Olivia Munn's Breast Cancer Journey
- Actress Olivia Munn, 44, beat hormone receptor-positive (HR+) breast cancer, a disease her husband insists a lifetime breast assessment risk test was the “only reason” the disease was diagnosed.
- The “X-Men: Apocalypse” star had both her breasts removed, a hysterectomy, removing her uterus, as well as surgeries to remove her fallopian tubes and ovaries. After preserving her fertility and undergoing an egg retrieval, she is now taking medication to help prevent cancer recurrence.
- The Breast Cancer Risk Assessment Munn credits to saving her life is a “statistical model that allows healthcare professionals to calculate the probability of a woman developing breast cancer throughout their lifetime,” Dr. Ruth Oratz, breast medical oncologist at NYU Langone, tells SurvivorNet. It assesses a woman’s age, family history with breast cancer when she first had a menstrual period, and her reproductive history to determine her risk of breast cancer.
- Genetic testing for breast cancer is done to determine if a person has a specific mutation that puts them at a higher risk of developing cancer.
- Like anything in life, there are limitations to genetic testing for breast cancer, specifically the commercially available tests women can take. And one of those limitations is the lack of genetic counseling available to people who receive positive results on a genetic test.
The 44 -year-old mom of two, who also acted in the HBO political drama series “The Newsroom,” was diagnosed with hormone receptor-positive (HR+) breast cancer, which means that the hormones estrogen or progesterone stimulate cancer cell growth. She fought the disease with a hysterectomy (removal of the uterus) and additional surgeries to remove her fallopian tubes and ovaries (oophorectomy).
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He also shared how much he admired his wife, saying, “I have this feeling a lot of times, I go, ‘I can’t believe I know this person, let alone am married to her.”
In regard to how his life has been as a dad to him and Munn’s two beautiful children, Mulaney added, “I’m in the world now that I’m a father. My head was my only home before that.
“When my son was born, the first thought I had was, ‘Oh, there you are.’ And when my daughter was born, I had this, not to sound ‘woo-woo’ or anything, but when she was born, I went, ‘Oh!’ My thought was like, ‘Oh, we’ve met before. I’ve collided with you some other time.’ So, it’s like these people came in that just, I don’t know, make me like the world a lot more.”
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Last year, Mulaney also commented on life as a dad, when he hosted a Nov. 2 episode of Saturday Night Live.
The comedian said in his monologue, “My wife and I just welcomed a baby girl into our family.We have a five-week-old daughter, and a 2-year-old son. My wife takes care of the five-week-old, and I take the 2-year-old out. And that’s not fair.
“That’s not an equal distribution of labor at all. Saying, ‘You have a five-week-old, I’ll take a 2-year-old.’ That’s like saying, ‘I’ll transport this convict across state lines. You hold a potato.'”
Shortly before his SNL appearance, Mulaney again commended his wife at InStyle’s Imagemaker Awards, saying, “Olivia saving lives by speaking her truth is not surprising to me,” adding how she is “constantly trying to keep me out of danger and keep me alive through a series of texts throughout our entire relationship.”
He continued, “She shared her story to help anyone she could. According to the National Cancer Institute, in the week after Olivia shared the story of her breast cancer journey, there was a 4,000 percent increase in women visiting the breast cancer risk assessment. That was the first week.”
“We learned a lot from it. We learned she would need five surgeries. We learned there was a risk of lymphedema. We learned that if we had not caught it when we caught it, things could have been a lot worse,” Mulaney added.
Olivia’s Breast Cancer Journey
Olivia Munn’s breast cancer diagnosis emerged despite receiving a “normal” mammogram and testing negative for the BRCA-gene mutation, which increases your risk for breast and ovarian cancer.
At the suggestion of her OBGYN, the actress underwent a Breast Cancer Risk Assessment, which helps determine a woman’s probability of getting breast cancer. Her results called for additional screening, which revealed she had an aggressive form of cancer in both of her breasts.
“I wouldn’t have found my cancer for another year – at my next scheduled mammogram – except that my OBGYN…decided to calculate my Breast Cancer Risk Assessment Score. The fact that she did save my life,” Munn said in an Instagram post, shared in March 2024.
The Breast Cancer Risk Assessment she credits for catching her breast cancer is a “statistical model that allows healthcare professionals to calculate the probability of a woman developing breast cancer over the course of their lifetime,” Dr. Ruth Oratz, breast medical oncologist, NYU Langone Health’s Perlmutter Cancer Center; clinical professor of medicine, NYU Grossman School of Medicine tells SurvivorNet.
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Munn underwent genetic testing to better understand her cancer risk. Genetic tests can be as simple as a simple saliva swab or blood sample. The results help your care team determine if you have a specific mutation that puts you at higher risk for cancer. The results help doctors tailor your treatment and are helpful for breast cancer patients.
“I tested negative for all (different cancer genes), including BRCA,” Munn said.
The BRCA1 and BRCA2 gene mutations are among the most important genes to look for in breast cancer. Together, they are responsible for about half of all hereditary breast cancers. These genes prevent cells from dividing haphazardly and uncontrollably in a person without mutations. Mutations prevent these genes from doing their job and can allow unchecked growth of breast, ovarian, and other tissues.
Two months after undergoing genetic testing, Munn was diagnosed with Luminal B breast cancer in both of her breasts.
Expert Breast Cancer Resources
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- Breast Cancer Risk For Post Menopausal Women — Taking Hormones Can Increase Your Risk
- Alcohol Can Increase the Risk of Developing Breast Cancer
- How Does Molecular Testing Help Determine the Best Breast Cancer Treatment Option?
According to research in “Breast Cancer,” luminal B tumors are of a “higher grade” and tend to have a worse prognosis. This type of breast cancer is estrogen-positive (ER), meaning it is fueled by the hormone estrogen. It can also be progestogen (PR) negative, meaning it is not fueled by progestogen. This type of breast also tends to have a higher expression of the Ki67 protein, making it grow quickly. Hormonal therapy and chemotherapy are often used to treat this type of cancer. Luminal is one of several types and is distinguished by its molecular makeup.
What Are the Options if You Have a High Risk of Developing Breast Cancer?
Learning More About Breast Risk Assessment & Genetic Testing
The Breast Cancer Risk Assessment Munn credits for catching her breast cancer is a “statistical model that allows healthcare professionals to calculate the probability of a woman developing breast cancer over the course of their lifetime,” Dr. Ruth Oratz, breast medical oncologist, NYU Langone Health’s Perlmutter Cancer Center; clinical professor of medicine, NYU Grossman School of Medicine explained to SurvivorNet.
Genetic Testing for Breast Cancer: What is This Type of Test? And What Do My Results Mean?
As for genetic testing, it can be as simple as a simple saliva swab or blood sample. The results help your care team determine if you have a specific mutation that puts you at higher risk for cancer. Additionally, genetic testing aids doctors in tailoring your specific treatment, therefore very helpful for breast cancer patients.
BRCA Gene Mutations
When Olivia Munn said she “tested negative for all [different cancer genes], including BRCA,” she was referring to the BRCA1 and BRCA2 gene mutations, which are among the most important genes to look for in breast cancer.
How Testing For BRCA In Breast Cancer Works
Together, they are responsible for about half of all hereditary breast cancers. These genes prevent cells from dividing haphazardly and uncontrollably in a person without mutations. Mutations prevent these genes from doing their job and can allow unchecked growth of breast, ovarian, and other tissues.
Dr. Oratz says if the Breast Cancer Risk Assessment finds that a woman is at higher risk of getting breast cancer, she should expect further testing and screening. However, if a woman is positive for the BRCA gene mutation, a Breast Cancer Risk Assessment “is not really accurate.”
“Having information empowers patients,” Dr. Oratz added. “It is very important for people to be aware of the health risks, their family history, and their own personal medical conditions. All of these things can affect the risk of developing cancer.”
According to the National Cancer Institute, about “13% of women” in the general population will develop breast cancer sometime during their lives. By contrast, 55% to 72% of women who inherit a harmful BRCA1 or BRACA2 variant will develop breast cancer by 70 to 80 years of age.
Between 5% and 10% of breast cancer cases are thought to be hereditary. And about 10% of patients who undergo genetic testing will test positive for the BRCA1 or BRCA2 gene, Dr. Julie Rani Nangia, an assistant professor at Baylor College of Medicine, previously told SurvivorNet.
“The genetic BRCA1 and (BRCA)2 mutations, if a woman has one of these mutations … it puts her at basically the highest quantifiable risk for getting breast cancer,” Dr. Elisa Port, a surgical oncologist at Mount Sinai, also told SurvivorNet in an earlier interview.
“We typically say between the 60 (percent) and 80 percent range. Having a BRCA1 and (BRCA)2 mutation also means that that person is at higher risk of getting breast cancer at an earlier age, and also maybe at risk for other cancers like ovarian cancer, like pancreatic cancer for men, prostate cancer and male breast cancer may be a concern.”
Since the discovery of the BRCA mutations in the 1990s, doctors have gone on to identify many other gene mutations that put people at a higher risk of developing breast cancer.
“There’s actually eight to 10 genes that also can put someone at a higher risk for breast cancer,” Dr. Port says, adding that usually that risk isn’t as high as the BRCA mutations. These additional gene mutations include PALB2, ATM, TP53, CHEK2, PTEN, CDH1 and STK11.
Should I Get Genetic Testing to Assess My Risk for Breast Cancer?
“We call them more moderate penetrance genes and those genes, the risk of breast cancer associated with them can be anywhere from say 20 percent to 50 percent. … so still very high, but lower than the BRCA genes that were the ones we originally described.”
The PALB2 gene is a “moderate penetrance gene, and the risk of getting breast cancer with PALB2 can be a pretty broad range,” Dr. Port says. “And unlike the BRCA genes where we don’t really use the family history of who got breast cancer to affect the risk estimates, with PALB2, you really can dial up risk or dial down risk depending on how many relatives and the age of the relatives in the family got breast cancer.”
Limitations of Genetic Testing
Like anything in life, there are limitations to genetic testing for breast cancer, specifically the commercially available tests women can take. One of the most common types of commercially available tests is from 23andMe, a genomics and biotechnology company, as well as tellmeGen and MyHeritage genetic tests.
“There’s only a cadre of them that are approved and accurate and there can be both false positives and false negatives, so it really depends,” Dr. Port says. “If someone is suspicious of having one of these genes (mutations) and gets tested through one of what we call the direct to consumer type tests, it is important that those testing results may need to be verified before doing something irreversible based on those results.”
In other words, if you take one of these tests without your doctor’s knowledge, and you receive some concerning results, make sure you discuss those results with your doctor before taking your next steps.
The other limitation to genetic testing is genetic counseling. Dr. Port says this is the most critical part of genetic testing. What does genetic counseling mean? Well, if you get a positive result back, how are you going to cope with that news?
“If someone gets a genetic test result back, it’s really important for them to know what is this? (What does this) mean for them? Put it into context.”
“What does it mean for their family members? For their relatives? Genetic counseling to follow up genetic testing is a really, really important part of the whole process and is not always available in the direct to consumer type avenue.”
Based on your personal and family health history, your doctor can refer you for genetic counseling, according to the U.S. Centers for Disease Control and Prevention.
What to Know About Screening For Breast Cancer
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
WATCH: Screening for Breast Cancer
For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women who have a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
“We encourage only those who have a family history to really get [genetic testing],” Dr. Ginsburg previously told SurvivorNet.
“I would say that if you have anyone in your family who was diagnosed with a very rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome,” Dr. Ginsburg adds.
Contributing: SurvivorNet Staff
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