Olivia Munn has credited her doctor with ‘saving her life’ after discovering her breast cancer – which was missed by a genetic test and mammogram.
The actress, 43, revealed on Wednesday that she was diagnosed with the disease just two months after getting the all-clear from a mammogram and DIY genetic testing, which claimed to detect 90 genes linked to cancer.
But when her OBGYN calculated her disease risk, based in part on her family history of the disease, she feared Munn had a one in three chance of developing the disease and sent her for further testing.
That led to Munn being diagnosed with luminal B breast cancer in both breasts at an early stage. She then had a double mastectomy to prevent the cancer from spreading to other parts of the body when it becomes fatal.
Doctors told DailyMail.com that although mammograms are considered the gold standard for detecting breast cancer, the scans can still miss as many as one in eight cases due to various factors, including how small the tumors are and how dense the woman’s breasts are.
Dr. Christoph Lee, a professor of radiology specializing in breast cancer screening at the University of Washington, told DailyMail.com that “missing tumors on mammograms is not uncommon.”
Olivia Munn has revealed she was diagnosed with luminal B breast cancer last year – after undergoing four operations in the last 10 months. She Credited Her OBGYN (Here) For ‘Saving My Life’
Munn first had a mammogram, which came back negative two months before her cancer diagnosis
In addition, up to 70 percent of tumors can go unnoticed if a woman has particularly dense breasts, making it difficult to detect masses in the X-ray scans.
Experts also said that at-home genetic tests like 23andMe and Ancestry, which aim to find genes linked to cancer, should not be testing for cancer itself.
Munn revealed that she had taken a commercial genetic test in February 2023 that was billed to detect 90 genes linked to cancer.
She claimed hers came back negative for all the genes, including BRCA, which has the strongest link to breast cancer and has also been dubbed the Angelina Jolie gene.
She also had a mammogram that winter, which came back negative. It’s unclear whether Munn was experiencing symptoms or was simply receiving routine screening every two years, which health officials recommend women begin doing at age 40.
“Two months later I was diagnosed with breast cancer,” she said on Instagram.
Despite the negative test, Munn’s OBGYN decided to calculate her risk assessment score for breast cancer.
The doctor determined that based on her age, family history and the fact that she had her first child after the age of 40, the actress had a 37 percent risk of developing the disease.
“The fact that she did saved my life,” Munn said.
Based on this score, Munn was then sent for a breast MRI and ultrasound, which revealed luminal B cancer in both breasts. Just 30 days later, she had them removed.
Breast cancer is the most common form of cancer in both the United States and the world.
The National Cancer Institute (NCI) estimates that there will be more than 300,000 new cases this year, along with 43,700 deaths.
Death rates have plummeted by 43 percent between 1989 and 2020 following successful public health campaigns, better screening and new drugs.
And nine out of 10 patients are expected to survive after five years.
Luminal B breast cancer starts in the inner (luminal) lining of the mammary ducts, which are thin tubes in the breast that carry milk from the breast to the nipple.
This form of the disease accounts for about 10 to 20 percent of breast cancer cases and is considered more aggressive than other forms.
According to the Susan G Komen Foundation, women with luminal B tumors are often diagnosed at a younger age.
Over 98 percent of those with tumors diagnosed locally – before spread – are expected to survive after four years. Once the cancer spreads to other areas, this rate drops to 46 percent.
The graph above shows the changes in breast cancer screenings (black line) since 2017 per month. It also shows a predicted screening rate (yellow dashed line) and Covid infection rate (blue line) in the US during the same period. Screenings were initially stable, but fell in the first year of the pandemic by as much as 14 percent
A mammogram is a type of X-ray that involves placing the breasts between metal plates to flatten them and obtain images from above and from the sides
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A mammogram is considered the “gold standard” for diagnosing breast cancer.
This is a type of X-ray that involves placing the breasts between metal plates to flatten them and obtain images from above and from the sides.
Currently, all women over 40 are advised to have a mammogram every two years.
However, the test is not always completely accurate. In fact, the American Cancer Society (ACS) estimates that mammograms miss one in eight cancers.
“Mammography is the standard of care in terms of breast cancer screening, and it’s actually a very sensitive test,” said Dr. Lee.
“The sensitivity in the United States is about 87 percent, which means that 87 percent of the time, if breast cancer is present, a radiologist is able to detect it.”
However, the test cannot detect everything. In fact, the American Cancer Society (ACS) estimates that mammograms miss one in eight cancers.
Dr. Melissa Durand, a radiologist specializing in breast imaging at the Yale School of Medicine, said in a the university’s blog post: ‘With conventional mammography, while we can be as accurate as 98% in a fatty breast, our sensitivity can drop to as low as 30% in women with extremely dense breasts.’
Breasts consist of adipose, glandular and connective tissue, and breast density is a measure of how dense tissue (glandular and connective tissue) is compared to less dense (fat).
Breasts are divided into four categories: A, B, C and D.
Several at-home genetic tests claim to detect cancer genes from saliva and urine samples. However, doctors warn that they cannot predict cancer risk
Olivia, who is mum to two-year-old son Malcolm Hiep (pictured), said she had both breasts removed 30 days after her diagnosis
Those in the A group have almost exclusively adipose tissue, while B have scattered areas of dense tissue.
C breasts contain more dense than adipose tissue and D is considered ‘extremely dense’.
According to the NCI, about 50 percent of American women have dense breasts. Breast density is often inherited, although having a low body mass index (BMI) or taking hormone supplements during menopause can increase density.
However, aging and having children can lead to thicker breasts. Dr. Lee noted that breast density is measured during a woman’s first mammogram, so she wouldn’t know if she has this until she undergoes a test.
“Women with dense breasts have a higher risk of breast cancer than women with fat breasts,” states the NCI. “This risk is separate from the effect of dense breasts on the ability to read a mammogram.”
It is unclear whether Munn’s cancer was missed due to dense breasts or some other factor.
“Unfortunately, about 13 percent of mammograms are occult, meaning they are not visible on the X-ray images of an MRI,” said Dr. Lee.
These tend to be smaller tumors, as well as those masked by dense breasts.
Munn also said that before her mammogram, she used an at-home genetic test that claims to detect up to 90 cancer genes.
23andMe and Ancestry are two of the most popular, though it’s unclear if she used one of those or another method.
Dr. However, Lee cautioned against using one of these tests as the only method to determine your risk of breast cancer, regardless of whether you test positive for these genes or not.
‘A genetic test does not tell you your exact risk of breast cancer. Only a very small proportion of breast cancers are due to genetic mutations such as braca one or bracket two,” he said.
‘The vast majority of breast cancer cases are found in women with no history of breast cancer in their family and no genetic mutations.’
If you’re experiencing breast cancer symptoms — such as a lump, change in breast shape, scaly skin around the nipple and an inverted nipple — and have a negative mammogram, Dr. Lee to get a diagnostic mammogram or breast ultrasound.
Diagnostic mammograms are typically performed on women with breast cancer symptoms and may include additional screenings that are not part of screening mammograms.
An ultrasound, meanwhile, uses sound waves to show breast changes and cysts.
He also noted that people with a primary family history of the disease, such as a mother or sister, along with symptoms should get an MRI.
“It’s important to get a breast cancer risk assessment from your OBGYN or a primary care physician,” he said.