Cancer
Removing cancerous tissue is a critical part of cancer care. Our surgeons provide biopsy, removal of skin cancers, and reconstruction of the defects left behind, often in a single surgery.
Cancer Removal and Reconstruction
Skin cancers are among the most common human malignancies. Aging, genetics, sun exposure, and other environmental factors all play a role. Basal cell carcinoma makes up about 75 percent of skin cancers, squamous cell carcinoma about 20 percent, and melanoma about five percent.
When removing a cancer leaves a large defect, we can perform flap surgery to close the wound. This applies to any cancer, and we commonly perform breast reconstruction with implants or flaps as part of breast cancer reconstructive surgery.
The physicians of Northland Plastic Surgery are available for initial biopsy of suspicious lesions, definitive treatment of lesions that test positive, and reconstruction of the resulting defects. The two most common types of cancer that our surgeons care for patients are skin cancer and breast cancer.
Complete Care
From initial biopsy through definitive treatment and reconstruction, your care stays with one surgical team.
Same-Surgery Reconstruction
In most cases, we can provide complete excision and reconstruction during the same surgery.
Verified Margins
Frozen section evaluation helps document complete excision, with repeated stages when needed to obtain clear margins.
Warning Signs Worth a Closer Look
Any non-healing ulcer or gradually enlarging skin lesion should be considered for excision. Have a lesion evaluated if you notice any of the following.
- A sore or ulcer that does not heal
- A skin lesion that keeps growing
- Raised edges, crusting, or a pearly appearance
- Variable pigmentation or irregular borders
- Pain, bleeding, or itching
- Ulceration of the lesion surface
Basal Cell and Squamous Cell Carcinoma
These skin cancers are typically slow growing and curable with complete excision. Squamous cell carcinoma can be somewhat more aggressive and in some cases shows lymphatic invasion. Left untreated, both types can become locally invasive and disfiguring.
Suspicious lesions are biopsied first, using an incisional or excisional biopsy depending on the lesion’s size and location. Once the diagnosis is made, treatment generally consists of complete excision.
Confirming Clear Margins
Documenting complete excision often requires frozen sections to evaluate the margins. In some cases, several repeated stages are needed to obtain completely clear margins before reconstruction begins.
Melanoma
Melanoma is an aggressive malignancy that often metastasizes and requires a more involved treatment approach. Your treatment plan depends on the depth of the lesion, measured by Clark level and Breslow thickness, along with its size, location, and the clinical status of your lymph nodes.
Generally, wide excision is indicated, followed by reconstruction of the defect. Depending on the clinical situation, a sentinel node biopsy or radical node dissection may also be needed.
Reconstruction After Cancer Removal
Once a lesion is surgically removed, the defect is repaired. Often this is a straightforward skin closure. When the defect is large or involves critical tissues such as the nose, lips, or eyelids, a more complex reconstructive procedure may be required.
For large wounds left after removing any cancer, flap surgery can close the defect. We commonly perform flap procedures in breast cancer reconstruction.
What to Expect from Treatment
Evaluation: a suspicious lesion is examined and biopsied, incisionally or excisionally, based on its size and location.
Diagnosis: once results confirm cancer, your surgeon plans complete excision of the lesion.
Excision: the lesion is removed, with frozen sections checking margins. Several stages may be needed for clear margins.
Reconstruction: the defect is repaired, usually during the same surgery, from simple closure to flap procedures.
“My experiences at Northland Plastic Surgery have been very positive. They have gone above and beyond to make sure I always receive the necessary treatments.”
Candy · Skin Cancer Patient
Candy came to us with a large lesion on the top of her nose that proved to be basal cell carcinoma. She underwent excision with frozen section biopsies of the margins, and complete removal of the tumor required taking a large portion of the nasal skin. Reconstruction was done in two stages, turning a flap of skin down from her forehead to resurface the nose.