurance audit during excision, and then a dermatopathologist blindly read them at a separate time. Absence or presence of tumour and the final diagnosis were recorded on a standardized form.
  
  
  RESULTS
  An overall concordance of 99.4% was demonstrated. True discordance was recorded in only one of 170 cases. Intraepidermal atypia was the most challenging scenario for Mohs surgeons.
  
  
  CONCLUSIONS
  The high rate of agreement in this study confirms that adequately trained MMS surgeons have sufficient expertise and training for accurate and precise frozen sections interpretation.
authors.affiliation: Department of Dermatology and Venereology, Medical University-Sofia, Sofia, Bulgaria.
authors.forename: Kristina
authors.initials: K
authors.lastname: Semkova
authors.forename: Raj
authors.initials: R
authors.lastname: Mallipeddi
authors.forename: Alistair
authors.initials: A
authors.lastname: Robson
authors.forename: Ioulios
authors.initials: I
authors.lastname: Palamaras
mesh_terms: D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D005629:Frozen Sections; D006801:Humans; D015580:Mohs Surgery; D015588:Observer Variation; D010336:Pathology; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*