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Olivia Munn breast cancer hospital bed

Why Olivia Munn’s Breast Cancer Reveal Calls For Risk Assessment

CU Cancer Center member Nicole Christian, MD, talks about breast cancer risk assessment in younger women and those who have recently given birth.

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Written by Greg Glasgow on March 14, 2024

Bringing new attention to breast cancer in younger women and the importance of risk assessment, actress Olivia Munn, 43, announced Wednesday that she had been diagnosed with the disease last year. Munn said she has undergone four surgeries in the past 10 months, including a double mastectomy.

Munn played the role of Sloan Sabbith on the HBO drama “The Newsroom” and has appeared in movies including “X-Men: Apocalypse,” “The Lego Ninjago Movie,” and “Magic Mike.” She gave birth to a son, Malcolm — whom she welcomed with her partner, comedian John Mulaney — in late 2021. 

“I hope by sharing this it will help others find comfort, inspiration, and support on their own journey,” Munn wrote in an Instagram post that included pictures of her in a hospital bed.

Munn wrote that she had taken a genetic test for cancer in early 2023, with negative results, and that she underwent a normal mammogram around the same time. Her OBGYN, Munn said, decided to calculate her breast cancer risk assessment score, an analysis that takes into account factors such as age, familial breast cancer history, and the fact that Munn had her first child after age 30.

“She discovered that my lifetime risk was 37%,” Munn wrote. “Because of that score I was sent to get an MRI, which led to an ultrasound, which led to a biopsy. The biopsy showed I had luminal B cancer in both breasts. Luminal B is an aggressive, fast-moving cancer.”

Thirty days after her biopsy, Munn had surgery to remove both breasts. “I’m lucky,” she wrote. “We caught it with enough time that I had options. I want the same for any woman who might have to face this one day.  Ask your doctor to calculate your breast cancer risk assessment score.”

We spoke with University of Colorado Cancer Center member Nicole Christian, MD, assistant professor of surgical oncology in the CU Department of Surgery, about the importance of a breast cancer risk assessment as well as the risk of breast cancer in younger women and those who have recently given birth.

Q&A Header

In her Instagram post, Olivia Munn mentioned her OBGYN had calculated her breast cancer risk assessment score. What does that mean, exactly?

There are multiple tools to help assess risk that use a combination of personal and family history. In our High-Risk Breast Cancer Screening Program, we offer risk assessments for individual patients to help them decide what screening imaging to obtain. Depending on the context and the application of the tools, they could show different risk assessments because they use different pieces of information. So it's important to select the correct risk assessment tool for any individual woman. We typically use multiple risk assessment tools for our high-risk patients.

Does the risk of breast cancer go up when women have children?

I can’t speak to Olivia Munn’s specific situation, but given the age of her child, there’s a chance that this is a pregnancy-associated breast cancer. The hormonal changes that pregnancy brings about can, in some women, be associated with the development of cancer. These cancers are frequently detected late because of the way the body changes during and after pregnancy and delays in screening associated with breastfeeding. These cancers can be associated with more aggressive subtypes.

Munn is in her early 40s; is that a fairly common age to develop breast cancer?

Hers would be considered a young woman's breast cancer. The broad guideline of when women should start screening for breast cancer is around age 40. This is also an appropriate time for her to get a risk assessment to find out if she should get supplemental screening. The risk assessment can give you a tailored screening recommendation, as opposed to a generic recommendation of starting at age 40.

Is a double mastectomy common in a case like hers?

One of the important things about getting a risk assessment is to identify how to reduce one's risk. Sometimes that can include surgery. In her case it isn't a risk reduction, because she developed cancer at a young age, but deciding whether or not a double mastectomy is the right choice is a very personal decision that depends on the specific situation and the conversation between the patient and her doctor. 

After a double mastectomy, is a woman still at risk for cancer?

The treatment of invasive cancer involves treating the disease in the breast and treating the whole body to keep it from coming back anywhere else. When it’s caught early, the prognosis is excellent. But the challenge about cancer is its ability to come back, even though that is unlikely when it is caught early.

What advice would you just give to someone who is around Munn’s age and hasn't had a mammogram before?

If you're over age 40 and have never had a mammogram, I would recommend a mammogram. There are multiple risk calculators online that women can use themselves, or they can ask to be evaluated either by their primary care provider or at a high-risk screening program to assess their risk.

Is it helpful when a high-profile person like Munn reveals something like this that possibly gets people thinking more about their own personal situation or their own risk?

The most common non-skin cancer among women is breast cancer, and high-profile conversations about breast cancer does increase awareness, which improves early detection. 

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Nicole Christian, MD