@lilacs777 as I wrote before, my doctors only use Signatera and other blood tests, for patients already diagnosed with metastasis, to measure effectiveness of treatment.

I am 10 years out and am mentally marking that anniversary with a wish for a check up but after a double mastectomy, none is offered. In fact, even though risk goes up for hormonal cancers as time goes on, I was discharged after my 5 years of letrozole.

That said, testing every few months after a primary cancer seems like an anxious way to live. As does too much focus on lifestyle management, but that's me. We are all different!

It seems that for stage 4, there is no concern about catching cancer early, on the part of the medical establishment. I don't know if early detection of stage 4 makes a difference: does anyone else know?

It is a tricky balance to stay vigilant but also put cancer on the back burner. Many of us never have recurrence or spread. I have not pursued any check ins other than a couple of hip x-rays over the years.