Objective To investigate the rates of interpectoral lymph node (IPN) metastasis in breast cancer patients with different clinicopathological characteristics, and to provide reference for the management strategy of IPN during axillary lymph node dissection. Methods Keywords, such as "interpectoral nodes, interpectoral lymph nodes, Rotter's nodes" (in English or in Chinese), were searched in the PubMed, EMBASE, The Cochrane Library, CNKI, Wanfang data, VIP, etc. Two researchers independently screened, reviewed and extracted the data, and collected the detection rate, metastasis rate and relevant clinicopathological characteristics of IPN. RevMan 5.3 software was used to conduct a meta-analysis on the detection rate and metastasis rate of IPN, analyzing the relationship among clinical stage of breast cancer, axillary lymph node metastasis and IPN metastasis rate. Results A total of 21 studies with 8 418 patients were included. Random-effect model was used in the meta-analysis, and the combined analysis results showed that the detection rate of IPN was 36% (95% CI 28%-44%, P<0.01) among the 19 studies with 8 119 patients, and the overall metastasis rate was 8% (95% CI 6%-9%, P<0.01) among the 20 studies with 8 178 patients. A total of 11 studies analyzed the relationship between the clinical stage of breast cancer and the IPN metastasis rate, and the IPN metastasis rate in patients with stage Ⅲ was significantly higher than those in patients with stage Ⅰ or Ⅱ in 6 of these studies (all P<0.05). A total of 15 studies analyzed the relationship between the axillary lymph node metastasis and the IPN metastasis rate, and the IPN metastasis rate was significantly higher in the axillary lymph node metastasis group than that in the non-metastasis group in 12 of these studies (all P<0.05). Conclusion IPN dissection is not necessary for most breast cancer patients undergoing ALND, but for stage Ⅲ patients with axillary lymph node metastasis, IPN dissection is recommended during axillary lymph node dissection.