Olivia Munn Had Kids After 30—Why That Matters for the Breast Cancer Risk Assessment That Saved Her Life

The actress said she’s “lucky” after a breast cancer risk assessment caught the disease early.

Fact checked by Sarah Scott

Actress Olivia Munn announced that she was diagnosed with breast cancer and has undergone multiple surgeries, including a double mastectomy over the past year.

In an Instagram post on March 13, 2024, the 43-year-old shared her unexpected diagnosis, while raising awareness for the risks of breast cancer, including having children after 30.

“In February of 2023, in an effort to be proactive about my health, I took a genetic test that checks you for 90 different cancer genes,” she writes in her post. “I tested negative for all, including BRCA (the most well-known breast cancer gene).” She says she celebrated the news with her sister, who had also tested negative on the test.

But just two months after taking the test and also receiving a “normal” mammogram result, Munn was diagnosed with breast cancer.

“In the past ten months I have had four surgeries, so many days spent in bed I can't even count and have learned more about cancer, cancer treatment and hormones than I ever could have imagined,” Munn adds, saying she’s only “cried twice” since the diagnosis.

She posted a series of photos and videos, including one of her receiving a mammogram, and another of her sitting in a hospital bed hugging her doctor. She said she was deliberate in maintaining her privacy up until now, narrowing her focus on her treatment and not allowing any emotions to interfere with her ability to “stay clearheaded.”

The Newsroom star credits her OB-GYN, Thais Aliabadi, MD, whom she calls “her guardian angel,” for calculating her breast cancer risk assessment score and helping her catch it early.

What Is a Breast Cancer Risk Assessment?

While the National Comprehensive Cancer Network (NCCN) recommends that all women begin yearly mammograms starting at age 40, some require them earlier, along with additional breast screening methods like an MRI. Even before that, the guidelines recommend that all individuals, regardless of gender, undergo a breast cancer risk assessment by age 25.

There are approximately 24 breast cancer risk assessment models, many of which are accessible online at no cost. The GAIL model, also known as the Breast Cancer Risk Assessment Tool (BCRAT), is one of the most widely used.

These assessment tools consider various factors such as age, race or ethnicity, history of past breast biopsies, and familial breast cancer history.

Munn says her doctor calculated that her lifetime risk was at 37%. Annual mammograms are recommended starting at age 30 for patients with a number higher than 20%, she says her doctor told her.

“Because of that score I was sent to get an MRI, which led to an ultrasound, which then led to a biopsy,” she explains. "The biopsy showed I had Luminal B cancer in both breasts."

About a month after her initial biopsy, Munn says she underwent a double mastectomy.

It’s important to understand that these assessments cannot definitively predict an individual's likelihood of developing breast cancer. Instead, they provide an estimation of the average risk based on a group of people with similar risk factors.

If a patient opts for an online assessment, it's essential to have a professional evaluate your results. Ruth Oratz, MD, a breast medical oncologist at NYU Langone Health’s Perlmutter Cancer Center, who does not treat Munn, advises patients to discuss the findings with their health care provider, especially if there's a family history of breast cancer. In such cases, genetic testing may be recommended.

“This information may give a more specific evaluation of the patient's risk of breast, or even other types of, cancer,” Dr. Oratz explains.

She cautions that the accuracy of the breast cancer risk assessment may be compromised if a patient already knows they carry BRCA gene or other genetic mutations. In these cases, she recommends they see a breast cancer specialist to discuss other options, which in some cases may even include prophylactic or preventive surgery.

Does Having Children After 30 Increase the Risk of Breast Cancer?

Munn, who welcomed her first child Malcolm with comedian John Mulaney in November 2021, when she was 41, also points out the assessment brings into consideration a person's age at the time of the birth of their first child.

"Reproductive history–having no term pregnancies or first pregnancy after age 30–does slightly increase the risk of breast cancer,” explains Dr. Oratz.

Those who had their first full-term pregnancy before 20 are found to have about half the risk of developing breast cancer than those who did after 30, according to the National Cancer Institute.

Research also shows those who have recently given birth have a temporary increase in the risk of breast cancer. That decreases after about 10 years.

It's important to note, “the risk of breast cancer is not the same for all women," says Rebecca Yang, MD, FACS, who is also Director of Breast Surgery and the Comprehensive Breast Health Center at Jersey City Medical Center.

Why Early Detection Is Key

In the United States, about 1 in 8 individuals assigned female at birth, or roughly 13%, will be diagnosed with breast cancer, according to the National Breast Cancer Foundation.

There are various types of breast cancers. Luminal B breast cancer, which Munn was diagnosed with, makes up about 15-20% of breast cancers. Luminal B tumors boast a high survival rate, despite their faster growth compared to other types.

Symptoms of Luminal B cancer mirror those of other breast cancers, which may include skin redness, lumps in the breast, swollen glands under the armpit, or a change in nipple size or discharge.

After gender, age is an important risk factor for developing breast cancer, according to Dr. Yang. While Luminal B cancer is prevalent among younger patients, Dr. Yang says the overall median age of breast cancer diagnosis is around 63 years old, with over 50% of breast cancer diagnoses occurring between the ages of 55-74.

But it's important to be proactive no matter your age or the age at which you had children. When breast cancer is detected early and localized, the five-year relative survival rate is 99%, according to the American Cancer Society. Early detection includes doing monthly breast self-exams, and scheduling regular clinical breast exams and mammograms.

“Know your own medical history and your family history,” urges Dr. Oratz. “Be aware of your body–and do not ignore any changes in the breast area that concern you.”

Munn followed all the recommended protocols for breast health and she advocated for herself.

On Instagram, Dr. Aliabadi called Munn “brave” and praised her for “inspiring countless women,” noting that many are unaware of their elevated lifetime risk and may end up with breast cancer at a more advanced stage.

“I'm lucky,” Munn shares in her post. “We caught it with enough time that I had options. I want the same for any woman who might have to face this one day.”

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