Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer

Abstract Thoracic aortic dilatations (TADs) are commonly detected incidentally. A TAD may develop into aortic aneurysm and subsequently lead to aortic dissection, a highly lethal condition. Earlier detection of TADs could improve the surveillance and surgical management of aneurysms, potentially red...

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Main Authors: Aada Lattu, Petteri Kauhanen, Ari Mennander, Marja Hedman, Mona Laaksonen, Irina Rinta-Kiikka, Tanja Skyttä, Otso Arponen
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-94420-4
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author Aada Lattu
Petteri Kauhanen
Ari Mennander
Marja Hedman
Mona Laaksonen
Irina Rinta-Kiikka
Tanja Skyttä
Otso Arponen
author_facet Aada Lattu
Petteri Kauhanen
Ari Mennander
Marja Hedman
Mona Laaksonen
Irina Rinta-Kiikka
Tanja Skyttä
Otso Arponen
author_sort Aada Lattu
collection DOAJ
description Abstract Thoracic aortic dilatations (TADs) are commonly detected incidentally. A TAD may develop into aortic aneurysm and subsequently lead to aortic dissection, a highly lethal condition. Earlier detection of TADs could improve the surveillance and surgical management of aneurysms, potentially reducing aortic ruptures. The opportunistic use of thoracic sectional imaging studies performed for other indications, including breast radiation therapy planning, could be used to detect TADs. However, the frequency of TADs and the clinical risk factors for TADs in females undergoing adjuvant breast radiation therapy remain unknown. We retrospectively collected a consecutive cohort of 861 females with breast cancer who underwent adjuvant radiotherapy planning with computed tomography (CT). Using CT scans, we manually measured thoracic aortic dimensions on the hospital’s dedicated picture archiving and communication software (PACS). Following the European Society of Cardiology guidelines, a segment of the aorta was considered dilated when its maximal diameter exceeded 40 mm. Additionally, we collected clinical patient data regarding known risk factors predisposing patients to TADs. Out of 861 patients, 80 (9.3%) had a TAD. Compared to those without any TADs, patients with at least one TAD were older (71.3 ± 9.7 years vs. 62.9 ± 11.7 years; P < .001) and more frequently displayed hypertension (62 [77.5%] vs. 354 [45.3%], P < .001), a history of a TIA or stroke (10 [12.5%] vs. 36 [4.6%], P = .007), and aortic valve insufficiency (10 [12.5%] vs. 51 [6.5%], P = .047). The opportunistic use of radiotherapy planning CT scans allows earlier TAD diagnosis, and a significantly large number of female patients (9.3%) had at least one abnormal thoracic aortic dimension. This finding could indicate a need to consider a systematic screening of TADs in patients undergoing adjuvant radiotherapy.
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spelling doaj-art-1e4dbc1be95d4c648c1b45db7ca17b7c2025-08-20T04:01:34ZengNature PortfolioScientific Reports2045-23222025-07-011511710.1038/s41598-025-94420-4Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancerAada Lattu0Petteri Kauhanen1Ari Mennander2Marja Hedman3Mona Laaksonen4Irina Rinta-Kiikka5Tanja Skyttä6Otso Arponen7Department of Radiology, Tampere University HospitalClinical Radiology, Clinical Imaging Center, Kuopio University HospitalTampere University Heart Hospital, Cardiac Research and Faculty of Medicine and Health Technology, Tampere UniversityClinical Radiology, Clinical Imaging Center, Kuopio University HospitalFaculty of Medicine and Health Technology, Tampere UniversityDepartment of Radiology, Tampere University HospitalFaculty of Medicine and Health Technology, Tampere UniversityDepartment of Radiology, Tampere University HospitalAbstract Thoracic aortic dilatations (TADs) are commonly detected incidentally. A TAD may develop into aortic aneurysm and subsequently lead to aortic dissection, a highly lethal condition. Earlier detection of TADs could improve the surveillance and surgical management of aneurysms, potentially reducing aortic ruptures. The opportunistic use of thoracic sectional imaging studies performed for other indications, including breast radiation therapy planning, could be used to detect TADs. However, the frequency of TADs and the clinical risk factors for TADs in females undergoing adjuvant breast radiation therapy remain unknown. We retrospectively collected a consecutive cohort of 861 females with breast cancer who underwent adjuvant radiotherapy planning with computed tomography (CT). Using CT scans, we manually measured thoracic aortic dimensions on the hospital’s dedicated picture archiving and communication software (PACS). Following the European Society of Cardiology guidelines, a segment of the aorta was considered dilated when its maximal diameter exceeded 40 mm. Additionally, we collected clinical patient data regarding known risk factors predisposing patients to TADs. Out of 861 patients, 80 (9.3%) had a TAD. Compared to those without any TADs, patients with at least one TAD were older (71.3 ± 9.7 years vs. 62.9 ± 11.7 years; P < .001) and more frequently displayed hypertension (62 [77.5%] vs. 354 [45.3%], P < .001), a history of a TIA or stroke (10 [12.5%] vs. 36 [4.6%], P = .007), and aortic valve insufficiency (10 [12.5%] vs. 51 [6.5%], P = .047). The opportunistic use of radiotherapy planning CT scans allows earlier TAD diagnosis, and a significantly large number of female patients (9.3%) had at least one abnormal thoracic aortic dimension. This finding could indicate a need to consider a systematic screening of TADs in patients undergoing adjuvant radiotherapy.https://doi.org/10.1038/s41598-025-94420-4Thoracic aortic dilatationBreast cancerIncidental findingRadiotherapyComputer tomography
spellingShingle Aada Lattu
Petteri Kauhanen
Ari Mennander
Marja Hedman
Mona Laaksonen
Irina Rinta-Kiikka
Tanja Skyttä
Otso Arponen
Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer
Scientific Reports
Thoracic aortic dilatation
Breast cancer
Incidental finding
Radiotherapy
Computer tomography
title Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer
title_full Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer
title_fullStr Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer
title_full_unstemmed Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer
title_short Prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning CT scans in patients with breast cancer
title_sort prevalence and risk factors of thoracic aortic dilatation detected incidentally in adjuvant radiotherapy planning ct scans in patients with breast cancer
topic Thoracic aortic dilatation
Breast cancer
Incidental finding
Radiotherapy
Computer tomography
url https://doi.org/10.1038/s41598-025-94420-4
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