Micrographic surgery was developed in the 1930s by Dr. Friedrich Mohs, using the in vivo tissue fixation method. In 1970, Stegman and Tromovitch published a series of cases using ex vivo fixation. In 1995, the Munich method was described.

Since then, surgeons have been constantly learning these techniques.1–4

In the study by Portela et al.5 a new form of debulking assessment was described, but it is identical to the Munich method previously described in the literature. The concepts of margin and surgical border are imprecise. The authors illustrate an essential feature of the Munich method: the possibility of assessing the tumor–surgical margin relationship and observation of the tumor. Thus, it is possible to better demonstrate the subtype, cytological aspects, and tumor architecture, which have clinical and oncological relevance and are important for decision making. These factors gain importance in tumors with rarer histology and with greater metastatic potential; it also facilitates the identification of perineural invasion. In turn, peripheral methods evaluate only the surgical border, and do not observe the tumoral core. Although bread-loafing of the paraffin block is performed during debulking, the sample is smaller and the results are not available in the trans-operative period, given the time required for paraffin embedding and processing. A drawback of the fresh method is the greater chance of technical artifacts (Table 1).

The author of this correspondence highlights the importance of broadening the discussion of the technical and laboratory details of the various forms of micrographic surgery, including the implications of each technique for the clinical and oncological data.