New recommendations from a federal task force may change the way women think about breast cancer. The panel has suggested that mammography is no longer necessary for women under 50, leaving local doctors scrambling to decide what to tell their patients.

Duke University Researcher Dr. Gary Lyman, a nationally recognized breast oncologist, said the recommendations from the U.S. Preventive Services Task Force contradict numerous clinical studies that show screening mammograms are an effective tool.

"Breast cancer demonstration projects done in the U.S. show women who comply with the full screening, which is annual checkups, mammography and breast self exams, 95% of those patients, if they develop breast cancer, will be early stage disease and highly curable," he said.

But Duke Oncologist Dr. Amy Abernathy, who directs the hospital's cancer support programs, said current evidence supports the new recommendations, especially for women at average risk.

"Part of the reason that the guidance has shifted away from women under the age of 50 is that the risk of breast cancer and developing breast cancer in that group is so low," said Abernathy.

The recommendations also include spacing out mammograms for older women, with screenings once every two years for women between 50 and 74. Perhaps the most controversial suggestion is that doctors should not teach women to do breast self-examination.

"The breast self exam itself has come with a very structured approach in the screening world," said Abernathy. "You do it this way, once a month, here's how you give people advice to do it. And that structured approach has not proven to change outcomes."

But breast cancer survivor Amelia Frahm disagrees. The Apex mother of two was diagnosed 15 years ago, prompting her to write a children's book about her family's experience. Since then, she has met many other young women who developed breast cancer and had no family history.

"There are a lot of other young women out there who may not have a family history, but need to be comfortable doing a breast self exam," she said. "If for no other reason than to just be comfortable with their own body where if there is something amiss, they know about it."

Lyman said while the recommendations are new and will still have to pass muster with physician organizations, he is concerned that the recommendations could lead to confusion among patients and potentially to reduced reimbursement for mammography, which is now standard in most health plans.

"I have no doubt that mammography rates will be affected by this," he said.  "And eventually, lives will be lost if this is implemented."

Click here to read more of the U.S. Preventive Services Task Force recommendations on breast cancer screening.