'Cancer doesn't care who you are': Olivia Munn opens up about 'tough' mastectomy and a risk tool that 'saved' her life

Actress Olivia Munn says her breast cancer diagnosis came as a shock. Here's what you need to know.

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Olivia Munn at the 96th Annual Oscars held at Ovation Hollywood on March 10, 2024 in Los Angeles, California. (Photo by Gregg DeGuire/WWD via Getty Images)
Actress Olivia Munn secretly battled breast cancer and had both of her breasts removed in the last year. Here's what you need to know. (Photo by Gregg DeGuire/WWD via Getty Images)

Olivia Munn is sharing more about her recent battle with breast cancer that lead to a double mastectomy and medically induced menopause. The actress recently opened up to People in an exclusive interview, where she said her mind went to her son when she received the shocking diagnosis.

"I was not someone who obsessed over death or was afraid of it in any way... But having a little baby at home made everything much more terrifying," Munn, 43, told People.

You realize cancer doesn't care who you are; it doesn't care if you have a baby or if you don't have time... It comes at you, and you have no choice but to face it head-on.Olivia Munn, via People.

Her diagnosis came as a shock. Despite negative results from a comprehensive genetic test and a normal mammogram, Munn was diagnosed with an aggressive form of breast cancer, Luminal B, in both of her breasts. This diagnosis came after her OBGYN decided to calculate her Breast Cancer Risk Assessment Score, a move that Munn credits with saving her life.

When it came to removing her breasts, Munn revealed it was an emotional process. "I really tried to be prepared, but the truth is that nothing could prepare me for what I would feel like, what it would look like and how I would handle it emotionally. It was a lot tougher than I expected," she told People. As for the reconstruction, she said she wanted to "go smaller."

BEVERLY HILLS, CALIFORNIA - MARCH 10: John Mulaney and Olivia Munn attend the 2024 Vanity Fair Oscar Party hosted by Radhika Jones at Wallis Annenberg Center for the Performing Arts on March 10, 2024 in Beverly Hills, California. (Photo by Taylor Hill/Getty Images)
Munn told People that her husband, John Mulaney, has been by her side through her cancer battle, adding 'It would’ve felt like climbing an iceberg without him.' (Photo by Taylor Hill/Getty Images)

The actress previously shared her diagnosis over Instagram. "In February of 2023, I took a genetic test that checks you for 90 different cancer genes. I tested negative for all, including BRCA," Munn wrote. Yet, just two months later, following a normal mammogram, she faced a diagnosis that led to four surgeries and a challenging recovery.

"I've kept the diagnosis and the worry and the recovery and the pain medicine and the paper gowns private. I needed to catch my breath and get through some of the hardest parts before sharing," she admitted.

Munn's story is a reminder of the unpredictable nature of breast cancer. Despite having no genetic markers and a normal mammogram, her OBGYN's decision to delve deeper into her risk factors — age, family history, and timing of first childbirth — unveiled a 37 per cent lifetime risk of developing the disease. This led to further investigations (an MRI, an ultrasound and a biopsy).

"I went from feeling completely fine one day, to waking up in a hospital bed after a 10-hour surgery the next," Munn detailed. "I'm lucky. We caught it with enough time that I had options."

Breast cancer is the most common cancer among Canadian women, and is the second leading cause of death from cancer in Canadian women. But what exactly is the Breast Cancer Risk Assessment score and should you get one? Here's everything you need to know.

What is the Breast Cancer Risk Assessment?

Female holding tablet in front of body to display coloured x-ray illustrations made out of hand made paper structures
Early detection of breast cancer can significantly improve treatment outcomes. (Getty)

The Breast Cancer Risk Assessment Tool (BCRAT) is a crucial tool in the early detection and prevention of breast cancer. It involves evaluating various factors — including genetic history, lifestyle and reproductive history — to estimate a woman's risk of developing invasive breast cancer over the next five years and up to age 90.

The list of risks for developing breast cancer is long. According to the Canadian Cancer Society, some known risks include:

  • Personal history of breast cancer

  • Family history of breast and other cancers

  • BRCA gene mutations

  • Dense breasts

  • Certain genetic conditions

  • Other gene mutations

  • Ashkenazi Jewish ancestry

  • Reproductive history

  • Exposure to ionizing radiation

  • Hormone replacement therapy

  • Oral contraceptives

  • Atypical hyperplasia

  • Alcohol

  • Being obese

  • Physical inactivity

  • High socio-economic status

  • Tall adult height

In Canada, women who are over the age of 40 (in some places 50), are encouraged to receive mammograms (x-rays) to scan for cancerous tissue in the breasts, every two years. However, a mammogram "may not detect breast cancer even though it is present (called a false negative)," the Canadian Cancer Society explained.

Senior woman having mammography scan at hospital with medical technician. Mammography procedure, breast cancer prevention
A mammogram can give a false negative result. (Getty)

Munn's experience emphasizes the need for personalized screening plans. The Breast Cancer Risk Assessment Score, a tool used by her OBGYN, incorporates various factors to guide screening recommendations. This tool looks at factors like:

  • Age

  • Age at the start of menstruation

  • Age at first live birth of a child

  • Number of first-degree relative (mother, sisters, daughters) with breast cancer

  • Number of previous breast biopsies (whether positive or negative)

  • Presence of atypical hyperplasia in a biopsy

Dr. Michelle Specht, co-director of the Avon Comprehensive Breast Evaluation Center at Mass General Cancer Center, tells Yahoo Canada breast specialists in Canada use this tool "to help evaluate a woman for their risk of breast cancer." In addition to BCRAT, a test that's also routinely used in Ontario is the IBIS risk calculator.

In Canada, specifically among Ontario breast specialists, a 25 per cent or higher lifetime risk is used to refer a patient for breast MRI screening, Specht explained. In the U.S. a risk of 20 per cent and up is used.

"Mammograms do detect most cancers and therefore it’s the best tool for screening. MRIs can help with women at higher risk," the doctor added.

How important is early detection?

A pink ribbon on a pastel pink background. Breast cancer concept. In Canada, the five-year net survival for breast cancer in women is 89 per cent. (Getty)
In Canada, the five-year net survival for breast cancer in women is 89 per cent. (Getty)

Early detection of breast cancer can significantly improve treatment outcomes. In Canada, the five-year net survival for breast cancer in women is 89 per cent. However, those who are diagnosed with Stage 3 breast cancer have a 74 per cent change of a 5-year survival, and those with Stage 4 just 23 per cent.

Advanced screening methods, like MRIs and ultrasounds, can identify cancers that mammograms may miss, particularly in women with dense breast tissue or those at high risk.

Munn was diagnosed with Luminal B breast cancer, a subtype known for its aggressiveness and rapid growth. "Luminal B cancers are fueled by hormones and therefore respond to endocrine therapy like Tamoxifen. Unlike other estrogen-receptive cancers, they may have a slightly higher risk of recurrence, and be more sensitive to chemotherapy," Specht claimed. "More women with Luminal B may get hormonal therapy and chemotherapy."

The actress said early intervention, facilitated by her risk assessment, was crucial in providing her with treatment options, including a double mastectomy.

How can I get screened for breast cancer?

The Canadian Cancer Society advises Canadian women to talk to their doctor about screening for breast cancer. Canada federally recommends starting routine mammograms at 50, but access differs by province.

Specht said she recommends screening with a mammogram and if the patient has a family history of breast cancer, "they should do a risk assessment in order to determine their lifetime risk of breast cancer." Her recommendation is those with a lifetime risk greater than 20 per cent consider adding a breast MRI.

Recently, Ontario announced it is lowering its public mammogram age to 40 in fall of 2024 — a move that experts and patients have been calling for for years. Quebec recently expanded its range to include women aged 50 to 74. Regular mammograms are already available to B.C. women at the age of 40, every two years. Yahoo Canada has a rundown of access by each Canadian province.

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