breast cancer risk q

[MudPhud20XX]

A 58 yr old woman with a 20 yr history of smoking has a history of breast cancer in her mother. Her diet is poor in fiber and rich in saturated fats. Menarche occurred at 13 yrs of age and menopause began at 52 yrs of age. She has had 3 children. She had a cervical conization at 28 yrs of age for severe cervical dysplasia and has since had normal cervical Pap smears. Which of the following is her greatest risk factor for the breast cancer?
A. Age
B. Family hx
C. Smoking hx
D. Severe cervical dysplasia
E. Low fiber, high saturated fat diet

So I am debating between A and B. Isn't the age the #1 risk factor for breast cancer?

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[Transposony]

I'll go with B since she is only 58 yrs old.
However, Age has RR of >4 as compared to RR of >2 with Hx of Breast Ca in a first degree relative.

Factors that increase the risk of breast cancer include the following:

Advanced age
Family history of cancer in a first-degree relative – Family history of ovarian cancer at < 50 years, 1 first-degree relative with breast cancer, ≥2 first-degree-relatives with breast cancer
Personal history – Positive BRCA1/BRCA2 mutation, breast biopsy with atypical hyperplasia, breast biopsy with lobular or ductal carcinoma in situ
Reproductive history – Early menarche (< 12 years), late menopause, late age of first term pregnancy (>30 years) or nulliparity
Use of estrogen-progesterone hormone replacement therapy (HRT)
Current or recent oral contraceptive use
Lifestyle factors – Adult weight gain, sedentary lifestyle, alcohol consumption

 

[MudPhud20XX]

yeah that's exactly what I thought, age would beat the first degree relative. This is one of the Goljan questions and he actually said the answer was B.

 

[nidusiamnot]

Age it is, even though she didn't have early menarche or late menopause. Kinda makes me wonder who's making these rules up. Just because the incidence is higher in older women doesn't mean that it should be considered a greater risk factor than a first degree relative...

 

[Transposony]

yeah that's exactly what I thought, age would beat the first degree relative. This is one of the Goljan questions and he actually said the answer was B.

Maybe, the age factor is considered when over 60 yo that's why they gave the age as 58 yo.
The keyword here being "Advanced" Age.