Do ALL skin cancers require ‘clear margins’?

When faced with skin cancer and surgical excision, the ideal is to have ‘clear margins’.  However, you must realize that not all ‘involved margins’ cases require a re-excision.  If you  have a basal cell carcinoma, and the excision site visually appears clear of any obvious cancer, you can CHOOSE to observe this rather than have a re-excision.  Your chances of having residual disease is 1 in 3.  2 in 3 will not have a recurrence.  Those odds are not bad in my opinion and observation is always offered as a choice to my patients.