Interpectoral nodes

At a glance

English

Interpectoral nodes

Latin (TA2)

Nodi interpectorales

System

Lymphatic

Region

Trunk

Side

Paired, left and right

About the interpectoral nodes

The interpectoral nodes, also known as Rotter's nodes, form a small and variable group on the anterior chest wall. They lie in the thin layer of fat and connective tissue that separates the two pectoral muscles, usually close to the pectoral branches of the thoraco-acromial artery and the lateral and medial pectoral nerves.

Although they sit outside the axilla proper, they belong functionally to the axillary nodes. There may be only one or two, each a few millimetres across, scattered over the front of pectoralis minor and under cover of pectoralis major. Their vessels pass up and back around pectoralis minor to reach the higher axillary groups.

They collect lymph from the two pectoral muscles and from the deep part of the mammary gland, whose vessels pierce pectoralis major on their way back from the breast. Lymph leaving them goes mainly to the apical axillary nodes at the top of the axilla, and sometimes to the central group, before draining into the subclavian trunk.

Their main clinical interest is in breast cancer. Tumour cells can travel from the breast straight to these nodes, bypassing the lower axillary groups, so a deposit here may be missed if only the axilla is checked. At surgery the plane between the pectoral muscles is opened when these nodes need to be removed, and care is taken to spare the pectoral nerves that run through it.

Course and drainage

Begins at

Afferent vessels from pectoralis major and minor and from the deep part of the mammary gland.

Drains into

Efferent vessels pass to the apical axillary nodes and sometimes the central axillary nodes, and so to the subclavian trunk.

Drains

Filters lymph from the pectoral muscles and the deep breast. Breast cancer may reach them directly, missing the lower axillary nodes, so they are considered in staging and in axillary surgery.