This is a non-interventional observational study conducted in Germany to evaluate the real-world effectiveness, tolerability, safety, and quality of life in patients with locally advanced/metastatic HR+/HER2- breast cancer treated with one of the following 1st line treatments: Ribociclib + AI/FUL, or endocrine monotherapy, or chemotherapy

This non-interventional study collects data from clinical practice capturing on effectiveness, safety and tolerability, duration of therapy, and quality of life of ribociclib in combination with an aromatase inhibitor/fulvestrant in daily routine and in line with the respective current German summary of product characteristics. In order to put these results into perspective, data is also collected on patients treated with endocrine therapy or chemotherapy for first line locally advanced or metastatic breast cancer. To gain insight into algorithms and outcome of sequential therapy, up to three lines of treatment are documented within this study. The information gathered and evaluated in this NIS is helping to answer open questions for the treatment of locally advanced/metastatic breast cancer and provides first insights into the treatment reality with ribociclib in this setting. This includes, but is not limited to, the questions on baseline demographics leading to a specific treatment decision, as well as efficacy and clinical routine related to treatment sequencing. In addition, data on the mutation status (including PIK3CA and BRCA1/2) is collected at different time points to generate insights into the clinical routine of mutation testing and to understand its impact on therapy sequencing.

Inclusion Criteria:

• Patients with a histological diagnosis of locally advanced/metastatic HR+/HER2- breast cancer. Histological diagnosis does not necessarily origin from metastasis, but must reflect the most recent disease status
• No prior systemic treatment for locally advanced/metastatic disease in the palliative setting
• The treating physician has made the decision to treat the patient
• with ribociclib in combination with an aromatase inhibitor or fulvestrant as initial treatment in first line, or
• endocrine therapy as initial treatment in first line (e.g. letrozole, anastrozole, fulvestrant), or
• chemotherapy as initial treatment in first line (e.g. taxanes, capecitabine, with or without bevacizumab)
• Written informed consent of the patient
• Patient who initiated treatment for first line no longer than 4 weeks (28 days) prior to written informed consent for this study
• Planned treatment is in line with the respective current German SmPC ("Summary of product characteristics")
• Patient is ≥18 years

Exclusion Criteria:

• Patients unable to provide written informed consent
• Contra-indication according to the respective current German SmPC ("Summary of product characteristics"), as judged by the treating physician
• The patient is currently under active treatment in an investigational study

Adult females with HR+/HER2- locally advanced/metastatic breast cancer (progressed following prior therapy or de novo). Hereby locally advanced is defined by the following criteria (at least one must apply): tumor size > 5 cm (T3), skin or chest wall infiltration (T4a, T4b), inflammatory breast cancer (T4c), fixed axilla-located lymph node conglomerate or intraclavicular lymph node metastasis (cN3; German S3 guideline for early detection, diagnosis, therapy and follow-up care of breast cancer; Version 4.1.2018). Patients are classified as therapy naïve for locally advanced/metastatic disease if they have not yet received a systemic therapy in the palliative setting. Patients with locally advanced breast cancer who have received therapy-(lines) in the adjuvant/curative setting are eligible after progression to e.g. a metastatic breast cancer. All patients who already received a palliative therapy for locally advanced/metastatic breast cancer are excluded from study participation.