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Consider

chemotherapy

NCCN guidelines recommendations for the use of endocrine

therapy vs chemo in ER+/HER2- MBC

Sequential

endocrine therapy

Chemo

Visceral crisis

YES

NO

Progression or unacceptable

toxicity

No clinical benefit after 3 consecutive endocrine

therapy regimens

HR+/HER2- ABC

NCCN. V1.2018