{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:56:21Z","timestamp":1785412581333,"version":"3.56.0"},"reference-count":47,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy Timi\u0219oara, Romania"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Langer\u2019s axillary arch, also known as the axillopectoral muscle, represents a relatively uncommon anatomical variation of the axillary region. Although often asymptomatic, its presence may have important implications in surgical procedures involving the axilla, particularly during breast surgery, axillary lymph node dissection, and reconstructive procedures. Despite numerous anatomical and surgical reports describing this variation, the true prevalence of Langer\u2019s axillary arch remains uncertain due to variability in study design and detection methods. Objective: The aim of this systematic review and meta-analysis was to evaluate the reported prevalence of Langer\u2019s axillary arch and to assess methodological variability among anatomical and surgical studies. Methods: A systematic literature search was conducted in accordance with PRISMA guidelines using electronic databases including PubMed, Scopus, and Web of Science. Studies reporting original data on the presence or prevalence of Langer\u2019s axillary arch in cadaveric or surgical populations were included. Data extraction included study characteristics, sample size, number of detected axillary arches, and reported prevalence. A random-effects meta-analysis was performed to estimate the pooled prevalence and to evaluate heterogeneity between studies. Results: The analysis included studies comprising both cadaveric anatomical investigations and surgical series. Considerable variability in reported prevalence was observed across studies. Cadaveric studies generally reported higher prevalence rates compared with surgical series, reflecting differences in detection methods. Meta-analytic synthesis demonstrated that Langer\u2019s axillary arch represents a relatively uncommon but clinically relevant anatomical variation. Conclusions: Langer\u2019s axillary arch should be recognized as an important anatomical variant of the axillary region. Awareness of this variation is essential for surgeons performing axillary procedures, as its presence may influence surgical exposure and lymph node identification. Further large-scale anatomical and clinical studies are needed to better define its prevalence and surgical implications.<\/jats:p>","DOI":"10.3390\/life16071112","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T11:39:11Z","timestamp":1783078751000},"page":"1112","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Langer\u2019s Axillary Arch: A Systematic Review and Meta-Analysis of Its Prevalence and Clinical Relevance"],"prefix":"10.3390","volume":"16","author":[{"given":"Cosmin","family":"Burta","sequence":"first","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"Doctoral School of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razvan","family":"Danau","sequence":"additional","affiliation":[{"name":"Urology Department, Prof. Dr. \u201cTh. Burghele\u201d Clinical Hospital, 050692 Bucharest, Romania"},{"name":"Department of Urology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8249-3556","authenticated-orcid":false,"given":"Andrei","family":"Korodi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, \u201cVasile Goldis\u201d, Western University of Arad, L. Rebreanu St. 86, 310048 Arad, Romania"},{"name":"Department of General Surgery II, Emergency Clinical County Hospital of Arad, 2-4 Andreny Karoly Str., 310037 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flaviu Ionut","family":"Faur","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"X Department of General Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aida","family":"Iancu","sequence":"additional","affiliation":[{"name":"Department XV, Radiology and Medical Imaging Clinc, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian","family":"Duta","sequence":"additional","affiliation":[{"name":"X Department of General Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Adelina","family":"Faur","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"Doctoral School of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0809-5310","authenticated-orcid":false,"given":"Paul","family":"Pasca","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"Doctoral School of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"X Department of General Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-5469","authenticated-orcid":false,"given":"Catalin Prodan","family":"Barbulescu","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"Department I\u2014Discipline of Anatomy and Embryology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"Braicu","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"X Department of General Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5736-572X","authenticated-orcid":false,"given":"Amadeus","family":"Dobrescu","sequence":"additional","affiliation":[{"name":"IInd Surgery Clinic, Timisoara Emergency County Hospital, 300723 Timisoara, Romania"},{"name":"X Department of General Surgery, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1002\/ca.10053","article-title":"Coexistence of a pectoralis quartus muscle and an unusual axillary arch: Case report and review","volume":"15","author":"Bonastre","year":"2002","journal-title":"Clin. 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