The study was aimed at analyzing metastatic involvement in interpectoral (Rotter\u27s) lymph nodes related to site, size and grade in primary breast cancer.
The study includes 210 female patients undergoing surgery for breast cancer at the University Hospital for Tumors, Zagreb, Croatia. In addition to the standard surgical procedure, interpectoral (Rotter\u27s) lymph nodes were removed in all of the patients.
Rotter\u27s lymph nodes were identified in 66.2% of the patients, with metastatic involvement revealed in 18.5% of the Rotter\u27s nodes. Metastatic involvement of Rotter\u27s nodes in patients with negative and positive axillary lymph nodes was 2.8% and 34.6%, respectively. Considering location of the tumor in patients with metastatic involvement of Rotter\u27s nodes, it was shown that tumors located in the upper breast quadrants were more prone to metastasis to Rotter\u27s nodes, demonstrating a significant positive correlation between tumor location within the breast and positive Rotter\u27s lymph nodes (r=0.93, p=0.02). As regards tumor size, Rotter\u27s nodes were identified in 15%, 20% and 60% of stage T1 (5 cm), respectively with a significant positive correlation (r=0.759, p=0.09). Also considering tumor grade it was shown that metastatic involvement of Rotter\u27s lymph nodes was 3.8%, 17.6% and 31.6% of grade I,II and III, respectivly with a significant positive correlation (r=0.993, p=0.08).
The results show that one-fifth of breast cancer patients, or even one-third of them with positive axillary lymph nodes, are discharged with positive interpectoral lymph nodes that remain undiagnozed and non-extirpated. As the nodes can be surgically removed without additional mutilation, the exploration of Rotter\u27s lymph nodes should be introduced into routine clinical practice. In upper breast quadrants, tumors were more prone to metastase in to Rotter\u27s nodes, as well as higher tumor size and grade.U ovom je radu analizirana metastatska zahvaćenost interpektoralnih (Rotterovih) limfnih čvorova u odnosu na lokaciju, veličinu i gradus primarnog raka dojke.
Analizirano je 210 bolesnica s rakom dojke operiranih u Klinici za tumore u Zagrebu. U svih su bolesnica, uz standardni kirurški zahvat, uklonjeni i interpektoralni (Rotterovi) limfni čvorovi.
Rotterovi limfni čvorovi otkriveni su u 66,2% bolesnica, od kojih je 18,5% bilo zahvaćeno metastazama. Metastatska zahvaćenost Rotterovih čvorova uočena je u 2,8% bolesnica s negativnim aksilarnim čvorovima, odnosno u 34,6% bolesnica s pozitivnim aksilarnim čvorovima. S obzirom na lokaciju tumora u bolesnica s metastatskom zahvaćenosti Rotterovih čvorova, uočeno je da tumori u gornjim kvadrantima dojke češće metastaziraju u Rotterove limfne čvorove, što pokazuje znakovitu pozitivnu povezanost izme|u lokacije tumora u dojci i pozitivnih Rotterovih čvorova (r=0,93, p=0,02). Kad je riječ o veličini tumora, Rotterovi su čvorovi otkriveni u 15% bolesnica sa stadijem tumora T1 (5 cm) uz znakovitu pozivitnu povezanost (r=0,759, p=0,09). S obzirom na gradus tumora, tako|er je uočena metastatska zahvaćenost Rotterovih limfnih čvorova u 3,8% bolesnica s gradusom I, 17,6% bolesnica s gradusom II i 31,6% bolesnica s gradusom III uz znakovitu pozitivnu povezanost (r=0,993, p=0,08).
Rezultati pokazuju da je jedna petina bolesnica s rakom dojke, ili čak jedna trećina s pozitivnim aksilarnim limfnim čvorovima otpuštena iz bolnice s pozitivnim interpektoralnim limfnim čvorovima koji nisu dijagnosticirani, pa tako ni uklonjeni. Kako se ti čvorovi mogu ukloniti bez dodatne mutilacije, otkrivanje Rotterovih limfnih čvorova treba postati redovitom kliničkom praksom. Tumori smješteni u gornjim kvadrantima dojke češće metastaziraju u Rotterove čvorove, kao i tumori veće veličine i višega gradusa
