Mohs Micrographic surgery in the treatment of basal cell carcinoma: an integrative review of current evidence

Abstract

Basal cell carcinoma is the most common malignant skin neoplasm worldwide and, despite its low metastatic potential, it can cause significant local morbidity due to its infiltrative and destructive growth pattern. In this context, Mohs micrographic surgery has emerged as one of the leading therapeutic approaches for high-risk tumors, particularly those located in anatomically and aesthetically sensitive areas. This study aimed to analyze the current scientific evidence regarding the use of Mohs micrographic surgery in the treatment of basal cell carcinoma. An integrative literature review was conducted using the PubMed/MEDLINE, Cochrane Library, and ScienceDirect databases, including studies published between 2014 and 2025. Clinical trials, systematic reviews, meta-analyses, observational studies, and clinical guidelines addressing indications, effectiveness, margin control, recurrence rates, and clinical perspectives of the technique were analyzed. The findings demonstrated that Mohs micrographic surgery provides high cure rates and lower recurrence rates when compared with conventional surgical excision, particularly in recurrent, aggressive, or facial high-risk tumors. Furthermore, the nearly complete histopathological assessment of surgical margins allows greater tissue preservation and improved reconstructive outcomes. It is concluded that Mohs micrographic surgery currently represents the gold standard treatment for high-risk basal cell carcinomas, offering superior oncological control and improved functional and aesthetic outcomes.