When Is Surgical Removal Recommended for Skin Cancer?

If you notice a new or changing mole, an unusual growth, or a spot that won’t heal, a skin cancer screening can help determine whether further evaluation is needed. When an area looks suspicious, a skin biopsy may be performed to check for cancerous cells and identify the type of skin cancer present. If skin cancer is diagnosed, surgical removal is often an effective treatment option, although the recommended approach depends on the cancer’s type, size, depth, location, and other individual factors. 

At The Oregon Clinic in Portland, OR, board-certified plastic surgeon Sean McNally, M.D., offers skin cancer screenings, biopsies, and surgical skin cancer removal to provide patients with comprehensive care from evaluation through treatment. Keep reading to learn when skin cancer surgery may be necessary and what to expect when determining the most appropriate treatment approach. 

 

Who should get a skin cancer screening, how often, and why? 

Skin cancer screenings are an important way to identify suspicious spots that may be difficult to recognize on your own, particularly in areas that are hard to see. How often you should have your skin checked depends on your individual risk factors and history rather than a single schedule that applies to everyone. Regular professional skin exams may be especially important if you have:  

• A personal or family history of skin cancer 
• Numerous or unusual-looking moles 
• Fair skin or skin that burns easily 
• A history of significant sun exposure or sunburns 
• Frequent use of tanning beds 
• A weakened immune system 
• A new or changing mole, growth, or lesion 

Between screenings, becoming familiar with your skin can also help you recognize changes worth having evaluated. If Dr. McNally identifies a suspicious area during a skin cancer screening, a biopsy can provide the information needed to determine whether cancer is present. 

 

What if my skin cancer biopsy is positive? 

A positive skin biopsy means cancerous cells were identified in the tissue sample, but the next step depends on what the pathology report shows. Skin cancer includes several different types, and characteristics such as the specific diagnosis, depth, size, and location can influence the recommended treatment. Dr. McNally will review the biopsy results and explain what they mean for your care, including whether surgical skin cancer removal is appropriate or if another treatment should be considered. Additional evaluation may sometimes be necessary before a treatment plan is finalized. The goal is to choose an approach suited to the specific cancer rather than treating each positive biopsy the same way. 

 

When is skin cancer surgery the best option? 

Surgical removal is commonly recommended when skin cancer can be effectively treated by excising the cancerous tissue along with an appropriate margin of surrounding tissue. The decision may be influenced by whether the cancer is basal cell carcinoma, squamous cell carcinoma, melanoma, or other types of skin cancer, as well as how large or deep the lesion is and where it appears on the body. 

Previous treatment and the likelihood of recurrence may also factor into the recommendation. For skin cancers in highly visible or functionally important areas, careful surgical planning is particularly valuable because treatment involves considering both complete cancer removal and reconstruction of the resulting defect. 

 

What happens during skin cancer excision surgery? 

During skin cancer excision, Dr. McNally surgically removes the identified lesion along with a margin of surrounding tissue when appropriate. The removed tissue may be sent for pathology evaluation to assess whether cancerous cells extend to the edges of the specimen. After the necessary tissue has been removed, attention turns to closing and reconstructing the area. 

The complexity of skin cancer reconstruction depends on the size, depth, and location of the surgical defect. Some areas may be closed directly, while larger or more complex wounds can require techniques such as a skin graft or local flap to restore coverage and support the best possible functional and cosmetic outcome. 

 

Can skin cancer come back after surgery? 

Skin cancer can recur after surgical removal, although the likelihood varies based on the type and characteristics of the original cancer and whether it was completely removed. Having one skin cancer can also mean you have a greater chance of developing a new skin cancer elsewhere, which is different from the original cancer returning. For these reasons, follow-up skin exams remain important even after successful skin cancer surgery. 

Dr. McNally and our colleagues  — including oncologists, dermatologists, and other providers around the Portland, OR area — can recommend an appropriate surveillance schedule based on your diagnosis and risk factors, while ongoing sun protection and monitoring your skin for new or changing spots can help support early detection moving forward. 

 

Put healthy skin front and center with skin cancer screening in Portland, OR  

From evaluating a suspicious spot to determining whether surgical excision is necessary, skin cancer care starts with understanding exactly what you are dealing with. Board-certified plastic surgeon Sean McNally, M.D., provides skin cancer screenings, biopsies, surgical removal, and referrals with attention to both effective treatment and the appearance and function of the treated area. If you have noticed a concerning skin change or need care following a skin cancer diagnosis, contact our team at The Oregon Clinic for skin cancer evaluation and treatment in Portland, OR.