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We included women aged 66 and above at the diagnosis of first pathologically confirmed metastatic BC15 during 2010–2013 with HER2-negative status. Women diagnosed via a death certificate or autopsy were excluded. Additionally, we excluded women who were enrolled in health maintenance organizations, who were not continuously enrolled in Medicare parts A and B for 12 months before cancer diagnosis through at least 6 months following diagnosis or death, and who were not continuously enrolled in Medicare part D for at least 6 months following diagnosis or death, whichever occurred first.

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