March 14, 2024—Actress Olivia Munn's candid reveal on instagram The story of her aggressive breast cancer, the surprising discovery after a „clean“ mammogram and negative genetic test, is interwoven with details of her cancer journey and lessons for women. It was heart-wrenching content.
Earlier this week, Mann revealed her 10-month battle with the disease. breast cancerThis resulted in four surgeries and a double mastectomy, and she used social media sites as a way to educate women about the disease and the importance of proper screening tests.
Mann's experience reveals some truths that women may not know. Most women who get breast cancer please do not have a genetic predisposition.Mammography cannot detect all cancers. Personal Risk Assessment — Mr. Mann's OB/Gynecology Doctor's Recommendations — They can point out that additional tests are needed to find tumors missed by the mammogram.
Mann, 43, is known for the following works: jon stewart's daily showwho plays economist Sloane Sabis in the HBO political drama news room, and movies included magic mikeIt is written in detail in on instagram Despite a normal mammogram and a negative genetic test for 90 different cancer genes, she was found to have an aggressive form of cancer known as Luminal B.
After conducting an individualized risk assessment, her doctor determined that Ms. Mann's lifetime risk was very high at 37% and recommended that she undergo further extensive testing, which revealed that she had cancer in both breasts. Detected.
In a series of Instagram posts, Mann said she initially kept her diagnosis private, explaining that she „needed to take a breath and get through the hardest part before sharing.“ She praised Dr. Tais Aliabadi, the obstetrician-gynecologist who decided to calculate the risk score. „The fact that she saved my life,“ Mann wrote.
Mann's fighting spirit and positive attitude are evident. „I'm lucky,“ she posted. „We had plenty of time to catch it, so we had options.“ She praised her efforts, along with her partner John Mulaney, with whom she has a two-year-old son. He researched treatments and medications and posted photos of his son's bedside.
Mann was assisted by doctors and other staff at Cedars-Sinai Medical Center in Los Angeles and Providence St. John's Health Center in Santa Monica, including oncologic surgeon Armando Giuliano, MD, reconstructive surgeon Jay Olinger, MD, and medical oncologist Dr. (including Monica Mita). , MD, Aliabadi.
A spokesperson for Ms. Mann said that she is not being interviewed at this time. A Cedars-Sinai spokesperson declined to comment on Mann's case.
Genetics and breast cancer
„Most people who get breast cancer don't have an inherited genetic mutation,“ said the researchers at Legacy Health Systems Cancer Institute and Legacy Breast Cancer Institute in Portland, Oregon, which were not involved in Mann's treatment. said Dr. Natalie Johnson, medical director of the health center. .
„only 5-10% „A large percentage of people who develop breast cancer have a gene that tests positive,“ says Joanne Mortimer, M.D., director of the Women's Cancer Program and a medical oncologist at City of Hope in Duarte, California. agree. Mortimer was also not involved in Mann's treatment, and she spoke generally about the treatment of breast cancer in cases similar to Mann's.
cancer subtypes
Luminal breast cancer is cancer that occurs in:The lumen or inner wall of a milk duct. Both Luminal A and Luminal B require estrogen to grow, Johnson said. Luminal A has a good prognosis and is easy to treat. Luminal B has an even worse prognosis and is sometimes called B, meaning „bad,“ she said.
Luminal B says, „I need chemotherapy, but if it comes back, it comes back. It's just difficult. It doesn't respond to endocrine therapy or estrogen inhibitors, so other treatments have to be used.“
Genomic testing can help doctors determine whether a luminal tumor is type A or type B, she said. Johnson said the prognosis for Luminal B cancer may still be good, she said.
Beyond the mammogram
„Mammography isn't perfect,“ Johnson says. Screening can miss cancer, especially in breasts with dense tissue, because cancers do not show up very clearly on images.
density Refers to the amount of fibrous and glandular tissue within the breast compared to fatty tissue. According to the CDC, about half of women over the age of 40 have dense breasts. Your mammogram report may include information about whether your breasts are dense or dense.
If your breasts are dense, an ultrasound or breast MRI may be a good follow-up test, Johnson said.
Even though mammograms may miss some cancers, Johnson encourages women to get tested as recommended.of U.S. Preventive Services Task Force; The draft recommendations call for mammograms to begin at age 40 and be repeated every other year.
Even if a mammogram shows no evidence of cancer, if a woman notices something unusual in her breasts, it's time to see her doctor and ask about further testing, Johnson said.
Mortimer said young women like Mann are often given an MRI scan if they have dense breasts or a family history, both of which are known to increase the risk of breast cancer. „For people with a family history, we alternate MRIs and mammograms to increase the chances of detection,“ she says.
personal evaluation
In an Instagram post, Mann praised the obstetrician-gynecologist who suggested the individual risk assessment. „Dr. Aliabadi (who is Thai) considered factors such as my age, my familial history of breast cancer, and the fact that I gave birth to my first child after the age of 30,“ Mann wrote on Instagram. I wrote this. „She found that my lifetime risk was 37% of hers.“
The score prompted doctors to order Mann an MRI, followed by an ultrasound and a biopsy. „A biopsy revealed that I had Luminal B cancer in both breasts,“ Mann wrote. „Luminal B is an aggressive, fast-growing cancer.“ Thirty days later, Mann underwent a double mastectomy.
One such risk assessment is National Cancer Institute site. Consideration includes breast cancer history, previous breast radiation, genetic mutations, age, race, ethnicity, history of benign breast biopsy, age at menarche, and age at birth of first child (30 years or older) will be done. (increases your risk), and a first relative (parent, sibling, or child) who has breast cancer.
From there, it compares the patient's risk to the population's average risk and predicts the five-year and lifetime risk of developing breast cancer.
For example, a 43-year-old Caucasian woman has no history of breast cancer, no prior radiation, no genetic mutations, no history of breast biopsy, had her first menarche at age 12, was over 30 years old at first birth, and has a first-degree relative. has no blood relatives. The lifetime risk of breast cancer is 13.2%, slightly higher than the average risk of 12.1%.
treatment options
In addition to the type of tumor detected, factors such as lymph node involvement will influence treatment decisions, Johnson and Mortimer said.
For young women with Luminal B breast cancer, surgery, chemotherapy, and estrogen blockade therapy are usually used. „The prognosis for Luminal B remains good when combined with chemotherapy and endocrine therapy,“ Johnson said.
Johnson said the model can assess survival rates for whether treatment includes chemotherapy, helping women decide for themselves.
Mortimer said it was „absolutely amazing“ that Mann's gynecologist suggested a risk calculator and took action to detect the tumor much earlier than the next scheduled mammogram.