Actress Olivia Munn's message after breast cancer: Get risk assessment, know your score
Olivia Munn is an A-list celebrity and accomplished film star.
But no doubt her most important role is one she recently disclosed to the public: breast cancer survivor.
A couple of days after attending last month’s Academy Awards ceremony with boyfriend and father of her child, standup comedian John Mulaney, Munn, 43, stunned the entertainment world when she made the following revelation on Instagram: "In the past ten months I have had four surgeries, so many days spent in bed I can't even count and have learned more about cancer, cancer treatment and hormones than I ever could have imagined. Surprisingly, I've only cried twice."
Among the procedures she endured was a double mastectomy.
Equally notable were some of the unique details about how she was diagnosed, as well as that she has brought public awareness to a health-care tool she and her doctor discussed — and was instrumental in leading to her diagnosis — her “breast cancer risk assessment score.”
Munn's mammogram was negative
Munn’s most recent mammogram, in early 2023, came back negative.
She explained that in February 2023 she and her sister also took a genetic test that looked for “90 different cancer genes” — including the BRCA1 and BRCA2 genetic mutations, which are associated with increased risk for breast cancer.
After learning they were both were negative for all cancer genes, she said “we called each other and high-fived over the phone.”
Nevertheless, Munn’s doctor decided to look at her breast cancer risk assessment score, which considered factors such as “age, familial breast cancer history, and the fact that I had my first child after the age of 30.”
Munn’s lifetime cancer risk was calculated at 37%.
Her OB-GYN, Dr. Thais Aliabadi, told her that if one’s risk score “is greater than 20%, then you need annual mammograms and breast MRIs starting at age 30.”
Sure enough, Munn’s MRI led to an ultrasound and then biopsies — which revealed that she had “an aggressive fast-moving cancer” in both breasts.
Munn believes the only reason her cancer was “caught early” is that she trusted Aliabadi’s instincts and underwent the MRI.
That’s why in thanking her team of oncology physicians, she called Aliabadi her “guardian angel.”
Understanding breast cancer risk assessment scores
According to Cleveland Clinic there are about two dozen breast cancer risk assessment models.
Generally speaking, the models take into account the following factors:
Age: Breast cancer risk increases with age.
Family history: A family history of breast cancer (especially a first-degree relative or multiple cases within one’s family) increases one's risk.
Genetic mutations: Carrying mutated copies of the BRCA1 or BRCA2 genes increases one’s risk.
Race/ethnicity: Certain ethnic groups are at a higher risk. For example, people of Ashkenazi Jewish descent are more likely to develop breast cancer because they’re more likely to inherit BRCA1or BRCA2 genetic mutations.
Breast density: People with dense breast tissue are more likely to develop breast cancer than people with mostly fatty breast tissue.
Previous breast biopsies: People who’ve had breast biopsies with abnormal results are at a greater risk of developing breast cancer.
Hormone exposure: Long-term exposure to high estrogen or progesterone levels can increase one's risk. This includes exposure to the hormones the body naturally produces during the menstrual cycle. It also includes exposure through medication, such as birth control pills or hormone replacement therapy.
Age when menstruation started: Starting menstruation at a younger age exposes one to hormones for a longer period of time, thus increasing the breast cancer risk.
Age when menstruation stopped: Experiencing menopause at an older age also exposes one to hormones for a longer period of time — again increasing risk.
Childbirth history: People who haven’t given birth are at increased risk of developing breast cancer. That’s because they’ve have more menstruation periods, which means they’ve been exposed to hormones for longer than people who’ve given birth. On a related note, breast cancer risk decreases if a person has given birth, especially if the mother did so before the age of 35. One’s breast cancer risk is further decreased with each subsequent child the mother gives birth to.
Breast cancer risk assessment tests are available to be taken online. They usually can be completed in 10 or fewer minutes. Among the commonly used models are the following:
The Gail model (BCRAT): The oldest and most popular risk assessment tool, it predicts a person’s risk of developing invasive breast cancer within five years and up to age 90.
IBIS (Tyrer-Cuzik model): It predicts the likelihood of developing cancer within 10 years or within one’s lifetime.
Breast Cancer Surveillance Consortium’s (BCSC) Risk Calculator: It predicts one’s chances of developing invasive breast cancer within the next five years or metastatic breast cancer within the next six years.
BRCAPRO: It predicts the likelihood one has the BRCA1 or BRCA2 genetic mutation based on family history.
Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA): It calculates risk for both breast cancer and ovarian cancer and relies largely on family history and genetic information.
Black Women’s Health Study (BWHS) Breast Cancer Risk Calculator: It predicts the risk of developing invasive breast cancer within the next five years for people who are Black.
While it’s important to remember that all breast cancer risk assessment scores are simply tools for you and your doctor to consider when making important health-related decisions, Munn is certain that the information helped save her life.
That’s why her Instagram post urged everyone: “Ask your doctor to calculate your Breast Cancer Risk Assessment Score.”
This article originally appeared on Palm Beach Post: Actress Olivia Munn survived breast cancer thanks to early detection
