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

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.