MRI is not used as a routine screening test for which group?

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MRI screening is extremely sensitive, but its routine use as a screening test is not justified for average-risk women. In this group, the likelihood of cancer is relatively low, so using MRI routinely would lead to many false positives, unnecessary biopsies, anxiety, and substantial cost and resource use. For women at high risk, the added detection from MRI provides a meaningful benefit when combined with mammography, so MRI is recommended as an adjunct in that population. MRI is also used for problem-solving when mammography or ultrasound is inconclusive, to characterize uncertain findings, or to evaluate implant-related issues, but these scenarios are not considered routine screening. Therefore, average-risk women are not candidates for routine MRI screening.