It comes down to insurance quite honestly. I had my surgery August 2022. I am on the AI's to block estrogen. I see my oncologist every 6 months now. He asks how I am feeling. Asks about aches/pains and fatigue levels. Monitors my weight. As long as nothing looks out of ordinary, we assume all is good. Should I exhibit any atypical symptoms that would lead him to think cancer may have returned in another area of my body, he said he would schedule (and insurance would approve) an appropriate diagnostic tool. Insurance will not cover random scans to just check for cancer. Sad but true. Insurance does cover bone density scans every 2 years to check for bone loss due to the AIs that I am on. I see my primary care doctor annually for all the usual things (PAP, colonoscopy, blood work, etc)
So my PCP might would pick up an abnormality through these things and schedule a diagnostic tool to further investigate.

Here is one example of what might happen. About a month after radiation, I picked up a cold with a terrible cough. It slowly improved but never completely went away. Lungs sounded fine but cough persisted. After 3 months my primary care doctor ordered a chest xray. Insurance paid - no issue with them. Xray showed a "spot". I freaked out. My PC doctor then ordered a lung CT scan. Insurance paid for it - no issue with them. The spot was a bit of scar tissue. Maybe from radiation, maybe from a past pneumonia. My radiation oncologist and my PC doctor thought the cough lingered on because of my recent radiation and that it would slowly go away. And it eventually did.

So as long as you are not exhibiting any abnormal symptoms, your insurance probably will not cover MRIs, CT scans or PET scans as a routine thing to check for cancer that has spread beyond the breasts.

I guess thats why when women have a mammogram every year and then 6 months later have a need to have something evaluated that turns out to be Metastases thats why it would be helpful to have at least 1 full imaging a year so the questionable area that could be Mets can get treated ASAP. But women are at the mercy of insurance companies .

I do self examination of my breast often. If there's a change ,shape or size in your nipples or breast contact your health care team immediately. This question often runs through my mind and I just had my 6 month mammogram. Everything is well.

A mammogram probably won't show any changes within a year's time. BC doesn't really grow that fast and mets to bones or organs will only show up on a CT scan or MRI. Those are very expensive and insurance won't pay for them unless you are having some symptoms that lead your physician to believe that there might be a problem. Also, your initial dx will give your oncologist a good idea of whether you might have metastasis down the road. In my case, it is unlikely though not impossible. With others it can be quite likely. I don't think insurance will ever pay for CT scans or MRIs as a screening tool when there are no symptoms. Insurance companies don't exist to help people. They are in business to make money.

You have to be your own advocate. I receive mamagrams annual, but because of my bone metastasis I get a
Pet scan and MRI every 3 months. When something doesn't feel right I let my Oncologist know and he orders a scan or xray or ultrasound.