The majority of new breast cancer episodes are early-stage breast cancer and successfully undergo a series of systemic treatments including surgery. However, approximately 30% of these patients eventually develop local recurrence and distant metastases, and the proper follow-up of these asymptomatic patients becomes an important topic. In general, it is believed that early detection and treatment of disease recurrence can lead to better treatment outcomes. However, there is still controversy about the optimal frequency and necessary content. For those patients with a high risk of recurrence, it is important to aim for the most effective monitoring modality. In one retrospective study, the period of high risk of recurrence was 1-2 years after surgery, followed by a rapid decline in the risk of recurrence over 2-5 years and a return to a plateau over 5-12 years. Another study showed that ER-positive patients have a stable risk of recurrence for many years, requiring prolonged monitoring. However, patients with HER2-positive and triple-negative breast cancer have a higher risk of recurrence in the early years of follow-up and therefore require more intensive surveillance in the first year after surgery. Breast cancer metastases are found in local soft tissues and lymph nodes, bone, lung, and liver. Fifty to 70% of first recurrences are single organ recurrences, with bone metastases being the most common, followed by local recurrences. The main manifestation of bone injury is bone pain. Chest wall masses or enlarged lymph nodes are often not associated with any symptoms and usually need to be detected by physical examination. Patients with lung metastases usually present with shortness of breath, cough, chest pain, chest tightness, and hemoptysis. Liver metastases rarely present with clinical symptoms, and when symptoms such as pain, anorexia, and jaundice appear, they usually indicate advanced disease. Central nervous system metastases present with symptoms that usually manifest as functional changes innervated by the metastatic site. Patients may have non-specific complaints such as headache, back pain, idiosyncratic sensation or loss of function. In summary, approximately more than 70% of patients have clinical symptoms, but some are also asymptomatic. Asymptomatic patients are reviewed every 3-6 months for 2 years postoperatively, every 6-12 months for 2-5 years postoperatively, and annually thereafter. History taking and physical examination must focus on complaints that are likely to suggest breast cancer metastasis. This includes a careful examination of local soft tissues, lymph nodes, bone, lung, liver and nervous system. Patients taking tamoxifen should also undergo annual gynecologic examinations as they are at increased risk for endometrial cancer, especially if they have abnormal vaginal bleeding while taking the drug. For patients taking AI drugs calcium supplements should be taken to prevent osteoporosis. Regarding the routine examination items, they include: systematic physical examination, medical history taking and mammography (for those with dense breast glands, mammography can be considered, and mammography is generally recommended by major guidelines at home and abroad, but further clinical studies are needed to confirm whether there is another better option given the characteristics of the national breast). Many patients are overly nervous when they see tumor markers such as CA153, CA27.29 and CEA, which are not recommended by ASCO for routine monitoring of breast cancer after primary treatment.