MIAMI – The American Cancer Society's new recommendation for women to start getting mammograms at age 45 instead of 40 applies to women "at average risk." But there is no way for women to know with certainty if they are "at average risk."

Scientists have yet to define how and if the disease that hits one in eight women can be prevented. It is not yet possible to know the specific risk factors that contributed to a diagnosis. And many patients have no apparent risk factors other than being a woman and growing older.

Why recommend less screening?

These are some of the reasons why The American Cancer Society issued a new recommendation:

- Even though mammography reduces deaths from breast cancer, it does not eliminate them.

- Screening increases the rate of false positives

- Evidence does not show that regular breast self-exams help reduce deaths from breast cancer.

- Only a small percentage of women are considered to be at very high risk for breast cancer.

- After 55, get screened every other year, because some breast cancers grow more slowly after menopause.

Brandy Hotkowski was one of thousands of survivors on social media, who worried that the guidelines published on the Journal of the American  Medical Association Tuesday were on shaky grounds when referring to "average risks."

"As a woman who is currently battling stage 2 breast cancer at 32, this really is just infuriating!" Hotkowski said on Facebook. "I was average risk. Negative for the gene and no family history."

Ultimately, insurance companies are the ones setting the standards for what they will cover. They have been paying for mammograms starting at age 40, even though the federal government task force, the U.S. Preventive Services, recommends mammograms starting at age 50.

Survivors who were upset with the recommendations from the country's best-known advocate for screening, said over testing may be the price of saving lives. Most survivors reminded women that they should not assume that their risk is average, even if they are younger than 45.

There are many unknown variables such as exposure to environmental cancer-causing factors and an ignorance of family history. There is not enough data yet to predict who the disease will kill. But we know this year about 430,000 women will die of breast cancer --- and about 1,200 of those women will be under 40.

"The new guidelines are horrible," Madeline Bartorillo said. "Clinical breast exams are a necessity for women of all ages. There is no such thing as too young. I was 17 when I had breast cancer."

OTHER RECOMMENDATIONS

The American College of Radiology and Society for Breast imaging: Annual mammograms beginning at 40.

The U.S. Preventive Services Task Force: Biennial mammograms for ages 50 to 74.

ON THE WEB: Get the Breast Cancer mobile app to learn how to check your self

Oncologists who are at the forefront of the fight do know that in most cases, an early diagnosis can mean a more treatable disease. Early diagnosis usually happens during clinical breast exams, a medical professional's exam to detect visible and palpable cancer.

Without access to mammograms, most women under 40, who don't have the means to pay for the screening, end up finding the tumor through self-breast exams and clinical breast exams, which the Society is also not recommending. 

The Young Survival Coalition is a New York-based non profit that aims to help women worldwide who are diagnosed with breast cancer before they turn 40. Their Facebook page blew up with commentary, after the announcement.

Mandy Melanie Giannattasio shared a post. She was diagnosed at 36, and said she owes her life to a clinical breast exam.

"I am appalled and thoroughly disappointed by the new guidelines," Giannattasio said.

The organization's CEO Jennifer Merschdorf is a breast cancer survivor, who was diagnosed when she was 36. She said they are concerned about the recommendation to not perform clinical breast exams.

"Until data supporting The American Cancer Society's decision is presented, the Young Survival Coalition will remain opposed to this new recommendation."

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Local10.com reporter Andrea Torres is a breast cancer survivor, who was diagnosed at 33 years old.

Follow Local10.com reporter Andrea Torres @MiamiCrime