Understanding Olivia Munn's Breast Cancer Diagnosis
- Actress Olivia Munn, 46, recalls the “freight train of fear” after being diagnosed with aggressive, hormone-positive bilateral breast cancer following an MRI prompted by her high-risk assessment.
- Munn’s type of breast cancer, called hormone receptor-positive (HR+), means that the hormones estrogen or progesterone stimulate cancer cell growth, which is why HR+ cancer is typically treated with hormone therapy drugs that lower estrogen levels or block estrogen. Munn’s sub-type, luminal B, meant that her cancer was specifically estrogen-fueled.
- The mom of two 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 has since been taking hormone-suppression treatment to prevent cancer recurrence.
- Hormone therapy is used for hormone receptor-positive cancers. These types of cancers are the most common types of breast cancer. Hormone receptor-positive means the cancer or tumor needs the hormones estrogen and/or progesterone to grow and flourish. Hormone therapy works by driving the estrogen levels down or blocking the estrogen’s ability to interact with the estrogen receptor on the cancer cell.
- To further help you on your cancer journey, explore SurvivorNet’s proprietary AI tool, “My Health Questions.” This powerful resource, embedded across the SurvivorNet website, was built to bridge that gap by offering on-demand explanations of treatment options, clinical trials, side effects, insurance concerns, and more.
Munn, who was diagnosed in April 2023, opened up in the second installment of her Instagram “series,” created to strengthen the sense of sisterhood among women facing breast cancer, “I like talking about the day I was diagnosed with breast cancer, because it is the same moment anyone who has battled any type of cancer has gone through, where a doctor says, ‘It’s cancer.’
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Recounting what led doctors to her diagnosis, Munn explained further, “I had been doing everything I was supposed to be doing. I had a clear mammogram, a clear ultrasound. I even did genetic testing. That came back with zero. I was feeling good.”
However, Munn’s doctor, Dr. Thaïs Aliabadi, an obstetrician-gynecologist in Beverly Hills, California, decided the actress should take a Lifetime Risk Assessment Test, which is a free, online test.
“Anything above 20% is considered high risk. My score was 37.3%. Dr. Alibadi sent me to get an MRI. I got a callback that same day from the radiologist, and he said, ‘We think we found something in your right breast. ‘So when the biopsy results came back, Dr. Alibadi called me into her office, and I just blurted out, ‘Is it cancer?’ And she said, ‘Yes, it is,'” Munn explained.
“Our breasts are circular. So then they put a cross through it, and then there are four quadrants. Dr. Alibadi explained to me that it is not that unusual to have multiple tumors in one quadrant. That would be called multifocal.So it’s more unusual to have tumors in multiple quadrants. I had, at that moment, multifocal, multi-quadrant breast cancer.”
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The Breast Cancer Risk Assessment Munn credit’s 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 previously told SurvivorNet.
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Munn confirmed that the type of assessment test she took is called the Tyrer-Cuzick Risk Assessment Calculator.
She then explained that the multiple tumors found in her breast led her doctors to suspect that cancer might also be present in the other. A second look at her MRI revealed another tumor in her left breast, which was later confirmed to be cancer.
“At that point, I was diagnosed with multifocal, multi-quadrant, bilateral breast cancer. It is called luminal B. Luminal B is an aggressive, fast-moving cancer. It is a hormonal cancer. My specific cancer is ER-positive, PR-positive, HER2 negative. That is estrogen positive, progesterone positive, HER2 negative,” said Munn.
“I like to be specific because those going through breast cancer often ask me that, and it is something that I specifically looked for when I was trying to connect with other people going through breast cancer. The difference between hormonal breast cancer and triple negative: hormonal breast cancer, they can use hormone blockers to starve out the cancer. Triple negative lacks the three molecular targets that doctors use to treat breast cancer, which means they have fewer tools to stop it. So that means the type of tumors I had fed off of estrogen and progesterone.”
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Munn, who beat cancer after undergoing a double mastectomy [surgical removal of both breasts], hysterectomy, and removal of her fallopian tubes and ovaries, previously shared part one of her “series” on August 12, where she spoke about being in “surgical menopause.”
She said, “I’m doing really good. Now, I think most people who are going through any type of cancer can tell you that every day is different. And sometimes you feel like you’re really on an upswing, and then there are other times when you’re like, oh my gosh, this is so difficult. How is this still so hard? And what does my life look like on a daily basis right now?
“Well, I’ve got my two kids, four and a half and 22 months old, and they’re just the best things in the whole world. I’m filming, I’m working, traveling with my husband as he’s working. When it comes to the medical side, I went into a surgical menopause, which I will talk about in another video. And that means I went from not being menopausal or perimenopausal to just instant menopause. And not only that, but I’m on another medication called an aromatase inhibitor that shuts down testosterone production that turns into estrogen in my body.”
Munn has spent approximately two years on anastrozole (Arimidex), a hormone therapy that lowers estrogen levels in the body to reduce the risk of the cancer recurrence.
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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 earlier Instagram post.
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.
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.”
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.
How To Manage Anxiety During High-Stress Times
Battling a mental health issue, cancer, or learning to move forward after treatment can be an extremely stressful time for so many people. How can you manage your anxiety andfear while dealing with so many other things?
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Dr. Marianna Strongin, a clinical psychologist and founder of Strong In Therapy, has been helping the SurvivorNet community by sharing coping mechanisms and a structured way to think about handling these issues.
“The way that I define anxiety is that it’s an internal question that we simply can’t find the answers to,” Dr. Strongin previously toldSurvivorNet.
Dr. Strongin says that one of the main causes of anxiety is uncertainty about life, and a cancer battle can fuel anxiety for individuals because of the lack of uncertainty about the future.
Many people will turn to media platforms for answers, but Dr. Strongin says that individuals often end up with more questions as a result which leads to more anxiety.
The first step for coping during stressful circumstances is understanding one’s anxiety. To do this, Dr. Strongin suggests checking in with oneself everyday to see where the anxiety is manifesting and what questions are causing the anxiety. From there, it’s important to answer those questions and reassure oneself with positivity.
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“The answers are our coping skills,” Dr. Strongin says. “Some people are really good at always giving themselves answers…other people don’t have the coping skills to answer their anxiety and as a result the anxiety increases. … We are all facing the same questions.”
She continues, “Some are facing them much more than others and some are better at answering those questions than others. What’s really important is to pay attention to is what those questions are, what the frequency of those questions are, and how you’re answering them.”
Questions To Ask Your Doctor
If you have a breast cancer screening coming up or have recently had one, you may have questions you want answered. SurvivorNet’s proprietary AI tool “My Health Questions” is designed specifically for patients and caregivers.
WATCH: How One Cancer Survivor and Her Sister Used “My Health Questions” to Navigate Care
This powerful resource is embedded across the SurvivorNet website and delivers structured responses grounded in clinical guidelines and medically reviewed research to help people better understand their treatment options and feel more confident navigating care.
My Health Questions can also help patients come up with useful questions ahead of their next appointment.
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Contributing: SurvivorNet Staff
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