When actress Olivia Munn, 43, posted on Instagram that she had been diagnosed with an aggressive form of breast cancer, not only received an outpouring of support, but used her celebrity status to raise awareness about the little-known test that saved her life.
Last year, Munn was checking health tests off her list before heading to Germany to shoot a new sci-fi movie. She had her annual mammogram and even had genetic testing for the BRCA mutation. Both tests came back clean. But when her doctor took the extra step of using it Breast Cancer Risk Assessment Tool (BCRAT)which asks a series of questions about family history and reproductive health, Munn’s risk was 37%. This was high enough for her doctor to recommend the MRI which detected her cancer.
Munn’s life descended into an unexpected nightmare, and instead of heading to Germany, she had four major surgeries over a 10-month period, including a double mastectomy, lymph node cleansing, reconstructive surgery and nipple delay procedure. In February 2024, she had her ovaries and uterus removed to prevent the cancer from returning.
When Munn went public with her cancer journey, she credited her doctor’s use of BCRAT for early detection. “I’m lucky. We caught it with enough time that I had options. I want the same for every woman who might have to deal with this one day,” she posted on Instagram.
According to Mary Jane Minkin, MDgynecologist at Yale New Haven Hospital and a member of HealthyWomen’s Advisory Council, women should have a mammogram every year starting at age 40. However, as was the case with Munn, a mammogram isn’t always enough.
“Mammograms miss 10 to 15% of cancers. It is not the be all and end all of breast health. That’s where the Risk Assessment Tool comes in,” said Minkin, who explained that if you catch breast cancer early, like Moon did, survival rate is too high.
How the Breast Cancer Risk Assessment Tool works
BCRAT uses a woman’s personal information to estimate her risk of developing invasive breast cancer over the next five years and up to age 90. “It basically makes sure that people who are at higher risk are getting tested regularly,” Minkin said. .
According to the National Cancer Institutethe tool assesses:
- Age
- Age at your first period
- Age at first live birth of a child
- Number of first-degree relatives with breast cancer
- Number of previous breast biopsies
- Presence of precancerous cells in the breast
“Being a woman is the biggest risk. The older we get, the greater the risk,” Minkin said. But there are many other factors to consider. “If you were 9 or 10 years old when you started getting your period, you’re at higher risk than someone who got their period at 15,” she explains.
The number of children you have and the age you have them can also contribute to your risk. Having children before the age of 35 and having many children reduces the risk.
Genetics also play a role. The more first-degree relatives – your mother, daughters or sisters – who have been diagnosed with breast cancer, the higher your risk.
Read: My sister, mom and I diagnosed with breast cancer within 18 months of each other >>
The more breast biopsies you have had, the higher your risk. Even if the biopsies are negative, the fact that they were needed suggests that something fishy is going on in the breast.
BCRAT, which is available both online and at your healthcare provider’s office, gathers all your information and provides a risk assessment score. People with a score above 20% should have annual mammograms and breast MRI starting at the age of 30.
The limitations of BCRAT
While BCRAT can save lives, it has limitations. The tool is not a substitute for genetic testing and cannot accurately detect risks for women who carry BRCA1 and BRCA2 mutations. It also cannot assess the risk for women who have a previous history of breast cancer.
According to the Susan G. Komen Foundation, the tool measures group risk, not individual risk. This means it provides the average risk of breast cancer for a group of women with similar risk factors, so it cannot predict whether any individual woman will develop breast cancer.
The BCRAT also does not use all the established known risk factors for breast cancer, such as smoking, diet and obesity, which may limit its predictions.
The original model only used data collected from white women, but it can now estimate risk for black women, Asian and Pacific Islander women, and Hispanic women. However, it may not accurately assess other racial and ethnic groups.
Know your options
If you use the online tool, discuss the results with your healthcare provider to make sure you are reading it correctly. If you are at high risk, find an expert you trust who will support you in getting the appropriate tests and care you need.
If you score high on the BCRAT, it doesn’t mean you need a mastectomy. “There are medications that can be used to reduce the risk and things that people can do on their own,” Minkin said. Cutting back on alcohol, exercising regularly, maintaining a healthy weight and avoiding smoking can all help. “No matter what risk you’re in, be aware of what’s going on in your chest.” If you see changes, don’t ignore them.
This educational resource was created with the support of Daiichi Sankyo and Merck.
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