If the server is compromised by an attacker who manages to get local administrator rights, the data is already compromised even with BUILTIN\Administrators removed.
Attack Vector 1:
Stop SQL Server service. Copy off all user database files. Restart SQL Server service. And the attacker merely needs to re-attach the files to his/her own SQL Server. Even with EFS, the local administrator usually has the ability to recover the encrypted files for a given server. With local admin rights, the attacker resets the administrator password and then uses it to get to the database files. Other 3rd party encryption tools are handy here.
Attack Vector 2:
Grab backup file (most backups are going to go to the file system at least initially). Copy backup file. Restore it. Even if password protected, this doesn't encrypt the backup file. While restore may be more difficult, the data is plain to see. Here is where a product like SQL Litespeed is handy.
Attack Vector 3:
Install sniffer to monitor the traffic passing across the NIC to/from SQL Server. Since we're only interested in the traffic for this server, the NIC doesn't have to go into promiscuous mode. Unless stream is encrypted with SSL, data goes across in a TDS packet in a known format. SQL Server logins do as well and the encryption is trivial to crack.
Attack Vector 4:
Take advantage of Act as Part of the Operating System right to impersonate the SQL Server service account without requiring authentication. Force connection to SQL Server and use sp_grantlogin and sp_addsrvrolemember to place BUILTIN\Administrators back into the sysadmin fixed server role.
Description of Act as part of the operating system
K. Brian Kelley