Social Media as a Sensor: Analyzing Twitter Data for Breast Cancer Medication Effects Using Natural Language Processing

Breast cancer is a significant public health concern and is the leading cause of cancer-related deaths among women. Despite advances in breast cancer treatments, medication non-adherence remains a major problem. As electronic health records do not typically capture patient-reported outcomes that may reveal information about medication-related experiences, social media presents an attractive resource for enhancing our understanding of the patients' treatment experiences. In this paper, we developed natural language processing (NLP) based methodologies to study information posted by an automatically curated breast cancer cohort from social media. We employed a transformer-based classifier to identify breast cancer patients/survivors on X (Twitter) based on their self-reported information, and we collected longitudinal data from their profiles. We then designed a multi-layer rule-based model to develop a breast cancer therapy-associated side effect lexicon and detect patterns of medication usage and associated side effects among breast cancer patients. 1,454,637 posts were available from 583,962 unique users, of which 62,042 (10.6%) were detected as breast cancer members using our transformer-based model. 198 cohort members mentioned breast cancer medications, with tamoxifen as the most common. Our side effect lexicon identified well-known side effects of hormone and chemotherapy. Furthermore, it discovered a subjective feeling towards cancer and medications, which may suggest a pre-clinical phase of side effects or emotional distress. This analysis highlighted not only the utility of NLP techniques in unstructured social media data to identify self-reported breast cancer posts, medication usage patterns, and treatment side effects but also the richness of social data to answer such clinical questions.