Because medical guidelines are based on satisficing, they are not always in the best interest of all patients. Satisficing is a mix of two words, the word satisfy, and the word suffice. The term satisficing was introduced in 1947 by Herbert Simon who received the Turing Award in 1975. Satisficing is a decision-making concept based on what is good enough for a broad population. But in many cases, good enough doesn’t mean optimal.

For example, 2D mammograms, which are recommended yearly as a breast cancer screening tool for average-risk-for-breast-cancer women over the age of 40, are widely available, fast, and cost-effective. But women with dense breasts might have small tumors missed by radiologists because instead of 2D mammograms, those women really need a 3D mammogram, which is more expensive but much more accurate.

Yet yearly 3D mammograms might not be enough either. Why is that?

Because there are different types of cancers. Some grow slowly while others could be very aggressive, growing quickly sometimes during the few months between two yearly mammograms.

Here is Debbie’s case:

Sixty-two-year-old Debbie never worried about breast cancer because there was no breast cancer in her immediate family, and she had been screened with a 2D mammogram every July since the age of 45. She thought that if any tumor started to grow, her yearly mammogram would pick it up right away.

Yet, one morning in May 2024, ten months after her last interpreted-as-normal mammogram, as she was drying her hair with both hands above her head, standing topless in front of her mirror, she noticed an unusual dimple in her left breast, as if something was pulling down on her skin.

Intrigued, she placed her fingers on the dimple, and under the dimple, her fingers felt a firm mass, about two centimeters in diameter (a little less than one inch). The mass was not painful and seemed to be glued to the tissues underneath. There was no skin discoloration.

Now alarmed, Debbie immediately called her primary care physician who, thankfully, saw her that same afternoon and ordered a mammogram plus ultrasound and........

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