post-menopausal (≥ 60 years old, or age ≥ 45 years with amenorrhea for > 12 months or follicle stimulating hormone and estrogen levels within post-menopausal range, or prior bilateral oophorectomy)

hormone receptor positive (er and/or pgr) disease as determined locally

who performance status 0-2

life expectancy of ≥ 3 months

the presence of at least one measurable or evaluable (non-measurable) lesion

informed consent prior to any study procedures

life threatening metastatic visceral disease

brain or leptomeningeal metastases

prior exposure to fulvestrant

history of bleeding diathesis or need for long term anti-coagulation