Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;26(11):2226-2228.
doi: 10.1111/tbj.14082. Epub 2020 Oct 13.

Langer's arch: A rare but important consideration for axillary surgery with implications for training

Gemma Elizabeth Scrimgeour  1 , Edward Robert St John  1   2 , Daniel Richard Leff  1   2
Affiliations

Langer's arch: A rare but important consideration for axillary surgery with implications for training

Gemma Elizabeth Scrimgeour et al. Breast J. 2020 Nov.

Abstract

Langer's arch (LA), although rare, is an important anatomical anomaly in the axilla that may be encountered during axillary lymph node dissection (ALND). Failure to recognize this anomaly may cause disorientation during ALND, resulting in inadequate clearance, with implications for local disease recurrence and inaccurate staging. Here, we present a case that highlights the confusion LA can cause even in experienced surgeons. With indications for ALND decreasing, resulting in lower operative numbers, surgeons are less likely to be exposed to this structure during their training. Improving knowledge and understanding of LA is important to ensure breast surgeons' preparedness for axillary surgery.

Keywords: Langer's axillary arch; anatomical variant; axillary lymph node dissection; sentinel lymph node biopsy; surgical training.

PubMed Disclaimer

References

REFERENCES

    1. Al Maksoud AM, Barsoum AK, Moneer MM. Langer's arch: a rare anomaly affects axillary lymphadenectomy. J Surg Case Rep. 2015;2015(12):rjv159.
    1. Saitta GF, Baum V. Langer's axillary arch. An unusual cause of axillary mass. JAMA. 1962;180(8):690.
    1. Hirtler L. Langer's Axillary Arch - Case Presentation and Literature Overview. Austin J Anat. 2014;1(4):1020.
    1. Taterra D, Henry BM, Zarzecki MP, Sanna B, Pekala PA, Cirocchi R, et al. Prevalence and anatomy of the axillary arch and its implications in surgical practice: A meta-analysis. Surgeon. 2019;17(1):43-51.
    1. Keshtgar MR, Saunders C, Ell PJ, Baum M. Langer's axillary arch in association with sentinel lymph node. Breast. 1999;8(3):152-153.

LinkOut - more resources