Identifying and Excising Tumor

To the Editor. —The article by Davidson et al 1 published in the March 1984Archivesis important in that it suggests the need for research to further resolve the conflict between two axioms of oncologic surgery relating to localized tumors. These axioms are, first, that the best possible cure rates are obtained when all of the cancer is removed and, second, that the preservation of normal tissue preserves form and function. Davidson et al, like Mohs and his followers before them, advocate meticulous histologic evaluation of the entire margin of the specimen with additional resection and histologic evaluation as necessary until all margins are proved to be free of cancer. Since this eliminates the need to excise wide margins of normal tissue in the blind hope of encompassing all of the potential tumor projections, thereby preserving the maximum amount of normal tissue, it more or less satisfies both axioms.