title: The surgical importance of an axillary arch in sentinel node biopsy.
abstract: OBJECTIVE
  When Carl Langer described the aberrant axillary arch in 1846 its relevance in sentinel node biopsy (SNB) surgery could not have been contemplated. The authors define an incidence and elucidate relevance of the arch in SNB of the axilla.
  
  
  METHODS
  A review of a database for breast and melanoma axillary SNB was carried out. The sample was 1 year at Princess Margaret Hospital, Toronto.
  
  
  RESULTS
  Of 319 axillary SNB, 3 (0.9%) had axillary arches noted. Two were in the melanoma group (n = 59) and one in the breast (n = 260). Interestingly one arch case had an ipsilateral 'idiopathic' axillary vein thrombosis as a child.
  
  
  CONCLUSIONS
  The authors see no reason to deviate from the practice of division of the arch at the highest level when recognised at SNB. This would abrogate the risk of concealed nodes and possible future neurovascular compression.
authors.affiliation: Department of Surgery, Trinity College Dublin at the Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland. ridgwayp@tcd.ie
authors.forename: P F
authors.initials: PF
authors.lastname: Ridgway
authors.forename: A M
authors.initials: AM
authors.lastname: Collins
authors.forename: D R
authors.initials: DR
authors.lastname: McCready
mesh_terms: D000328:Adult; D001365:Axilla / Q000033:anatomy & histology* / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid
chemical_list: D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid
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