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Mohs surgery technique is is typically reserved for skin cancers that have a high risk of reappearing or for skin cancers that have recurred. Mohs surgery is also a preferred option for removing skin cancer from areas such as the face

Prognosis (Outlook) The rate of basal cell skin cancer returning is about 1% with Mohs surgery, and up to 10% for other forms of treatment. Smaller basal cell carcinomas are less likely to come back than larger ones. Basal cell carcinoma rarely spreads to other parts of the body. You should follow-up with your doctor as recommended and regularly examine your skin once a month, using a mirror to check hard-to-see places. Call your doctor if you notice any suspicious skin changes.

Nodulo-cystic BCC. [Image, Photograph] Venura Samarasinghe, et al. J Skin Cancer. 2011;2011:328615.

Mohs micrographic surgery is also indicated for the treatment of the following: ~Tumors with histopathologic features showing morpheaform or sclerotic patterns. ~Tumors arising in regions where maximum preservation of uninvolved tissue is desirable 

Journal of Skin CancerVolume 2011 (2011), Article ID 571734, 6 pagesdoi:10.1155/2011/571734 © 2011 Mary H. Lien and Vernon K. Sondak.

There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides outcomes only marginally less satisfactory than surgery. There would be a place for imiquimod in treating patients with frequent multiple primary lesions when access to surgery is difficult or where clinical judgment may be influenced by patient factors as reported in some of the studies, eg, where patients may have contraindications to surgery.  It was noted that if recurrences occurred in this study they mostly occurred during the first 9 months after the end of treatment. The initial response was therefore predictive of long-term outcome so these authors recommend and encourage continued monitoring of skin lesions.

The proportion of subjects who were clinically clear at the 2-year follow-up visit was estimated to be 82.0%. Imiquimod was tolerated when applied daily, with erythema reported for all subjects participating in the study. The recurrence rate observed suggests that once daily dosing and 5x/week dosing yield similar clearance rates, but daily dosing increases local skin reactions.

79% of patients had no evidence of their sBCC at two years after finishing treatment.

We found that 5% imiquimod cream is an effective treatment option for superficial and nodular basal cell carcinomas, giving a clearance rate of 89.5% at an average of 39 months of follow up.

Raasch B. Clinical, Cosmetic and Investigational Dermatology. 9 June 2009.  There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides  outcomes only marginally less satisfactory t

For patients without comorbidities, our study revealed good cure rates for superficial BCC and superficial/nodular BCC (88% and 85%, respectively). Nodular and aggressive BCC and Bowen's disease exhibited lower cure rates (50%, 50%, and 57%, respectively). I