Interpectoral nodes !
The interpectoral nodes are a small group of lymph nodes between the two chest muscles (pectoralis major and minor); breast cancer can spread to them.
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What it is
A few nodes between pectoralis major and pectoralis minor (level II).
What it does
Drain part of the upper breast straight to the central and apical nodes, skipping the anterior group.
Key facts
- Where
- Between pectoralis major and pectoralis minor (Rotter's nodes)
- Drains
- Upper breast and pectoral region
- Into
- Apical axillary nodes
Relations
- In front
- Deep surface of the pectoralis major
- Behind
- Pectoralis minor and its fascia (clavipectoral fascia)
- Contents
- A few nodes in fat with the pectoral branches of the thoracoacromial artery and the lateral pectoral nerve
- Above
- Apical axillary lymph nodes and the infraclavicular region
How to find it
Not palpable. In surgery they are found by lifting the pectoralis major off the pectoralis minor; on imaging they are sought in the fat plane between the two muscles.
On imaging
CT, MRI or PET-CT can show an enlarged node in the plane between the pectoral muscles; ultrasound reaches it in some patients.
Common problems
- Can hold breast cancer even when the lower axillary nodes are clear.
How it is diagnosed
Examination of the armpit and ultrasound with a needle biopsy; in breast cancer, the sentinel node is found with a tracer during surgery.
Treatment
- Sentinel node biopsy: only the first one to three nodes are removed and checked.
- Axillary dissection (levels I–II) or radiotherapy when the nodes contain cancer; arm swelling (lymphoedema) is the main risk.
Clinical notes
- Grouped with level II nodes in many surgical systems (level I lateral, level II behind and level III medial to pectoralis minor); some texts list them separately
- Removing them puts the medial and lateral pectoral nerves at risk; injury weakens and wastes the pectoralis major
- Breast cancer in men follows the same lymph pathways, including these nodes
- After mastectomy, involved nodes left between the pectoral muscles are a recognised site of regional recurrence, which may appear as a lump under the pectoralis major
Anatomical variants
- Not found in every person, and their number varies when present; some surgical series find none on careful dissection
Test yourself
Think of the answer, then tap the question to see it.
Where do the interpectoral (Rotter) nodes lie?
Between the pectoralis major and minor, along the pectoral branches of the thoracoacromial artery and the lateral pectoral nerve.
Why do interpectoral nodes matter in breast cancer?
They can receive breast lymph directly and carry metastases that bypass the lower axillary levels.
Which nerves are at risk when interpectoral nodes are removed, and with what result?
The medial and lateral pectoral nerves; injury weakens and wastes the pectoralis major.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- nodi interpectorales TA2 5242
- Official Spanish (DeCS)
- Nódulos linfáticos interpectorales
- English (TA2)
- Interpectoral nodes
- Also called
- Rotter's nodes
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Thorax: Mammary Gland; Anatomy, Shoulder and Upper Limb, Axillary Lymph Nodes.
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Representative model, for educational purposes only.