How does a breast cancer risk assessment work?

How do breast cancer risk assessment tests work?

MINNEAPOLIS — Answering a quick online questionnaire proved to be a lifesaver for a Hollywood actress.

Earlier this month, Olivia Munn revealed she had a double mastectomy following a breast cancer diagnosis. She's recovering and thankful it was discovered with the help of a breast cancer risk assessment score, which acts like a detailed questionnaire.

How does the questionnaire work? And when should women start to take it? Good Question.

The spotlight on actress Munn shone in a more humbling yet meaningful way this month when she shared on Instagram her breast cancer diagnosis. She would go on to have four surgeries. The whirlwind change in her life came after initially thinking she was healthy.

"I took a genetic test that checks you for 90 different cancer genes. I tested negative for all," she said in her Instagram post. "That same winter I had a normal mammogram."

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"A negative mammogram, we do miss some breast cancers," said Dr. Tony Severt, the head of mammography at Hennepin Healthcare.

How did Munn test negative for all those cancer genes and still get cancer? 

"The genes are just one of the risk factors for developing breast cancer. There's a family history, that's gonna involve genes that we didn't test for," said Severt.

Munn said she wouldn't have found her cancer for another year if not for being encouraged to take a breast cancer risk assessment score.

How does the breast cancer risk assessment score work? It feels like an online questionnaire or survey asking detailed questions about your body, family history and more. Your age, when you had your first period, your age when you had your first kid and whether someone in your immediate family tree had breast cancer were just a few examples.

After a quick online search, WCCO tried out two questionnaires. One took about a minute to complete while the other had a longer list of questions about family members and relatives. Once complete, a percentage score is given determining the likelihood of getting breast cancer in a person's lifetime. 

Severt said any score higher than 20% likelihood should warrant further testing. Munn's score was 37%. That led to an MRI, then an ultrasound, and lastly a biopsy which revealed her cancer.

"Seeing that, a woman with breast cancer taking it public and making that step, that's very crucial," said Severt. "I think that public awareness is gonna save a lot of lives."

READ MORE: University of Minnesota researchers hope to limit heart issues related to breast cancer treatment using AI

When should a woman start taking this assessment? Severt said around 20 years old, as a woman's breasts are getting to be fully formed. 

"But as soon as you know you have a family history, as soon as you're worried you might have breast cancer, start looking at those questions," he added.

There were two different online questionnaires, the Gail Model and the Ibis Model. The Ibis Model takes significantly longer to complete but both are rather easy. Severt said women should take both questionnaires. 

"It's kind of known that the Gail Model underestimates breast cancer risk in African American patients. So, at our institution we're using the Ibis Model just because of that," he said.

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