Breast Cancer Awareness Month: A Conversation with FNP & Survivor, Dania Francis
- Lauren Cascone
- Oct 22
- 4 min read
October is Breast Cancer Awareness Month — a time to educate, empower, and remind every woman that early detection saves lives. As an IBCLC, I often hear hesitation from breastfeeding parents about pursuing breast imaging. To bring clarity and perspective, I sat down with Dania Francis, FNP-BC — a family nurse practitioner, triple negative breast cancer survivor, and recipient of the 2025 Courage Award from the TNBC Foundation.
Dania is also a mom to Peter (6) and Emilia (4), a breast cancer advocate, and a pediatric nurse practitioner. Her personal and professional experience offers invaluable insight into breast cancer screening, risk factors, and the importance of self-advocacy.
Screening in the Lactating Parent
Lauren: As an IBCLC, I often hear concerns about delaying or avoiding breast imaging due to breastfeeding. Can you clarify the current guidelines on the safety and efficacy of screening mammograms or diagnostic ultrasounds for lactating mothers? What are your top tips for a parent who needs imaging?
Dania: The American Cancer Society recommends that breastfeeding mothers follow the same screening guidelines as non-breastfeeding women. It is absolutely safe to have a mammogram or ultrasound while breastfeeding — and delaying screening could be dangerous.
As a young mom and breast cancer survivor myself, I’ve learned that breast cancer among younger women—especially postpartum—is on the rise. I was diagnosed when my daughter was just one year old. My best advice? Pump or nurse right before your appointment to make the breasts more comfortable and improve image quality, but don’t delay your imaging.
Personalized Risk and Supplemental Screening
Lauren: We know that average-risk guidelines suggest screening around age 40, but many women have unique risk factors. What are the key risk factors that might prompt earlier or more intensive screening?
Dania: There are several risk factors that could lead your provider to recommend earlier or additional screening:
Family history, especially on your mother’s side (breast, ovarian, or even prostate cancer)
BRCA or other genetic mutations
Dense breast tissue — this not only increases risk but makes cancers harder to detect
Having children later in life or not at all
Smoking, alcohol, or drug use
Sedentary lifestyle or being overweight
Chronic stress
IVF treatment or hormonal medication use
For many women, this means adding a breast MRI or ultrasound in addition to mammography.
Breast Awareness and Self-Exams
Lauren: The traditional “monthly self-breast exam” has evolved into the concept of “breast awareness.” How do you encourage patients to stay breast aware, and what changes should prompt immediate evaluation?
Dania: I always tell my patients to know their normal. That’s what breast awareness really means. Even without feeling a lump, there are other changes to watch for:
Skin dimpling
Inverted nipples
Nipple discharge
Pain, rash, or swelling
Asymmetry between breasts
Armpit pain or swelling
If you notice any of these — even while breastfeeding or after a recent “normal” screening — don’t wait. Schedule an appointment.
Patient Experience and Advocacy: Dania’s Story
Lauren: You’re both an FNP and a survivor. What is the most important piece of advice you would share with other women about advocating for their health?
Dania: Trust your gut. If you feel something is wrong, don’t let anyone dismiss your concern. When I first found my lump, my gynecologist told me it was likely a fibroadenoma and that I didn’t need to rush an ultrasound. My mammogram was normal because I have dense breasts — but I pushed for an ultrasound anyway.
One month later, I was diagnosed with aggressive, fast-growing triple negative breast cancer. If I had waited, I might not be here today. I saved my own life by advocating for myself.
Supporting Survivors and Advocacy Organizations
Lauren: Are there causes or organizations you’d like to highlight that support breast cancer patients or survivors?
Dania: Absolutely. Two that are close to my heart are:
Boxed by an Angel – founded by fellow survivor Cathy Angel in Florida, this organization delivers beautifully curated care packages to those newly diagnosed. https://www.boxedbyanangel.com/
The Triple Negative Breast Cancer Foundation – dedicated to funding research and supporting patients with TNBC. https://tnbcfoundation.org/
Supporting these organizations helps bring comfort and hope to those navigating treatment and survivorship.
The Role of Primary Care and Collaboration
Lauren: Since family nurse practitioners are often the first point of contact, how critical is primary care in assessing breast cancer risk — and how can IBCLCs or other healthcare providers collaborate?
Dania: Primary care providers play a vital role in early detection. Risk assessment tools like the IBIS Risk Calculator can help identify patients who might benefit from earlier or supplemental screening.
Collaboration between FNPs, OB/GYNs, and IBCLCs ensures that every patient—especially postpartum and breastfeeding mothers—receives comprehensive breast health education, guidance, and timely imaging when needed.
Final Thoughts
Dania’s story is a powerful reminder that breastfeeding is not a reason to delay screening and that self-advocacy saves lives.
During Breast Cancer Awareness Month and beyond, let’s continue to normalize conversations about breast health — in lactation, in primary care, and in every stage of motherhood.
Written by:Lauren Cascone, MSN, RNC-OB, IBCLC
Strong as a Mother, LLC
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