EVALUATION OF ROTTER'S LYMPHNODE METASTASIS IN BREAST CANCER:THERAPEUTIC AND PROGNOSTIC CONSIDERATION IN RADICAL MASTECTOMY

概要

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The interpectoral lymph nodes (Rotter's nodes) have a therapeutic importance in radical mastectomy, because these nodes are not completely dissected unless the pectoral major muscle is sacrificed. In our institution, Rotter's nodes were disclosed by hand dissection in 71.4% of 35 recent, consecutive radical mastectomy specimens. The average number of dissected Rotter's nodes was 1.9 per specimen. In recent 109 cases of curative radical mastectomy, ten had metastases to Rotter's nodes, which accounted for 9.2% of all cases and 28.6% of those with axillary node metastasis respectively. In all cases with Rotter's node metastasis, the tumors were larger than 2.1 cm in size by palpation and located in the lateral half of the breast. Metastasis found only in Rotter's nodes occurred in one case (0.9% of all cases). But in the other 9 cases, more than 3 of the axillary lymphnodes were positive for metastasis, and their porgnoses were significantly poor. These reuslts suggest that the dissection of Rotter's nodes might be negligible in a case with a tumor smaller than 2.0cm in size, and that a case with swollen or hardened Rotter's nodes which denotes metastasis should not be a candidate for modified radical mastectomy that preserves the pectoral major muscle.
日本臨床外科学会の論文