An emergency department (ED) is a complex scene where various diseases and processes are intertwined. Annually, over 4.8 million patients visit EDs in Korea, and 137.8 million visit EDs in the United States [1,2]. Moreover, the number of patients and the severity of their complaints are increasing due to aging of the population and advances in emergency medicine [3]. When resources are not sufficient, the increased load on EDs results in a poor quality of care, which leads to a suboptimal outcome [4]. Triage systems have been developed where demand is greater than supply [5]. The purpose of triage in an ED is to prioritize patients to allocate clinical resources as beds

Background: The aim of this study was to investigate the relationship between changes in breast density during menopause and breast cancer risk. Methods: This study was a retrospective, longitudinal cohort study for women over 30 years of age who had undergone breast mammography serially at baseline and postmenopause during regular health checkups at Samsung Medical Center. None of the participants had been diagnosed with breast cancer at baseline. Mammographic breast density was measured using the American College of Radiology Breast Imaging Reporting and Data System. Results: During 18,615 person-years of follow-up (median follow-up 4.8 years; interquartile range 2.8–7.5 years), 45 participants were diagnosed with breast cancer. The prevalence of dense breasts was higher in those who were younger, underweight, had low parity or using contraceptives. The cumulative incidence of breast cancer increased 4 years after menopause in participants, and the consistently extremely dense group had a significantly higher cumulative incidence (CI) of breast cancer compared with other groups [CI of extremely dense vs. others (incidence rate per 100,000 person-years): 375 vs. 203, P < 0.01]. Conclusion: Korean women whose breast density was extremely dense before menopause and who maintained this density after menopause were at two-fold greater risk of breast cancer. Prevention Relevance: Extremely dense breast density that is maintained persistently from premenopause to postmenopause increases risk of breast cancer two fold in Korean women. Therefore, women having risk factors should receive mammography frequently and if persistently extremely dense breast had been detected, additional modalities of BC screening could be considered.

<div>AbstractBackground:<p>The aim of this study was to investigate the relationship between changes in breast density during menopause and breast cancer risk.</p>Methods:<p>This study was a retrospective, longitudinal cohort study for women over 30 years of age who had undergone breast mammography serially at baseline and postmenopause during regular health checkups at Samsung Medical Center. None of the participants had been diagnosed with breast cancer at baseline. Mammographic breast density was measured using the American College of Radiology Breast Imaging Reporting and Data System.</p>Results:<p>During 18,615 person-years of follow-up (median follow-up 4.8 years; interquartile range 2.8–7.5 years), 45 participants were diagnosed with breast cancer. The prevalence of dense breasts was higher in those who were younger, underweight, had low parity or using contraceptives. The cumulative incidence of breast cancer increased 4 years after menopause in participants, and the consistently extremely dense group had a significantly higher cumulative incidence (CI) of breast cancer compared with other groups [CI of extremely dense vs. others (incidence rate per 100,000 person-years): 375 vs. 203, <i>P</i> < 0.01].</p>Conclusion:<p>Korean women whose breast density was extremely dense before menopause and who maintained this density after menopause were at two-fold greater risk of breast cancer.</p>Prevention Relevance:<p>Extremely dense breast density that is maintained persistently from premenopause to postmenopause increases risk of breast cancer two fold in Korean women. Therefore, women having risk factors should receive mammography frequently and if persistently extremely dense breast had been detected, additional modalities of BC screening could be considered.</p></div>

<p>Hazard ratios (95% CI) for the incidence of breast cancer by change in breast density among participants who had scattered fibroglandular or heterogeneously dense breasts premenopause</p>