A nurse reviews the health history of a client who will be seeing the health care provider to obtain a prescription for a combination oral contraceptive. Which finding would cause the nurse to determine that use is contraindicated?

• A. The client has hyperlipidemia.
• B. The client has been treated for breast cancer.
• C. The client is being treated for hypertension.
• D. The client has type 2 diabetes mellitus.

Answer: (B)

Using an estrogen-containing combination oral contraceptive is not appropriate for someone being treated for breast cancer because estrogen can stimulate hormone-sensitive breast tissue. If the cancer is estrogen receptor–positive or has a history of estrogen-driven growth, adding estrogen through the pill could promote tumor growth or recurrence. That direct hormonal influence on breast cancer makes this method contraindicated.

Hyperlipidemia, hypertension, and type 2 diabetes mellitus raise considerations for contraceptive choice and may necessitate precautions or alternative methods, but they do not universally rule out estrogen-containing pills. The presence of active breast cancer presents a clear, direct contraindication due to the potential impact of estrogen on tumor behavior.