Purpose: The COVID-19 pandemic resulted in a rapid move to virtual care. Questions exist as to whether reduced in-person assessment, with physical examination of early breast cancer patients (EBC), will affect the detection of recurrences. We evaluated recurrence patterns of patients transferred into a survivorship program through a single centre Wellness Beyond Cancer Program (WBCP).Methods: Consecutive EBC patients who returned to formal oncologist follow-up between February 1, 2013, and January 1, 2019, due to breast cancer recurrence were reviewed. Descriptive analyses were used to present patients and disease characteristics stratified by type of recurrence and mode of cancer detection.Results: Of 206 recurrences, 41 were ipsilateral breast recurrences (19.9%), 135 were distant recurrences (65.5%), and 30 were contralateral new breast cancers (14.6%). Ipsilateral breast recurrences were detected by patients in 53.7% (22/41) of cases and by routine imaging in 41.5% (17/21). The majority of distant recurrences (125/135, 92.6%) were detected via patient-reported symptoms. Contralateral breast primaries were primarily detected by imaging 83.3% (25/30) and patient-reported symptoms 16.7%, (5/30). Only 2/206 (1.14%) recurrences/new primaries were detected by healthcare providers at routinely scheduled follow-up visits.Conclusions: Despite following ASCO follow-up guidelines, healthcare providers rarely detect recurrences at routine follow-up appointments. While reduced in-person visits may affect other aspects of follow-up care (e.g. toxicity management), it appears unlikely, provided patients attend regular screening tests, that less frequent in-person follow-up is associated with worse breast cancer-related outcomes.