Background: The presence of tumor involving surgical margins after excision of basal cell carcinoma (BCC) presents a therapeutic dilemma. Some authors advocate a conservative policy whereas others recommend immediate reexcision. Objective: Our purpose was to evaluate residual tumor utilizing Mohs micrographic surgery (MMS) of those BCCs with margin involvement after primary excision. Methods: We retrospectively reviewed 77 patients with 78 tumors who underwent MMS because of margin involvement after primary excision of BCC to detect the presence or absence of residual tumor. Results: Residual tumor was found in 55% of the cases as defined by the need for two or more stages of MMS to achieve a tumor-free plane. Conclusion: We suggest reexcision of all BCCs that are found to have marginal involvement after primary excision because of the large percentage of cases found to have residual tumor.
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