‘Your Friends & Neighbors’ Actress Olivia Munn, 45, Says Breast Cancer Journey Brought Her Greater Self-Compassion

“People would ask me, ‘how do you handle that?’ and I’m like, ‘well, what I would say to myself was harder.’ The internal thoughts were much more difficult to deal with.”

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“X-Men: Apocalypse” star—who beat breast cancer after having both breasts removed, as well as surgeries to remove her fallopian tubes, uterus, and ovaries— continued, “As soon as I was diagnosed, and I didn’t know I did this until months later, when I look back … but I just dropped all that baggage.

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“I was looking at this mountain, this Everest that I had to climb, and I just intuitively knew I couldn’t do that without extra baggage. When I got to a place where I could assess everything, I looked down and I could see that baggage and I thought, ‘I don’t want to pick that back up.'”

She added, “I’ve lived my life a lot more forgiving of myself and and kinder to myself.”

Munn, who shares her four-year-old son Malcolm and daughter Méi (born via surrogacy in 2024) with her husband, comedian John Mulaney, then shared how she was “always looking into the future,” until she acknowledge how she was “missing” life in the present.

She explained, “Having small children, I started thinking about if I’m lucky enough to live to 80 or 90, I would do anything to get back to this age. I said to my husband just a few days ago, when we’re 80 or 90 and we’re looking back on our life, these are the moments we’ll come back to. These are the memories that we will hold on to and will reminisce about.

“I want to be here, and I don’t want them to just be memories in the future. I want to feel them now. That really grounds me and brings me back.”

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Munn also noted how she dealt with “horrible postpartum anxiety” after having her first child.

“I was not even prepared for postpartum anxiety. I didn’t even know what it was for the first couple months it was happening. So that lasted like a year, and as soon as I came out of that fog, I was diagnosed with breast cancer,” she recalled.

Looking back on how a lifetime risk assessment test led to her life-saving diagnosis, Munn explained how pushing her mom to also undergo the risk assessment test led to her mom’s “more aggressive” breast cancer diagnosis.

Munn then suggested that “every doctor should be asking every woman, what is your lifetime risk assessment?”

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Olivia Munn’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.

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.

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.

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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.

As for the hormonal therapy drug she’s now taking, according to BreastCancer.org, Arimidex (chemical name: anastrozole),  it’s “an aromatase inhibitor used to treat all stages of hormone receptor-positive breast cancer in post-menopausal women.”

In an earlier Instagram post, Munn revealed the following timeline of her breast cancer journey:

• January 2022 — 2 Mammograms, 2 Ultrasounds: Clear
• January 2023 — Mammogram: Clear
• February 2023 — Genetic Testing: 0% Chance of Genetic Cancer
• March 2023 — Tyrer-Cuzik Breast Cancer Assessment Score: 37.3%
• March/April 2023 — MRI+ Ultrasound + Biopsies
• April 2023 — Bilateral Breast Cancer Diagnosis
• May 2023 — Nipple delay, Lymph Node Dissection and Double Mastectomy
• June 2023 — Egg Retrieval
• September 2023 — Breast Reconstruction
• November 2023 — Begin Lupron
• April 2024 — Partial Hysterectomy/ Oophorectomy
• August 2024 — Begin Arimidex

Munn has since been on a five-year hormone suppression plan to prevent cancer recurrence and taking the drug Anastrozole (brand name: Arimidex) since August 2024.

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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.

All About Breast Cancer Screenings

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.

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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.

Mindfulness & Meditation

For some people, learning how to slow life down and live in a certain moment can have great benefits for mental health. Mindfulness is the feeling of being fully present in the moment. And when it comes to meditation, there’s a great deal of scientific research that shows it can be really helpful for people facing some sort of challenge.

Acclaimed author and pioneer of the mindfulness movement Deepak Chopra told SurvivorNet in a previous conversation that a big step in taking charge of mental health is understanding what stress does to our bodies.

“Stress is nothing other than the perception of threats,” Dr. Chopra said. “Whether it’s real or imagined doesn’t matter. You perceived stress emotionally or you imagine a super stressful, threatening situation it doesn’t matter. It will create the same biological responses, compromising your immune system to basically offset its fine tuning and also increasing inflammation.”

Recognizing where this stress comes from can help in the healing process for some.

Dr. Marianna Strongin, a clinical psychologist, explains how patients can learn to cope with their anxieties. 

Clinical psychologist Dr. Marianna Strongin told SurvivorNet that sometimes, anxiety is caused by questions we ask ourselves and feel, or fear, we don’t have the answers to. If you are really struggling, a therapist may be able to help you find answers to your internal questions, and learn tactics to cope with the ones you can’t answer.

“How often are you checking in with your anxiety?” Dr. Strongin asked. “Where do you feel it in your body? And what are the questions that it’s asking you? Is it asking you, is everything going to be OK? What’s happening? Will I survive? Now, the second most important thing is, are you providing it some answers? The answers are our coping skills.”

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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