The nurse is taking a history of a 68-year-old woman. What assessment findings would indicate a high risk for the development of breast cancer? (Select all that apply)

A. Osteoporosis: Osteoporosis is related to low bone mineral density and estrogen deficiency but is not directly associated with an increased risk of breast cancer. In fact, lower lifetime estrogen exposure (which can contribute to osteoporosis) may slightly reduce breast cancer risk, making this finding less relevant as a risk factor. B. History of multiple births: Having multiple full-term pregnancies (multiparity) generally decreases the risk of breast cancer by reducing lifetime exposure to estrogen and progesterone. This protective factor does not indicate high risk. C. Age greater than 65 years: Advanced age is a significant risk factor for breast cancer because the cumulative lifetime exposure to estrogen and the increased likelihood of genetic mutations over time elevate cancer risk. Most breast cancers are diagnosed in women over 60. D. Early menarche: Menarche before age 12 increases lifetime estrogen exposure, which is associated with higher risk of developing breast cancer. Prolonged exposure to estrogen stimulates breast tissue and can increase susceptibility to malignant transformation. E. Increased breast density: Dense breast tissue contains more glandular and fibrous tissue, which is associated with a higher risk of breast cancer and can also make mammograms less sensitive, delaying detection. F. Genetic factors: A family history of breast cancer, particularly mutations in the BRCA1 or BRCA2 genes, significantly increases an individual’s lifetime risk of developing breast cancer. Genetic predisposition is one of the strongest risk factors.