Breast Exams and Health Strategy

The U.S. Preventive Task Force issued new clinical guidelines recommending that women 40-49 forgo annual mammograms. Given the attempt at the government to take over all health care and the way politicians send mixed signals, this is worth discussing in terms of health strategy. The report described the problems with more frequent mammograms as:

Harms of screening include psychological harms, additional medical visits, imaging, and biopsies in women without cancer, inconvenience due to false-positive screening results, harms of unnecessary treatment, and radiation exposure. Harms seem moderate for each age group.

False-positive results are a greater concern for younger women; treatment of cancer that would not become clinically apparent during a woman's life (overdiagnosis) is an increasing problem as women age.

To summarize, the "problem" is that you might find out after the fact that it was unnecessary. If nothing else, this should demonstrate how little government officials understand about how to make good strategic decisions and how foolish we are to trust the "officials" with decisions about our personal health.

Personally, I recommend that everyone takes the primary responsibility for their own health strategy, not even completely trusting their doctors (get a second opinion) and certain not government recommendations. Nobody knows your body like you do and nobody cares about your life like you do. As a former cancer patient, I have written extensively about this problem. Taking care of your health is in itself a vital reason to learn good strategy.

The strategic error here is thinking that experiments that have a negative result are wasted when, in fact, we cannot know the negative results without doing the experiment. This is a form of hindsight bias, thinking we know more before the fact than we did or could have.

Quoting from S-RULE 3.1.5 Unpredictable Value describing the nature of opportunities:

6. The only value we can are assured is that of more information. The goal is experimentation and exploration. The competitive world is a maze and many of its branches are dead-ends. When we explore a dead end, we get a little better picture of our situation.

As a cancer survivor myself whose wife had a "false positive" from a mammogram and got a "wasted" biopsy to find out she was okay, I can tell you that there is a tremendous value to the knowledge that you don't have cancer. Since we have had friends die of breast cancer in their twenties, it is foolish to think that the inconvenience of a false positive now and then isn't worth the piece of mind.

Warrior's Rules: 

Competitive Arenas: