Olivia Munn does not cry easily. But recalling her breast cancer diagnosis a year ago, which ultimately led to four surgeries, a double mastectomy and medically induced menopause, tears threaten. She takes a steadying breath.
At the time, her mind went straight to her son Malcolm, then 1, with partner John Mulaney. “I was not someone who obsessed over death or was afraid of it in any way,” she tells PEOPLE in this week’s cover story. But “having a little baby at home made everything much more terrifying.”
Malcolm is now two years old, and the curious toddler arrives at the PEOPLE photo shoot post afternoon nap, by way of his father’s hip. “You look beautiful,” says Mulaney, leaning down to give Munn a kiss as “Malcie” spots a blue plastic ball waiting for him on the balcony nearby.
The actress was diagnosed with bilateral breast cancer after tests revealed she had luminal B—a fast-moving, aggressive cancer—in both breasts. She was two weeks away from starting a new sci-fi film in Germany when she was diagnosed. “You realize cancer doesn’t care who you are; it doesn’t care if you have a baby or if you don’t have time,” she says. “It comes at you, and you have no choice but to face it head-on.”
Within 30 days, Munn underwent a lymph node dissection, a nipple delay procedure (a surgical procedure which spares the nipples) and a double mastectomy. “I had amazing doctors, but it was still a negotiation sometimes on what we are doing,” she says, recalling being told that she could opt for the nipple delay—but didn’t have to. “But I’m glad I did. I want to give myself the best shot of keeping the parts of me that I can keep.”
Munn’s diagnosis came as even more of a shock to her because her annual mammogram just three months prior had come back clear, and she had recently tested negative for the BRCA cancer gene. “I was walking around thinking that I had no breast cancer,” she says. “I did all the tests that I knew about.”
While four out of five types of breast cancer are discovered through mammograms, an estimated 20 percent of breast cancers, like Munn’s, go undetected, according to the National Cancer Institute. During the actress’s appointment for her annual Pap smear in March 2023, Munn’s ob-gyn Dr. Thaïs Aliabadi, who co-hosts the SHE MD podcast on women’s health, asked if she knew her lifetime breast cancer risk score. Munn did not. In minutes, using a free online tool called a Tyrer-Cuzick risk assessment calculator, Aliabadi calculated Munn’s score based on various factors, including her age at her first period and her family’s history of breast cancer.
Anything above a 20 percent score is considered high-risk, signaling that additional screening beyond a standard mammogram is likely necessary. Munn’s score was an alarming 37.3 percent. Aliabadi ordered an MRI, which revealed a spot in Munn’s right breast, “just a hairline away from my lymph nodes,” the actress recalls. A subsequent ultrasound detected two more tumors in her right breast, which biopsies confirmed to be stage 1 invasive cancer. Further review of Munn’s original MRI led to a biopsy which confirmed cancer in the left breast as well.
Munn’s medical team recommended a double mastectomy to remove all of the known cancer—as well as greatly reduce any further risk. “There’s so much information, and you’re making these huge decisions for the rest of your life,” says Munn. “I really tried to be prepared, but the truth is that nothing could prepare me for what I would feel like, what it would look like and how I would handle it emotionally. It was a lot tougher than I expected.”