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Related Concept Videos

Assessing Body Temperature - Axilla01:14

Assessing Body Temperature - Axilla

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Procedural Guide for Assessing Axillary Body Temperature using a Digital Thermometer:
Step 1: Perform hand hygiene and put on clean gloves to maintain infection control and prevent cross-contamination.
Step 2: Prepare the patient by explaining the procedure to ensure understanding and cooperation. Ensure privacy, expose the axilla, and inform the patient that minimal movement is crucial for an accurate reading.
Step 3: Adjust the patient’s clothing to expose only the axilla. It minimizes...
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Detailed Structure and Function of Lymph Nodes01:23

Detailed Structure and Function of Lymph Nodes

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Lymph nodes are bean-shaped structures that cluster along the lymphatic vessels in the inguinal, axillary, and cervical regions. Each node is divided into compartments by a capsule that extends trabeculae inward.
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
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Related Experiment Video

Updated: Oct 27, 2025

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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Rotter's Lymph Nodes-Do We Really Need to Remove During Axillary Clearance?

Arun Gowda Keelara1, C Satish2, H K Rudresh1

  • 1Department of General Surgery, M. S. Ramaiah Medical College, Bangalore, Karnataka 560054 India.

Indian Journal of Surgical Oncology
|July 23, 2021
PubMed
Summary

Routine removal of interpectoral lymph nodes (IPNs) during axillary dissection for node-positive breast cancer is recommended. IPN metastasis correlates with aggressive tumor features, suggesting prognostic and therapeutic value.

Keywords:
Breast cancer stagingEstrogen receptorsKi-67PathologyProgesterone receptorsRotter’s nodes

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Area of Science:

  • Surgical Oncology
  • Breast Cancer Management
  • Pathology

Background:

  • Axillary dissection is standard for node-positive breast cancer.
  • The role of interpectoral lymph node (IPN) removal (Rotter's nodes) is debated due to low reported involvement.
  • Standardized axillary management protocols are needed to reduce recurrence and morbidity.

Purpose of the Study:

  • To assess the detection rate of lymph nodes in the Rotter's region.
  • To determine the metastasis rate in IPNs for node-positive breast cancer patients.
  • To analyze the prognostic and therapeutic significance of IPN excision during axillary clearance.

Main Methods:

  • A study of 56 patients aged ≥18 undergoing axillary clearance for node-positive breast cancer.
  • Exclusion of patients with recurrence or prior neoadjuvant chemotherapy.
  • Pre-operative investigations including core needle biopsy, ER, PR, and Ki-67 status assessment. Statistical analysis using Kruskal Wallis and Chi-square tests (R v 3.6.0).

Main Results:

  • Interpectoral lymph nodes (IPNs) were identified in 35.71% (20/56) of patients.
  • Metastasis prevalence in identified IPNs was 27.27% (9/33 node-positive patients).
  • IPN metastasis was associated with larger tumor size, advanced TNM classification, lower estrogen receptor (ER)/progesterone receptor (PR) expression, and higher Ki-67 positivity.

Conclusions:

  • Routine dissection and separate histopathological examination of IPNs during axillary clearance are advisable.
  • IPN status provides valuable prognostic information in node-positive breast cancer.
  • Inclusion of IPN assessment may refine staging and treatment strategies.