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How Olivia Munn's Doctor Helped Calculate Her Breast Cancer Risk, Leading To Early Diagnosis

Earlier this month, actor Olivia Munn publicly shared her journey with breast cancer.

Munn's doctor shares insight on the assessment test that Munn said saved her life.

Understanding the benefits of knowing your Breast Cancer Risk Assessment Score can help you advocate for yourself.

On March 13, 43-year-old actor Olivia Munn announced on Instagram that she underwent a double mastectomy after being diagnosed with breast cancer.

In her post, she thanked her gynecologist Dr. Thaïs Aliabadi, co-host of the SHE MD Podcast, for calculating her Breast Cancer Risk Assessment Score, which determined that Munn has a 37% lifetime risk of getting breast cancer.

Because of this, Munn qualified for an MRI, which led to an ultrasound and a biopsy that found Luminal B Cancer in both breasts.

In her post, Munn credits the assessment and follow-up preventive MRI screening for saving her life. Just months before, in February 2023, she took a genetic test that looked at 90 different cancer genes, for which she tested negative. Around the same time, she also had a normal mammogram.

"I wouldn't have found my cancer for another year — at my next scheduled mammogram — except that my OBGYN, Dr. Thaïs Aliabadi, decided to calculate my Breast Cancer Risk Assessment Score," she wrote. "The fact that she did saved my life."

Aliabadi also saved her own life after calculating her own lifetime risk of breast cancer. Knowing her risk led to a double mastectomy and, after surgery, the discovery of Stage 1 cancer in her breast tissue. She personally relates to her patients like Munn.

"Olivia's journey is truly remarkable, and as a breast cancer survivor myself, I couldn't be prouder of her," Aliabadi told Healthline. "By raising awareness about the importance of risk assessment and screening, she's not only making a difference in her own life but also in the lives of countless others…I adore her."

Aliabadi said Munn's advocacy is a step toward achieving her ultimate goal as a doctor, which is for every female to know their lifetime risk of breast cancer, no matter their family history or lifestyle.

"In my office, we calculate the lifetime risk of breast cancer for every single woman," she said. "Knowledge empowers, and it's vital for each individual to advocate for their own health."

Any female over age 18 can ask for a breast cancer risk assessment from their doctor or through a specialized healthcare professional in the cancer risk space, such as a genetic counselor, said Sara Pirzadeh-Miller, president-elect of the National Society of Genetic Counselors and associate director of cancer genetics at UT Southwestern Medical Center.

In fact, the U.S. Preventive Services Task Force (USPSTF) recommends that "primary care cliniciansassess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing."

"Overall, it is important for anyone to understand their cancer risk, whether it is breast or other cancers, to be empowered to make critical healthcare decisions," Pirzadeh-Miller told Healthline.

The Tyrer-Cuzick (T-C model) breast cancer risk assessment, is one model used for calculating lifetime breast cancer risk. The model considers the following:

Age

Height and weight

Age when you started having periods

Obstetric history (if you've had your first child after the age of 30 or have never birthed a child)

Age of menopause

History of hormone replacement therapy use

Family history of breast cancer, including age when breast cancer was diagnosed

The Tyrer-Cuzick model can be used to formally qualify someone for breast MRI by having a lifetime breast cancer risk of 20-25% or higher. Breast MRI can find some breast cancers that are missed on a mammogram. However, because MRI can wrongly identify some things as cancer, it is recommended in addition to a mammogram, not as a replacement for it.

"It is important to have the conversation of which models make the most sense given the individual, their risk factors and specific clinical scenarios for each individual," said Pirzadeh-Miller.

She noted that data in general populations and breast cancer screening and mammography centers has shown up to 25% of women have a family history of breast cancer that qualifies for further breast cancer risk assessment (genetic testing and/or high-risk breast cancer screening protocols). These women would have >20% lifetime breast cancer risk, said Pirzadeh-Miller.

If your doctor gives you pushback on requesting the breast cancer assessment, connect with another provider.

"If a person doesn't feel comfortable with the answers they receive from their healthcare provider to their inquiries on how to best create a well-rounded cancer prevention plan, it is important to obtain a second opinion," said Pirzadeh-Miller.

If you have a personal or family history of breast cancer and/or other cancers that contain 'red flags' for hereditary cancer risk, consider seeing a genetic counselor for genetic risk assessment.

Aliabadi is launching a breast cancer risk calculator, which will be able to be accessed on her website.

"Following the assessment, we will provide clear guidelines on the necessary steps every woman should take based on the final risk percentage. This will enable women to have a clear action plan to discuss with their doctor," said Aliabadi.

Knowing your breast cancer risk will enable important conversations with your doctor about cancer risk management and prevention strategies.

Like Munn, women who meet the greater than 20 to 25% lifetime breast cancer risk when calculated through the appropriate breast cancer risk models qualify for extra and possibly earlier breast cancer screening through breast MRI and other modalities.

"Other preventive measures for lowering the risk of breast cancer include medications like selective estrogen receptor modulators (SERMs) or aromatase inhibitors, maintaining a healthy diet and lifestyle, regular exercise, limiting alcohol intake, and considering risk-reducing mastectomies for high-risk individuals," said Aliabadi.

Before women undergo genetic testing or before finding out their breast cancer risk calculations, they should consider how it might affect them emotionally and psychologically.

Weighing what they would do with the information if their risk is high is something to consider.

"Will the individual use the information to make proactive decisions on breast cancer risk management? Will they not use it at all? The answers to these questions could impact a person's choice to obtain the breast cancer risk score information," said Pirzadeh-Miller.

While some women may choose to hold onto the information, others may take Munn's approach of acting on it and spreading awareness.

"Anyone sharing their story, like a breast cancer diagnosis and their journey surrounding it, will bring awareness to those who ingest the information," said Pirzadeh-Miller.

Public statements by celebrities also provide an opportunity to discuss facts surrounding breast cancer risk assessment.

"Olivia also reported that she had a 'negative 90 gene test result.' This statement brings an opportunity to highlight that there are other breast cancer risk factors that can elevate lifetime risk outside of genetic or inherited factors," said Pirzadeh-Miller.

A negative genetic test doesn't equal the same clinical interpretation for everyone, she explained, because some people who have a negative test result still have an elevated breast cancer risk for other reasons that need detailed evaluation by healthcare providers.

"This is where a specialist in this space, like genetic counselors, can provide detailed, evidence-based recommendations for ongoing risk management discussions with the healthcare team," Pirzadeh-Miller said.

What Is A Breast Cancer Risk Assessment Score—And Should I Get One?

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In an emotional Instagram post, Olivia Munn revealed that she was diagnosed with aggressive breast cancer after receiving an above-average score on a breast cancer risk assessment.

The 43-year-old actor shared that she had a mammogram and genetic testing done last year "in an effort to be proactive about my health"—both came back clear and normal. Her ob-gyn recommended doing the risk assessment next, and that test "saved my life," Munn said.

Because of the assessment, Munn learned that she had a 37% lifetime risk of developing breast cancer, which prompted her to get an MRI, followed by an ultrasound and biopsy. Those tests revealed the "fast-moving" cancer Luminal B in both of her breasts. She had a double mastectomy 30 days later and feels "lucky" that her cancer was caught in time.

Breast cancer is the second leading cause of cancer death in women in the US. The American Cancer Society (ACS) recommends getting annual mammograms starting as early as age 40—but should you do a breast cancer risk assessment before then? Here's what to know about this test, according to experts.

What is a breast cancer risk assessment score?

A breast cancer risk assessment score estimates your chances of developing the disease within certain time frames. There's the Gail model, a tool that helps health care providers estimate a person's five-year and lifetime risk of developing invasive breast cancer up to age 90, and the Tyrer-Cuzick model, which estimates the risk within 10 years and a lifetime. (Currently, the Tyrer-Cuzick model determines a high-risk person's MRI eligibility, while the Gail model serves as guidance for preventive drug therapy. Research hasn't found that one is better than the other.)

Your score is calculated via various questions that are designed to obtain information about your personal health history, along with your family history of breast cancer in first-degree relatives, like your parents and siblings. (If you're a parent, it also asks about your age when you first gave birth—something Munn noted in her Instagram, since she had her first child after the age of 30.)

While you can technically do the assessment on your own—the Gail Model is on the National Cancer Institute's website—it's designed for health care professionals to give to their patients. After the questions are completed, your breast cancer risk assessment score is electronically calculated: You'll be given a percentage for your 5- or 10-year risk of developing breast cancer, as well as your lifetime risk.

What happens if you get a "high" breast cancer risk assessment score?

A lifetime risk score of 20% or more is considered high, but remember: Your results are just an estimate. The National Cancer Institute specifically notes that some people who don't develop breast cancer have higher risk estimates than those who do end up developing the disease—meaning, it's not perfect. Another key limitation: It may underestimate the risk in certain people, including Black women who previously had biopsies done, and Hispanic women born outside the US, among other groups.

Some doctors, however, really recommend taking this step. "Any new patient that comes into our office gets a risk assessment," Amy Bremner, MD, the medical director of breast surgical oncology at MemorialCare Saddleback Medical Center in Laguna Hills, California, tells SELF. "It can help identify a patient who might not know they're high risk and allow us to follow them more closely in the future."

Dr. Bremner says it's best to have a health care professional give you the assessment to make sure you get a comprehensive test, and to help guide you on next steps if needed. (You can usually get this done at a primary care physician's office or during your ob-gyn check-up.) If you prefer going the online route to start: "There's no harm in doing this [assessment] yourself," Dr. Bremner says.

If you score high, the ACS recommends getting a breast MRI and mammogram every year starting at age 30 instead of 40.

The bottom line

Getting a breast cancer risk assessment score is a potentially helpful tool in your health care arsenal. It's understandable to feel a lot of anxiety with these types of tests, but talking through your results with a medical professional can help you come up with a preventive game plan, even if your score is on the lower end.

And it is still important to keep up with mammograms if you get a lower score, Jessica Shepherd, MD, a board-certified ob-gyn and minimally invasive surgeon in Dallas, tells SELF. "Screening is imperative, as there's still a one in eight lifetime chance of being diagnosed with breast cancer," she says. "The same recommended precautions should still be taken, regardless of your score."

Originally Appeared on SELF

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What To Know About Calculating Breast Cancer Risk After Olivia Munn's Diagnosis

Olivia Munn's revelation that she is battling breast cancer put an important spotlight on a tool used to help determine a person's risk of the disease.

The "X-Men: Apocalypse" actress, 43, revealed in an Instagram post Wednesday that she was diagnosed with breast cancer last year and has undergone four surgeries, including a double mastectomy, in the months since her diagnosis.

In her post, Munn credited her doctor with saving her life by calculating her breast cancer risk assessment score.

"Dr. Aliabadi looked at factors like my age, familial breast cancer history, and the fact that I had my first child after the age of 30," Munn wrote. "She discovered my lifetime risk [of breast cancer] was at 37%. Because of that score, I was sent to get an MRI, which led to an ultrasound, when then led to a biopsy. The biopsy showed I had Luminal B cancer in both breasts."

PHOTO: Olivia Munn attends the Vanity Fair Oscars Party at the Wallis Annenberg Center for the Performing Arts, March 10, 2024, in Beverly Hills, Calif.

Olivia Munn attends the Vanity Fair Oscars Party at the Wallis Annenberg Center for the Performing Arts, March 10, 2024, in Beverly Hills, Calif.

Michael Tran/AFP via Getty Images

Munn described her cancer as "aggressive" and said without her doctor's help, the cancer may not have been discovered for another year.

The Breast Cancer Risk Assessment Tool that Munn spotlighted is a critical tool in helping doctors calculate a patient's lifetime risk of breast cancer, according to Dr. Jennifer Ashton, ABC News chief medical correspondent and a board-certified OBGYN and obesity medicine physician.

Here are five questions answered about the tool.

1. What does the Breast Cancer Risk Assessment Tool calculate?

The tool uses personal information including age, family history of breast cancer, date of first menstruation, and whether or not you've ever given birth to help estimate your risk of developing breast cancer

"It helps to provide an actual numerical risk for lifetime risk of breast cancer and breast cancer diagnosis in the next five years," Ashton said. "It is what we use in medicine to stratify a woman's individual risk in a more precise way."

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