The surgical and oncologic significance of the axillary arch during axillary lymphadenectomy
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Updated: Oct 20, 2026

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
A J Petrasek1, J L Semple, D R McCready
1Department of Surgery, Women's College Hospital, University of Toronto, Ont.
Abstract:
An uncommon and often-overlooked anatomic variation of the latissimus dorsi muscle is the axillary arch. It is formed by an anomalous slip of the muscle that arises from the body of the latissimus dorsi but then inserts along with the pectoralis major muscle anterior to the axillary vein and neurovascular bundle. If an axillary arch is encountered during axillary lymphadenectomy, the lymph nodes posterior and lateral to the arch should be excised. Experience with a number of cases is used to consider local therapeutic and staging factors.
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