Life After Breast Cancer
- Olivia Munn, who welcomed her second child via gestational surrogate a few weeks ago, has taken to social media to share some joyous moments with her daughter Méi June Mulaney. In addition to offering her fans some insight into her life as a mom of two, Munn has decided to further spread breast cancer awareness after her battle with hormone receptor-positive (HR+) breast cancer.
- Munn has 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.
- Women are encouraged to talk with their doctor about how their cancer treatment may affect their fertility and what options make sense for them to preserve their fertility beforehand.
- The U.S. Preventive Services Task Force recommends women at average breast cancer risk begin screening at age 40. Women with the BRCA gene mutation, who have a family history of cancer, or have dense breasts are at higher risk and should talk with doctors about screening earlier.
- SurvivorNet experts recommend performing a monthly breast self-exam to look for anything unusual with your breasts as well.
The 44-year-old actress, also known for acting in the TV show “The Newsroom,” previously decided to freeze her eggs while undergoing treatment for a type of hormone receptor-positive (HR+) breast cancer in both her breasts. Now, as she’s enjoying life as a mom of two, she’s continuing to offer hope for other women fighting cancer and urging others to know their cancer risk and get checked.
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“The test is free, online and takes only a few minutes. To take it you can either google ‘Tyrer-Cuzick Test’ or you can go to Dr. Aliabadi’s website SheMD.org (@shemdpodcast) and also get action items on what to do depending on your percentage of risk.”
She concluded, “To everyone who is battling or has battled cancer, in whatever form, I send you all my love.”
As for how her soon-to-be three year old son Malcom feels about his little sister, Munn took to the comments to say he “loves her.”
Her post comes just weeks after announcing her daughter Méi June Mulaney was born on September 14, 2024.
She wrote alongside her celebratory Instagram post, featuring photos of her family and her precious newborn, “I had so many profound emotions about not being able to carry my daughter. When I first met our gestational surrogate we spoke mother to mother.
“She showed me so much grace and understanding, I knew I had found a real-life angel. Words cannot express my gratitude that she kept our baby safe for 9 months and made our dreams come true.”
Expert Cancer & Fertility Resources
- Fertility Preservation After a Cancer Diagnosis
- New Evidence That IVF Is Linked To Higher Rates Of Breast Cancer– A Leading Expert Explains Why Women Shouldn’t Necessarily Be Alarmed
- How Does Chemotherapy Affect Fertility?
- Can I Have A Baby After Breast Cancer?
- After A Cancer Diagnosis: Getting Fertility Hormone Injections
“I am so proud of my little plum, my little dragon for making the journey to be with us,” Munn explained. “My heart has exploded. Méi (pronounced may) means plum in Chinese.”
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Olivia’s Breast Cancer Journey
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 “X-Men” 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.
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“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.
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.
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.
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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.
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.
Learn Your Risk and Listen to the Guidelines: An Important Message About Breast Cancer Awareness
The Importance of Breast Cancer Screening
Screening for breast cancer is normally done through a mammogram, which looks for lumps in the breast tissue and signs of cancer.
While there is some disagreement about the exact age a woman should start getting mammograms, doctors generally agree it should happen in their 40s.
The American Cancer Society (ACS) suggests women should begin annual mammogram screenings for breast cancer at age 45 if they are at average risk for breast cancer.
However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) now says 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: Mammograms are still the best tool for detecting breast cancer.
The ACS also advises:
- Women aged 40-44 have the option to start screening with a mammogram every year
- Women aged 55 and older can switch to a mammogram every other year
- Women aged 55 and older could also choose to continue yearly mammograms
For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30.
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.
Don’t delay speaking with your doctor to make sure you are staying on top of your breast health.
Understanding Fertility Preservation
“When a woman is diagnosed with cancer in her childbearing years, fertility preservation should be a part of the conversation, like it’s part of the treatment plan,” Jaime Knopman, MD, a reproductive endocrinologist at CCRM Fertility in New York City, previously told SurvivorNet.
“Everyone in their reproductive years should be advised of their options.”
Freezing Eggs Or Embryos: What Should I Do?
Some types of chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the type of drug and your age—since your egg supply decreases with age.
“The risk is greater the older you are,” Knopman explained. “If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply.”
If your cancer treatment includes surgery in which both ovaries are completely removed, then IVF will likely be needed to help get pregnant.
Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.
Meanwhile, endocrine or hormone therapy may block or suppress key fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.
If you are having a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you for sure whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.
Dr. Terri Woodard Discusses Options For Preserving Fertility After Cancer
Research shows that women who have fertility preservation prior to breast cancer treatment, in particular, are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.
Options For Preserving Your Fertility Before Cancer Treatment
Most women who preserve their fertility before cancer treatment do so by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor who specializes in reproductive medicine can implant one or more embryos in your uterus, or the uterus of a surrogate, with the hope that it will result in pregnancy. If you freeze eggs only before treatment, a fertility specialist can use sperm and your eggs to create embryos in vitro and transfer them to your uterus.
When freezing eggs or embryos is not an option, doctors may try these less common approaches:
- Ovarian tissue freezing, an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment right away and don’t have time to harvest eggs.
- Ovarian suppression to prevent the eggs from maturing so that they cannot be damaged during treatment.
- Ovarian transposition, for women getting radiation to the pelvis, to move the ovaries out of the line of treatment.
In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to pause endocrine therapy to try to get pregnant—and they did not have worse short-term recurrence rates than people who did not stop ET (endocrine therapy). In the study from the Dana-Farber Cancer Institute, most of those people who paused ET were able to conceive and deliver healthy babies.
Of course, your doctor will be able to help you understand your unique circumstances and which path, such as pausing endocrine therapy, is right for you.
Surrogacy and Gestational Carriers
In some cases after cancer treatment, women may have difficulty giving birth to a child or they may be unable to at all. Having someone else carry their baby may be an option, either through surrogacy or a gestational carrier.
According to the National Cancer Institute, a surrogate pregnancy is “a type of pregnancy in which a woman carries and gives birth to a baby for a person who is not able to have children.”
“In a surrogate pregnancy, eggs from the woman who will carry the baby or from an egg donor are fertilized with sperm from a sperm donor to make an embryo,” the institute explains.
“The embryo is implanted in the uterus of the surrogate mother, who carries the baby until birth. Surrogate pregnancy may be an option for men or women who want to have children and have had certain anticancer treatments, such as chemotherapy or radiation therapy, that can cause infertility.”
As for a gestational carrier, the institute describes this person as “a woman who carries and gives birth to a baby for a person who is not able to have children.”
“Eggs from an egg donor are fertilized in the laboratory with sperm from a sperm donor to make an embryo. The embryo is implanted in the uterus of the gestational surrogate, who carries the baby until birth. The gestational surrogate (or carrier) is not genetically related to the baby and is not the biological mother.”
If you or someone you know is deciding on whether or not to go the route of surrogacy or gestational carrier, it’s important to know that each state has different laws and it may be necessary to speak with an attorney before moving forward.
Contributing: SurvivorNet Staff
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