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. 2021 Feb 19;11:4274. doi: 10.1038/s41598-021-83622-1

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Patient flowchart. (a) Informed consent written and signed prior to any specific study of procedures. In the case of patients who died at the time of inclusion, there were no signed informed consent, so the researcher assumed responsibility for data protection and confidentiality when recording the data; (b) Patients who experienced relapse during or after the end of adjuvant anti-estrogenic therapy and received first-line treatment with Fulvestrant 500 mg per month during the study period (started treatment with Fulvestrant January 1, 2011 to May 30, 2018.