For years, women have heard the dual drumbeat of the importance of breast self-exams and annual screening mammograms: Detect breast cancer early, and there's a better chance of eliminating it.

This week, breast cancer survivors and members of the medical community were shocked when they heard the new recommendations from the United States Preventive Services Task Force. The report - based on a review of scientific studies - changes the tune:

Women under the age of 50 no longer need screening mammograms. Women between the ages of 50 and 74 should be screened every two years. Breast self-exams are no longer recommended.

"I think it's ludicrous," said Dr. Thomas Schuster, diagnostic radiologist for Wheaton Franciscan Healthcare-All Saints. "A substantial amount of women are probably not going to have their breast cancer diagnosed basically because the government is saying it's expensive and not cost-effective to screen you."

The task force acknowledges breast cancer is the second-leading cause of cancer death among American women, and that widespread screening and treatment advances led to significant reductions in breast cancer deaths. With screening and improved treatment, the overall breast cancer mortality rate has dropped 2.3 percent since 1990, the report states; among women between the ages of 40 and 50, the drop was 3.3 percent.

Behind the recommendations are factors like the number of screenings needed to "extend one woman's life" - 1,904 for women between the ages of 40 and 49, and 1,339 for women between the ages of 50 and 59 - and the "psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results."

In Racine, Schuster said, about 15 percent of the women diagnosed with breast cancer each year are under age 50. Those women have the most to lose, Schuster said.

"The (cancers) in younger women tend to be more aggressive, grow faster, (spread) earlier," he said. "They're more devastating, more so than the ones we see in older women."

Women who survived breast cancer are amazed at these recommendations.

"Today, where there's so much publicity and awareness, so many more women are getting tests and that, why would you want to change that?" said Karen Barth, 37, of Racine. "I was shocked and upset by it."

Barth had a mastectomy after she was diagnosed with breast cancer two years ago, following a screening mammogram.

Vanessa Murray, 49, of Racine, was diagnosed with breast cancer after a routine mammogram two years ago. She also had a mastectomy.

"I cannot see where they go ‘Someone's going to die, but it's minimal,'" she said. "It's not minimal if it's you."

Murray worries insurance companies will pick up on the recommendations, and stop covering mammograms for women under age 50.

Schuster said government recommendations have become common practice in the past.

"We've seen in other things, the government makes a decision, Medicare and Medicaid take it up, and the other carriers fall in line," he said. "The government doesn't have to pay for that, why should we? It's always to save a buck. Any time the government does something to save a buck, that makes it OK for them to do it, regardless of medical research behind it."

Dr. Richard Odders, a medical oncologist for Wheaton Franciscan Healthcare-All Saints, said it is unlikely that the recommendations will be adopted by insurance companies.

Additionally, he said he understands the recommendations, and said it is possible that people acquiesced to political pressure 20 years ago, when women were encouraged to get mammograms starting at age 40.

"You have to spend a lot more money to find one cancer," he said. "If you're the one person with cancer, it's very important, but if you're a taxpayer, you might not want to spend that money."

Women should work with their doctors to make the best medical decision possible, he said, and recognize that the government's concern isn't with any individual patient.

"If I'm making a decision for you and I, you're my patient, we might decide to spend the money," he said. "If I'm the health care czar for the country, I might decide to spend the money for moms that don't have prenatal (care) or vaccinations for kids. It might save more lives, help more people. That one person with cancer's got problems, but what's the best way to spend the money? If the money's unlimited then we'd do mammograms on everyone all the time. At least when I check my savings account, money's not unlimited."