This Risk Assessment Tool Helped Olivia Munn Catch Her Breast Cancer Early

Key Takeaways

• Actress Olivia Munn shared on social media that she was diagnosed with breast cancer last year, crediting a risk assessment tool with helping her doctor catch the cancer early.

• The breast risk assessment tool refers to one of two different tools. Both use a patient’s age, race, family history of breast cancer, and other details about their health to estimate their chance of developing breast cancer.

• Experts say you can use these tools on your own but that it’s better to work closely with a provider while filling them out.

• The results can allow for additional screenings or preventative therapies if necessary.

Actress Olivia Munn, 43, revealed in an Instagram post last week that she was diagnosed with breast cancer last year and underwent a double mastectomy.

Munn said that she would not have discovered her cancer so early had it not been for the breast cancer risk assessment tool that her physician decided to do, despite the fact Munn tested negative for the breast cancer gene and had a normal mammogram.

“I wouldn’t have found my cancer for another year—at my next scheduled mammogram—except that my OB-GYN, Dr. Thais Aliabadi, decided to calculate my Breast Cancer Risk Assessment Score,” Munn wrote in her post.

Munn’s score of 37% prompted her doctor to order an MRI, followed by an ultrasound, followed by a biopsy, which helped her catch the cancer early and gave her choices for treatment.

“I’m lucky. 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,” Munn said. “Ask your doctor to calculate your Breast Cancer Risk Assessment Score.”

Here’s how the assessments work, who can take them, and what you should do when you get your score back, according to experts.

Related: Choosing Between Single vs. Double Mastectomy

What Is the Breast Cancer Risk Assessment Tool?

The Breast Cancer Risk Assessment is a tool typically used by doctors to help estimate a person’s chance of developing the disease, Jason Mouabbi, MD, assistant professor of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center, told Verywell in an email.

Two common models are the Breast Cancer Risk Assessment Tool (BCRAT), also known as the Gail Model, and the Tyrer-Cuzick (IBIS) model, Mouabbi said. These tools consider factors like age, family history, and menstrual history to provide a five-year, 10-year, and lifetime risk percentage.

The Gail Model tends to underestimate risk, while the Tyrer-Cuzick model may overestimate it, which is why physicians tend to consider both the scores and other factors when determining screening strategies, said Mouabbi.

“The purpose of these assessments is to guide decisions about what type of screening a person might need, such as the addition of breast MRIs to the yearly screening mammogram,” Mouabbi said.

He added that these assessments can also give physicians insight into whether the patient can qualify for preventative oral therapies, such as tamoxifen, which may reduce the risk of developing breast cancer by about 40%.

What Is the Average Age of Onset for Breast Cancer?

The average age of diagnosis of breast cancer is 62, according to the American Cancer Society. Other risk factors for breast cancer include high body mass index (BMI), breast density, personal history of breast or ovarian cancer, family history of breast or ovarian cancer, age, race, and more.

Who Can Use the Tool?

The Gail Model is designed for clinical use while the Tyrer-Cuzick model is not. But anyone can use the risk assessment tools to calculate their likelihood of developing breast cancer, as they are user-friendly and available online, Richard Reitherman, MD, PhD, board-certified radiologist and medical director of breast imaging at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, CA, told Verywell.

However, he specifically recommends that individuals with a family history of breast or ovarian cancer consider using these calculators. They are not recommended for those who have a BRCA1 or BRCA2 gene mutation or a previous history of breast cancer.

While you can calculate your risk score on your own, Mouabbi recommends doing it with a physician in order to properly answer more nuanced questions, like breast density value. Oncologists, OB-GYNs, and primary care physicians are all qualified to assist with these risk assessment tools.

“The other reason it is important to do them with a physician is that they can then stratify the score as low risk or high risk and offer the appropriate screening and preventative interventions,” Mouabbi said.

If you chose to use the breast cancer risk assessment tool independently, you should notify your physician or OB-GYN and forward your results, Stevie Otis, MD, an oncologist with the Center for Cancer Prevention and Treatment at Providence St. Joseph Hospital in Orange County, CA, told Verywell in an email. Your healthcare provider can then assist you in interpreting your score, clarify any questions you may have, and recommend appropriate next steps, such as additional screenings, interventions, or other treatments, if necessary.

Related: Why Your Mammogram Results May Soon Look Different

How Accurate Are the Risk Assessments?

Although breast cancer specialists and other healthcare providers use these assessments as guidelines for screening and risk reduction recommendations, Mouabbi said that no test is perfect.

In fact, the Gail Model tends to underestimate risk, especially in patients with a strong family history of breast cancer or those with a pathogenic genetic mutation such as BRCA1 and BRCA2, while the Tyrer-Cuzick model tends to overestimate it, said Mouabbi.

“Running both models can provide a range of probability, which can be more accurate for risk stratification,” Mouabbi said.

Otis added that with any statistic, the risk assessment does not give any one individual guarantee. “A woman with low risk can still develop breast cancer, and a woman with high risk may never develop breast cancer in their lifetime.”

How to Interpret Your Risk Assessment Score

Once you’ve completed a breast cancer risk assessment, you’ll receive a score in the form of percentages that outline your breast cancer risk over the next five years or 10 years, as well as your lifetime risk of developing the disease, Reitherman said.

If you use the Gail Model, your risk score can determine whether you’re considered at or above average risk compared to people of the same age, race, and ethnicity, as well as compared to the general population.

For instance, if your five-year risk is 3% and the population risk for your age group is 1.5%, your relative risk would be 2, said Reitherman. “This means that in the next five years, your risk of being diagnosed with breast cancer is twice that of the general population.”

If you use the Tyrer-Cuzick (TC) model, a score of less than 15% is considered average risk, while an intermediate score falls between 15-20%, and a high-risk score exceeds 20%, Otis said.

Otis said individuals with low or intermediate risk for breast cancer should do regular self-exams starting at age 25 and undergo routine screening mammograms starting at age 40. However, those who have a high risk for breast cancer should request a screening breast MRI from their physician.

It’s important to remember that the score itself does not tell you definitively whether you will or will not get breast cancer, it just provides a risk estimate, Mouabbi added.

Explainer

Munn wrote in her social media post that if your breast cancer risk assessment score is greater than 20%, you need to get annual mammograms and breast MRIs starting at age 30. However, Mouabbi said this statement is a generalization and may not apply to everyone.

“This recommendation would depend on a woman’s individual risk factors, including the specific risk assessment score, family history, and other factors,” he said.

What Other Breast Cancer Screening Methods Are Available?

Calculating your breast cancer risk assessment with either the Gail Model or the Tyrer-Cuzick model is a good first step in understanding your individual risk profile and making informed decisions about your health, Otis said.

Genetic counseling and/or testing is typically recommended if you have a known family history of a gene mutation like BRCA1 or BRCA2, or a family history of breast cancer, ovarian cancer, pancreatic cancer, or prostate cancer.

“It’s worth noting that most women with a personal or family history of breast cancer do not have an inherited gene, but they are more likely to have an inherited gene than women without a personal or family history of breast cancer,” Otis said.

Related: How to Do a Breast Self-Examination (BSE)

Home screening tests like 23andMe are not comprehensive enough to detect whether a patient has a pathogenic genetic mutation that can predispose them to breast cancer, Mouabbi said.

“In clinical practice, we do not use that test; we use more comprehensive tests,” he said. “We always tend to schedule a meeting with a genetic counselor to go over whether a patient qualifies for genetic testing and discuss the implications of such a test on the patient and their family.”

It is not necessary to seek a genetic test before calculating your Breast Cancer Risk Assessment Score, he said.

According to the Centers for Disease Control and Prevention, other breast cancer screening methods include regular self-examinations of the breast, clinical breast exams, mammograms, and breast MRIs.

What This Means For You

Several tools online, such as the Gail Model and the Tyrer-Cuzick model, are accessible to help you determine your risk for breast cancer. However, experts advise taking the assessment with a physician to ensure accurate interpretation of your results and score. This allows you to take necessary steps, such as additional screening and preventative interventions if needed.

Read the original article on Verywell Health.