However, he added, ACS "[does not] agree that 70% of the benefit from screening mammograms is the right way to go.... We should not forget that the 'benefit' in this situation is reducing deaths from breast cancer. A 30% reduction in saving lives in not acceptable."
Several patients posted comments to Lichtenfeld's blog, writing in essence that if they had followed what these guidelines propose, they "would be dead at 50." While the USPSTF has stated that the decision to screen at earlier ages should be based on the patient's and provider's judgment, there is concern that insurance companies will adhere to these guidelines, making it more difficult, or more expensive, for women to receive mammograms in their 40s, or on an annual rather than biennial basis.
One patient also expressed frustration with the lack of attention to women who are diagnosed with breast cancer in their 20s and 30s, saying, "If it's going to become more difficult for women in their 40s to get a mammogram, what is that going to do for women in their 20s and 30s, who already get blown off by their health care providers when they come in with a lump?"
There will undoubtedly be ongoing debate and discussion as to what impact the USPSTF recommendations will have, and clinicians will need to be prepared to answer questions from concerned (or even angry) patients. Lichtenfeld perhaps said it best in this blog posting: "These changes are bound to confuse women and health care professionals who must now make a professional and a personal choice as to which recommendations to follow. The worst outcome would be if the confusion leads women to do nothing, since the experts can't seem to make up their minds."