Fig. 2

Flowchart of patients included in the study. The flowchart shows the selection of patients included in the analysis. ^aIn Marketscan Commercial Claims and Encounters (CCAE) database & Medicare Supplemental and Coordination of Benefits (MDCR) database. ^bDefined as ≥ 2 claims containing ≥ 1 diagnosis code for breast cancer ≥ 30 days apart. ^cDefined as ≥ 2 claims for a secondary neoplasm on separate days (with the first claim occurring ≤ 30 days before or any time after the first diagnosis of primary breast cancer); patients who solely had secondary malignancy diagnosis codes of the breast, local regional lymph nodes, or non-melanoma of the skin were not considered to have mBC. ^dDefined as patients who received ≥ 1 prescription fill of endocrine therapy on or before index date or within 30 days after index date. ^eDuring − 12/ + 6 months prior and post index date. ^fUse before index date or within 30 days after index date. ^gDuring the look-back period, except for non-melanoma of the skin. HER2 + , human epidermal growth factor receptor 2-positive; HR + , hormone receptor-positive; mBC, metastatic breast cancer