Examining Surgical Margins in the Excision of Basal Cell Carcinoma and Squamous Cell Carcinoma: Evaluating Pre-Excision, Post-Excision, Post-Fixation, and Pathological Margin Measurements.

INTRODUCTION: There remains uncertainty regarding whether the determination of a safe margin is the responsibility of the surgeon or the pathologist during the pathological analysis of tissue from various procedures. This study aims to assess the alterations in surgical margin dimensions of tissue 1 h post-excision, following 24 h of formalin fixation, and pathological in comparison to the margin determined prior to excision.

PATIENTS AND METHODS: Measurements and mean values were taken for each specimen at four stages: before excision, 1 h post-excision, after 24 h of 10% formalin fixation, and following pathologic examination. BCCs and SCCs were evaluated independently, and statistical analyses were performed to assess changes in the measurements of the specimens.

RESULTS: Table 1 illustrates highly significant reductions of the order of 70%-80% overall in the measured specimen margin widths over time for all of the categories measured.

CONCLUSION: Excised skin cancers were found to undergo significant shrinkage at every stage of pathological evaluation, resulting in a surgical margin significantly narrower than the safety margin initially determined. We have clarified what the surgical margin reported by the dermatopathologist actually means. In this way, it was aimed to eliminate the disagreement between the surgeon and the pathologist and to prevent the need for additional surgery and morbidities.