Lifestyle
What is the breast cancer calculator actor Olivia Munn suggested after her mastectomy?
Chris Pizzello/Invision/AP
When Olivia Munn revealed this week that she was diagnosed with breast cancer and had a double mastectomy, she urged people to ask their doctors to figure out their score on a breast cancer risk calculator.
Munn said her score prompted further tests and the discovery of an aggressive form of the disease.
“I’m lucky. We caught it with enough time that I had options,” the 43-year-old actor posted on Instagram. “I want the same for any woman who might have to face this one day.”
A look at the calculator, the Breast Cancer Risk Assessment Tool:
What is the Breast Cancer Risk Assessment Tool?
It’s a questionnaire on the National Cancer Institute’s website that is designed for health care providers to use with patients. The tool received a “dramatic increase in visits” since Munn’s post, according to an NCI spokesperson.
First developed in 1989, it was originally based on data from only white women. Updates have made it more accurate for Black, Hispanic and Asian and Pacific Islander women.
It doesn’t take everything into account and can’t actually predict whether any one person will get breast cancer.
It asks about age, age at first menstrual period, age when the woman’s first child was born or if the woman has not given birth, family history of breast cancer, past breast biopsies, results of past biopsies, race and ethnicity.
The result is a lifetime risk and a five-year risk based on factors that have been tied to a higher risk of breast cancer. For comparison, it also gives an average risk for U.S. women of the same age, race and ethnicity.
Dr. Elizabeth Comen, who treats breast cancer at Memorial Sloan Kettering Cancer Center in New York, said women should do the assessment with their doctors, not by themselves.
“It’s very important to talk to your doctor about doing that together, and then making decisions about what imaging techniques are appropriate” based on the results, Comen said. Munn’s high score prompted additional imaging tests that aren’t recommended for women of average risk.
Should everyone use the tool?
It’s not the best risk calculator for some women. If you have a certain gene mutation or a previous history of breast cancer, it’s not for you. It also doesn’t take into account dense breast tissue, which can make cancer harder to spot.
The National Cancer Institute says the tool may underestimate risk in Black women with previous biopsies and Hispanic women born outside the U.S.
“The model needs further validation for Hispanic women and other subgroups,” the institute’s website says. “Researchers are conducting additional studies to gather more data to test and improve the model.”
There are dozens of similar tools, said Ashley Johnson, a nurse practitioner at Vanderbilt University Medical Center, who has studied them. Many health groups recommend that women over age 25 have such an assessment, she said, but there’s not enough evidence to say which tool is best.
What do the scores mean?
A five-year risk score of 2%, for example, means a woman’s estimated risk of developing breast cancer over the next five years is 2%.
A lifetime risk score of 7% means a woman’s estimated risk of developing breast cancer through age 90 is 7%.
Mammogram guidelines are for women at average risk, said Dr. Arif Kamal, chief patient officer at the American Cancer Society. Guidelines vary but the society says women can choose to start annual mammograms at age 40.
“Knowing your risk starts even before the age of 40,” Kamal said. That’s where a risk calculator can help.
How can I lower my risk of breast cancer?
Everyone has some risk of cancer, Comen said, but some lifestyle changes can reduce the chances.
She suggests avoiding processed foods, adding exercise and strength training to your routine, limiting alcohol and not smoking.
Lifestyle
Maureen Corrigan picks her favorite books from an 'unprecedented' 2024
“Unprecedented” surely was one of the most popular words of 2024 so it’s fitting that my best books list begins with an “unprecedented” occurrence: two novels by authors who happen to be married to each other.
James by Percival Everett
James, by Percival Everett, reimagines Huckleberry Finn told from the point of view of Jim, Huck’s enslaved companion on that immortal raft ride. Admittedly, the strategy of thrusting a so-called supporting character into the spotlight of a reimagined classic has been done so often, it can feel a little tired. So, when is a literary gimmick, not a gimmick? When the reimagining is so inspired it becomes an essential companion piece to the original novel. Such is the power of James.
Alternating mordant humor with horror, Everett makes readers understand that for Jim — here, accorded the dignity of the name James — the Mississippi may offer a temporary haven, but, given the odds of him making it to freedom, the river will likely be “a vast highway to a scary nowhere.”
Colored Television by Danzy Senna
Percival Everett is married to Danzy Senna, whose novel, Colored Television, is a revelatory satire on race and class. Senna’s main character, Jane, is a mixed-race writer and college teacher struggling to finish her second novel. Desperate for money, Jane cons her way into meeting a Hollywood producer who’s cooking up a bi-racial situation comedy. Senna’s writing is droll and fearless. Listen to Jane’s thoughts about teaching:
One of the worst parts of teaching was how, like a series of mini strokes, it ruined you as a writer. A brain could handle only so many undergraduate stories about date rape and eating disorders, dead grandmothers and mystical dogs.
Long Island by Colm Tóibín
Long Island is Colm Tóibín’s sequel to his 2009 bestseller, Brooklyn, whose main character, Eilis Lacey, is now trapped in a marriage and a neighborhood as stifling as the Irish town she fled. Abruptly, Eilis decides to visit her 80 year old mother back in Ireland, a place she hasn’t returned to in almost two decades, with good reason. There she’ll discover, much as another Long Islander named Jay Gatsby once did, that you can’t repeat the past. Tóibín floats with ease between time periods in the space of a sentence, but it’s his omissions and restraint, the words he doesn’t write, that make him such an astute chronicler of this working-class, Catholic, pre-therapeutic world where people never speak directly about anything, especially feelings.
Tell Me Everything by Elizabeth Strout
Tell Me Everything reunites readers with the by now familiar characters who populate Elizabeth Strout’s singular novels, among them: writer Lucy Barton, lawyer Bob Burgess and retired teacher Olive Kitteridge — all living in Maine. Nobody nails the soft melancholy of the human condition like Strout — and that’s a phrase she would never write because her style is so understated. Lucy and Olive like to get together to share stories of “unrecorded” lives. At the end of one of these sessions, Olive exclaims:
“I don’t know what the point is to this story!”
“People,” Lucy said quietly, leaning back. “People and the lives they lead. That’s the point.”
“Exactly.” Olive nodded.
Martyr! by Kaveh Akbar
Martyr! is Iranian American poet Kaveh Akbar’s debut novel about a young man named Cyrus Shams struggling with depression and the death of his mother, who was a passenger on Iran Air Flight 655, an actual plane that was mistakenly shot down in 1988 by an actual Navy ship, the USS Vincennes. All 290 passengers on board that plane were killed. Early in the novel, Cyrus articulates his need to understand his mother’s death and those of other “martyrs” — accidental or deliberate — throughout history. Akbar’s tone here is unexpectedly comic, his story antic, and his vision utterly original.
Creation Lake by Rachel Kushner
Rachel Kushner’s Creation Lake is a literary spy novel wrapped up tight in the soiled plastic wrap of noir. Kushner’s main character, a young woman who goes by the name of Sadie Smith, is a former FBI agent turned freelance spy who infiltrates a radical farming collective in France that’s suspected of sabotaging nearby agribusinesses. You don’t read Kushner for the “relatability” of her characters; instead, it’s her dead-on language and orange-threat-alert atmosphere that draw readers in.
Cahokia Jazz by Francis Spufford
In Cahokia Jazz, Francis Spufford summons up a femme fatale, crooked cops and politicians, and working-class resentment as bitter as bathtub gin. He weds these hardboiled elements to an eerie story about the actual vanished city of Cahokia, which, before the arrival of Columbus, was the largest urban center north of Mexico. Spufford’s novel is set in an alternative America of 1922 where the peace of Cahokia’s Indigenous, white, and African American populations is threatened by a grisly murder.
The God of the Woods by Liz Moore
There’s a touch of Gothic excess about Liz Moore’s suspense novel The God of the Woods, beginning with the plot premise that not one, but two children from the wealthy Van Laar family disappear from the same camp in the Adirondacks some 14 years apart. Moore’s previous book, Long Bright River, was a superb novel about the opioid crisis in Philadelphia; The God of the Woods is something stranger and unforgettable.
A Wilder Shore by Camille Peri
I’ve thought about A Wilder Shore — Camille Peri’s biography of the “bohemian marriage” of Fanny and Robert Louis Stevenson — ever since reading it this summer. In her “Introduction” Peri says something that’s also haunted me. She describes her book as: “an intimate window into how [the Stevensons] lived and loved — a story that is at once a travel adventure, a journey into the literary creative process, and, I hope, an inspiration for anyone seeking a freer, more unconventional life.” That it is.
The Letters of Emily Dickinson edited by Cristanne Miller and Domhnall Mitchell
This list began with the word “unprecedented” and I’ll end it with an “unprecedented” voice — that of Emily Dickinson. A monumental collection of The Letters of Emily Dickinson was published this year. Edited by Dickinson scholars Cristanne Miller and Domhnall Mitchell, it’s the closest thing we’ll probably ever have to an autobiography by the poet. Here’s a thank-you note Dickinson wrote in the 1860s to her beloved sister-in-law:
Dear Sue,
The Supper was delicate and strange. I ate it with compunction as I would eat a Vision.
1,304 letters are collected here and, still, they’re not enough.
Happy Holidays; Happy Reading!
Books We Love includes 350+ recommended titles from 2024. Click here to check out this year’s titles, or browse nearly 4,000 books from the last 12 years.
Lifestyle
How Polène Is Growing French DTC Handbags Into an International Success
Lifestyle
Writer Ted Chiang on AI and grappling with big ideas
Science fiction author Ted Chiang wishes he could write faster.
His entire body of work from the last 34 years almost completely fits into two book-length collections of short stories, and he says he feels the pressure that many writers do — to be more prolific.
“I can’t claim any moral high ground or deliberate strategy. It’s mostly just that I’m just a very slow writer,” Chiang said.
But each of his stories is meticulously crafted, the result of big philosophical questions that gnaw at him for months or even years. And he is no stranger to success: His novella-length “Story of Your Life” was the basis of the film Arrival. Many of his works have won science fiction’s highest accolades and prizes.
Chiang recently added another prestigious award to that list. He is the recipient of this year’s PEN/Malamud Award, which celebrates “excellence in the short story.”
Chiang sat down with All Things Considered host Scott Detrow to talk about his writing process, the philosophical ideas that undergird science fiction and why he doesn’t think AI is capable of making art.
This interview has been edited for length and clarity.
Interview highlights
Scott Detrow: I want to start really broadly because I think so many of your stories seem to be asking big questions, whether it’s how humans would behave when they encounter a disruptive new technology, or an alien race, or the physical presence of God. But then all the stories come back to the human reaction to that, as opposed to the existential problem itself. When you’re coming up with these stories, do you start with the big question? Do you start with the character? Where does your mind typically drift first?
Ted Chiang: I usually start with what you would call “the big question.” I am interested in philosophical questions, but I think that thought experiments are often very abstract, and it can be somewhat hard for people to engage with them. What science fiction is good at is, it offers a way to dramatize thought experiments. The way it happens for me is that ideas come and ideas go. But when an idea keeps recurring to me over a period of time, months or sometimes years, that is an indicator to me that I should pay more attention to this idea, that this idea is gnawing at me. The only way for me to really get it to stop gnawing at me is to write a story.
Detrow: In the last year or so, you’ve published a series of articles in The New Yorker taking a critical look at AI and often making arguments that this is being framed the wrong way when popular culture talks about artificial intelligence [or] large language models like ChatGPT. What is it about AI in this moment that interests you?
Chiang: As a science fiction writer, I’ve always had a certain interest in artificial intelligence. But as someone who studied computer science in college, I’ve always been acutely aware of the vast chasm between science-fictional depictions of AI and the reality of AI. I think the companies who are trying to sell you AI benefit from blurring this distinction. They want you to think that they are selling a kind of science-fictional vision of your superhelpful robot butler. But the technology they have is so radically unlike what science fiction has traditionally depicted.
Detrow: In one of these essays that I think perhaps got the most attention, you were making the argument that AI is not going to be making great art. Can you walk us through your thinking, your argument about the fact that ChatGPT probably isn’t going to write a great novel or DALL-E is not going to be creating really valuable fundamental works of art?
Chiang: So the premise of generative AI is that you, as the user, expend very little effort, and then you get a high-quality output. You might enter a short prompt, and then you get a long piece of text, like a short story or maybe a novel. Or you enter a short prompt, and then you get a highly detailed image, like a painting. You cannot specify a lot in a short text prompt. An artist needs to have control of every aspect of a painting. A writer needs to have control over every sentence in a novel. And you simply cannot have control over every sentence in a novel if all you gave was a pretty short text prompt.
Detrow: Tying this back to your fictional work, I think a lot of your stories will propose a new innovation or a scientific discovery that just rocks the society that it comes upon. Is it fair to say that, at least when we’re talking about generative AI, when we’re talking about AI in the current conversation, is it fair to say that you do not see it as that kind of game-changing development?
Chiang: I think that generative AI will have massive repercussions, not because it is fundamentally a transformative tool, but because companies will be quick to adopt it as a way of cutting costs. And by the time they realize that it is not actually that effective, they may have destroyed entire industries. But in the meantime, they might have made a lot of short-term money. And it costs thousands or millions of people their jobs.
Detrow: There are these big societal changes in your pieces. But in a lot of the stories, the main character won’t necessarily change that much of their identity. Whatever massive shift is happening seems just kind of to confirm their sense of purpose or their sense of identity. I’m wondering how you think about that, and if you think that’s maybe a hopeful takeaway from some of these stories.
Chiang: So, I would say that big technological changes, they often will demand that we kind of rethink a lot of things, but they don’t automatically change our fundamental values. If you loved your children before, you should continue to love your children — there’s no technological advance that will make you think, “Oh, actually, loving my children, I guess I’m going to discard that idea.” So, I wouldn’t say that the characters are unaffected or that they just go on being the same. It’s more that they hopefully find some way to live, which allows them to be faithful to their core beliefs, their core values, even in the face of a world that has changed in a very unexpected way.
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