Generic Latin America Report

7/31/2019 Generic Latin America Report

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Discussing advanced or metastatic

breast cancer in Latin America

An analysis of online conversations relating to advanced

breast cancer (ABC) or metastatic breast cancer (MBC) in

Latin America

April 2012

REVISED latin america breast cancer report in progress.indd 1 18/05/2012 12:13


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Section 1: Executive Summary 3

Section 2: Introduction 10

Section 3: Focus questions 12

1. What are the website categories in which conversations are taking place?

2. What are the prominent websites for those seeking information on advanced breast

cancer (ABC) or metastatic breast cancer (MBC)?

3. How are patients, caregivers and physicians interacting online?

4. What related topics are being discussed?

5. How does this community talk about the mainstream pink or Pink Ribbon

movement?

6. What are the primary concerns, frustrations or unmet needs discussed among this

community?

7. What brand treatment conversations are occurring, and what is the share of voice for

current competitors?

8. Who is participating in conversations about treatments?

9. Who are the leading inuencers among target demographics?

Section 4: Campaigns and additional keyword searches 60

Section 5: Breast cancer compared to advanced and metastatic research 65

Contents

Discussing advanced or metastatic breast cancer in Latin America 2

13

15

19

20

49

51

53

55

57

Section 6: Conclusions 67

Appendix 70

Methodologies 71

Glossary 72



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Section 1Executive Summary



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This report is designed to answer nine questions relating to online conversations regardingadvanced or metastatic breast cancer (ABC/MBC). The questions were devised to inform the

client of current themes or issues in Latin America based conversations, which may assist in

rening public relations activities.

The Latin America countries included in the research were:

Argentina

Brazil

Chile

Colombia

Mexico

Venezuela

The world wide web was searched, based on agreed search terms (see appendix). The date

ranges were dependent on the number of results obtained and also varied between each Latin

American country.

In order to capture the agreed relevant 2,000 online mentions for analysis, we had to go back

as far as 2001. Analyzed data ranged from July 9th 2001 to March 31st 2012.

The availability of results was heavily dependent on the use of the world wide web in

each country, which varied greatly during the above search periods. This is one of many

socioeconomic issues that, coupled with population size, education, healthcare access, and

nancial circumstances, can in part explain the differences in the proportions of results percountry in this report and the broad date range.

During the search the system

returned a total of 4,900 results.

From these results we extracted

2,195 that were relevant to this

analysis. Those 2,195 results

provided 4,053 separate pieces

of data that have been used

throughout this analysis.

That is a ratio of 1.85 pieces

of data per relevant result(please note an explanation of data

and results terminology is contained

in the introduction).

Executive Summary

EXECUTIVE

SUMMARY

4,053pieces of data

4,900results

2,195relevant results


Country Start Date End Date

Argentina 18/01/2002 31/03/2012

Brazil 01/10/2001 31/03/2012

Chile 26/11/2003 31/03/2012

Colombia 05/01/2006 30/03/2012

Mexico 09/07/2001 31/03/2012

Venezuela 06/10/2001 31/03/2012



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Executive Summary

EXECUTIVE

SUMMARY

0

200

400

600

800

1000

1200

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Argentina

Brazil

Chile

Colombia

Mexico

Venezuela

Average

Real-time data was supplemented with retrospective data to achieve robust sample size

Overall volume of results



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40%

26%

9%

14%

3%

8%

EXECUTIVE

SUMMARY

Executive Summary


The map and table below provide a summary of the results returned for each of the LatinAmerican countries analyzed in this report.

n = 2,195

% of relevant results by country

n = 2,195

n = 2,195

* Population statistics taken from the CIA world fact book. (Retrieved 19 April 2012)1 http://www.newmediatrendwatch.com/markets-by-country/11-long-haul/42-b

Country

No. of

relevant

results

% of total

relevantresults

Total

population ofcountry *

% of

combinedtotal

populations

Argentina 310 14.12% 42,192,494 9.31%

Brazil 880 40.09% 205,716,890 45.39%

Chile 201 9.16% 17,067,369 3.77%

Colombia 67 3.05% 45,239,079 9.98%

Mexico 575 26.20% 114,975,406 25.37%

Venezuela 162 7.38% 28,047,938 6.19%

Independent research suggests that there are just over 200 million Latin American users online,

which represents 36.7% of the regions population, compared to 58.3% of Europe and 78.3%

of the US.1

As a comparison of results to population indicates, the number of relevant results found for this

analysis is generally in proportion to each countrys population.

As such, the number of relevant results for each country represents a valid sample size.



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EXECUTIVE

SUMMARY

Executive Summary


The following section addresses each question with a summary answer, drawn from theinformation that is presented in this report:

1. What are the website categories in which conversations are taking place?

Four website categories were identied among results used in the analysis; with their percentage

of total relevant results in brackets, they were:

Medical news or journal sites (48.88%)

Medical - related blogs or discussions (47.06%)

Posts from individual and business accounts on social media sites such as Twitter and

Facebook (3.14%) Financial news (0.91%)

2. What are the prominent websites for those looking for information on advanced

breast cancer (ABC) or metastatic breast cancer (MBC)?

Twitter was the highest yielding website, accounting for 3.05% of all relevant results. However, a

total of 1,251 websites with conversations about advanced breast cancer were identied in the

research, with no site other than Twitter generating more than 18 results. This fragmentation of

conversations about ABC or MBC is indicative of a lack of online concentration for discussions

on the disease.

3. How are patients, caregivers and physicians interacting online?

Where commentators could be identied, 41.62% were the patients themselves, 28.65% were

family member of patients, 16.76% were physicians and 12.97% were friends of patients.

Notably, there was an absence of conversation among non-physician health care professionals,

such as other members of oncology multi-disciplinary team involved in the management of

ABC or MBC patients. In total 185 commentators were identied.

4. What related topics are being discussed?

Education was the most frequently discussed topic of conversation regarding metastatic or

advanced breast cancer, accounting for 15.72% of all discussions, which included sharing ofdisease facts and educating and increasing knowledge of the disease. Followed by risk factors

and prevention and thirdly, discussions related to treatment.



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EXECUTIVE

SUMMARY

Executive Summary


5. How does this community talk about the mainstream Pink Ribbon or pink movement?

The Pink Ribbon campaign was the only context in which the pink movement was mentioned,

accounting for just 0.52% of relevant results. Where sentiment was expressed towards the

campaign, it was always positive.

6. What are the primary concerns, frustrations and unmet needs discussed amongst

this community?

The largest driver of conversations in Latin America regarding ABC or MBC were related to

the psychological impact of advanced breast cancer, this accounted for 26.00% of unmet

need results and focused on issues of femininity after mastectomy, depression, and fear of the

unknown.

7. What brand treatment conversations are occurring, and what is the share of voice

for current competitors?

Herceptin (trastuzumab) was the most frequently mentioned brand treatment, accounting for

24.1% of all drug mentions. Roches Avastin (Bevacizumab) followed, accounting for 18.13%

of brand mentions. Novartis Anitor (everolimus) overall share of conversation was 1.39%.

8. Who is participating in conversations about treatments?

Discussions regarding treatment of ABC and MBC constituted 13.19% of topic mentions. Of

these, 99.00% were from medical discussions and news sites. The remaining 1.00% werefrom individual accounts such as Twitter or Facebook.

61 commentators were identied, 35 of whom were patients (57.38%), 13 were physicians

(21.31%), 12 were family members (19.67%), and one friend (1.64%)

The most frequent topics of discussions within treatments were chemotherapy, surgery and

radiotherapy.

9. Who are the leading inuencers among target demographics?

Inuencers were often mentioned in Latin America discussions and included notable peopleor groups. The most prominent inuencers within Latin America on advanced breast cancer

were Elizabeth Edwards (US - deceased) and Luciana Holtz (Brazil), followed by the National

Cancer Institute (Brazil).



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EXECUTIVE

SUMMARY

Executive Summary


Key ndings

The following takeaways and insights are comprised in accordance with generic marketing and

communications objectives; no denitive assumptions about the use of this analysis in a future

communications campaign are made:

The report ndings support the assertion that the use of social networking sites and

microblogs, such as Twitter and Facebook, have had a slower uptake in Latin America

when compared to the US.

There is some resistance among Latin American patients to present to physicians with

healthcare issues, which increases the likelihood of presentation at late stage disease.

Latin American conversations had a more emotional sentiment to them when compared to

the US study.

The prominence of education, risk factors and prevention and clinical trial conversations

demonstrate the desire of people in Latin America to get information on ABC or MBC

through sources other than physicians.

Social media conversations in Latin America around this topic are very fragemented,

particularly in the smaller markets. However, there has been a growth in these converstions

recently, specically in Brazil and to a lesser degree the other markets. This leads us to

believe that the fragmentation is not a reason to avoid these channels. It is an opportunityto build a communication platform with these patients.

The lack of involvement of medical or healthcare professionals in online discussion raises

questions of credibility in relation to the information being shared.

Opportunities

The absence of a prominent single online source of healthcare information, and the spread

of sources found herein, suggest a client sponsored website may meet an unmet need.

Client campaigns were not discussed during the timeframe based on search criteria.



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Section 2Introduction



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INTRODUCTION

Introduction

The number of people seeking information and advice on social and digital media continues to

increase signicantly. The growth of social media beyond innovators and early adopters also

increases the potential for campaigners to use it to inuence behavior and change opinions.

This presents considerable opportunities and threats for companies to engage with consumers.

However, the growth of social media channels has also fragmented the audience, who are

less likely to get information from a single source (such as a company website). And the wide

variety of companies and charities that now use digital media means that consumers have a

vast number of brands competing for their attention.

By gleaning intelligence from consumers digital behavior companies can get deeper insights

into attitudes and habits, identify trusted sources of information and devise compelling

campaigns which reach the target audience and engage consumers.

Denitions

When this report refers to results, it is speaking about the raw material Trufenet has generated

when it scours the Internet. Data, on the other hand, refers to the output of a rened result a

result that has been considered relevant, and topics and values applied to produce a piece, or

pieces of data that are applicable to the analysis.

The test for whether a result should be considered data (a relevant result) is that its value mustbe clear and completely unambiguous. No assumptions are made about data, for example,

unless someone clearly states where they are located, or it appears in their biographical

information a location value is not applied.

Conditions

This project is based on search terms that are designed to garner the best available results

from the Internet. The list of search terms used for this project can be found in the appendix

section of this document.

In all graphs that appear in this analysis you will nd an equation n=x. X is the number of piecesof data which combined have formed the basis of the information in the graph, unless otherwise

stated.

It is important to bear in mind when considering the information contained in this project the data

is not linear. A single result may provide data to answer one or multiple questions, meaning that

data sets throughout are not always directly comparable. It is important to consider the volume

of data used to answer any question, depicted in the n values of graphs and in other varying

locations particularly when drawing conclusions to inform next steps.

Introduction




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Section 3Questions



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WEBSITE

CATEGORIES

Social Media Platform

Websites, such as social networking sites, that are dedicated to dissemination of

user generated content including postings and videos from an individual or business

user. Notably, the only websites found among results that conformed to this category

were Twitter and Facebook

Medical related blogs or discussions

Websites that are forums, blogs, chat rooms or communities for medical discussion

Medical news

Websites that relate to medical news or medical journals

1. What are the website categories in which

conversations are taking place?

Total relevant results:

2,195Number of websites that

yielded relevant results:

1,251

The search for this analysis returned results from 1,251 different websites that generated 2,195

results deemed relevant to this project.

To help understand and identify the most important websites to the interests of the client, those

that yielded relevant data were divided into four categories:


In solid tumors such as breast cancer cell proliferation in constant and rapid tumor maylead to an underdeveloped and dysfunctional vascular network around the tumor. The result is called

hypoxia, a condition in which cancer cells are subject to reduced oxygen supply since they are not in

proximity to blood vessels. These hypoxic regions within the tumor may increase the aggressiveness

of the cancer and its potential to cause metastasis or recurrence of disease.

http://www.isaude.net/pt-BR/noticia/14439/ciencia-e-tecnologia/vitamina-b1-tiamina-pode-ser-prejudicial-para-pacientes-

com-cancer-de-mama



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Medical news and discussion sites accounted for 95.96% of all results, with social mediaplatforms and nancial news sites generating 3.14% and 0.91% respectively.

The uptake of user-generated social media platforms such as Twitter and Facebook in the

Latin American market is a comparatively recent phenomenon, which may account for the low

volume of social media platform results.

Likewise, the privacy settings of some popular Latin American social networking sites, most

notably Orkut, are signicantly more stringent than other English language communities,

permitting very little, if any, public viewing of commentary.

Volume of relevant results by website category

n = 2,195

Volume of websites that yielded results by category

n = 1,251

WEBSITE

CATEGORIES


What are the website categories in which conversations are taking place?

0

200

400

600

800

1000

1200

Medical news Medical

discussion

Individual Financial news

10731033

69 20

Medical discussion Medical news Financial news Social media

platform

700

600

500

400

300

200

100

0210

582

657

Social media

platform



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The table below identies the top ten websites by volume of relevant results. The categorieslisted are, in order from left-to-right:

The rank of the website (ranking)

The websites domain name (website)

The number of relevant results the website generated (no. of relevant results)

Which of the four categories identied in question one the website subscribes to (category)

The percentage of relevant results generated by that domain, as a percentage of the total

relevant results used throughout the report (% of total relevant results)

The ten websites listed below generated 8.97% of the total 2,195 relevant results used in this

analysis.

n = 2,195

www.isaude.net

0.77%

grupos.emagister.com

0.82%

2. What are the prominent websites

for those seeking information on

advanced breast cancer (ABC) or metastatic breast

cancer (MBC)?

PROMINENT

WEBSITES

Twitter

3.05%


What happened? She had overcome her breast cancer ... is it

complicated by metastasis or something?

@Josselyn_Lugo

Ranking Website

No. of

relevant

results

Category% of all

results

1 www.twitter.com 67 Individual 3.05%

2 grupos.emagister.com 18 Medical Discussion 0.82%

3 www.isaude.net 17 Medical News 0.77%

4 buscatextual.cnpq.br/buscatextual 15 Medical News 0.68%

5 www.lasalud.com.mx 15 Medical Discussion 0.68%

6 www.ayudacancer.wordpress.com 14 Medical News 0.64%

7 www.noticias.uol.com.br 14 Medical News 0.64%8 foro.enfemenino.com 13 Medical Discussion 0.59%

9 es.answers.yahoo.com 12 Medical Discussion 0.55%

10 www.zocalo.com.mx 12 Financial News 0.55%

Social Media Platform



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Top ten websites by volume of results, per category

To assist in identifying websites of importance to the client, the following section providesa detailed breakdown of the websites listed in the previous table, by category (individual,

medical discussion, medical news and nancial news).

Against each website you will see six descriptive categories:

Name: The name of the website.

Website: The website address that appeared in the results.

Volume: The number of results the website or domain returned, relevant to the

analysis. In brackets is the rank of the website against all relevant results,

across all categories.

Contact: A contact email address for the website owner or operator if available.

Country: Country in which the website owner is located, or the site is operated from.

Description: A brief description of the website and its content.

Individual

Name: Twitter

Website: www.twitter.com

Volume: 67 (1)

Contact: [email protected]

Country: US

Description: Twitter is the worlds largest microblogging site with approximately

200 million accounts. It connects users to the latest stories, ideas, opinions and

news from around the globe.

Name: Isade

Website: www.isade.net

Volume: 17 (3)

Contact: N/A

Country: Brazil

Description: Isade.net provides both regional and Brazil-specic medical news

encompassing developments for healthcare professionals, public health stories and

health science advances.

PROMINENT

WEBSITES


Medical News



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Name: Platforma Lattes

Website: buscatextual.cnpq.br/buscatextual

Volume: 15 (4)

Contact: [email protected]

Country: Brazil

Description: Scientic research database created by CNPq that collates information on

scientic research projects, institutions, and individuals involved in research.

Name: Cancer: therapies andtreatments

Website: www.ayudacancer.

wordpress.com

Volume: 14 (6)

Contact: N/A

Country: Argentina

Description: Hosts recent cancer news, blog posts and discussions as well as general

information about all cancer types.

Name: UOL Noticas

Website: www.noticias.uol.com.br

Volume: 14 (7)

Contact: N/A

Country: Brazil

Description: UOL is the largest (by market share) online and Internet services provider

in Brazil. Its news site, UOL Noticas, provides general news with a strong emphasis on

science and health.

PROMINENT

WEBSITES


Name: emagister.com

Website: grupos.emagister.com

Volume: 18 (2)

Contact: N/A

Country: Global

Description: Emagister hosts discussion boards with a primary focus on higher

education issues, for current and prospective students; and a variety of secondary

themes including health.

Medical Discussions



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PROMINENT

WEBSITES



Name: LaSalud

Website: www.lasalud.com.mx

Volume: 15 (5)

Contact: N/A

Country: Mexico

Description: Medical news and information site, with an array of health related discussion

forums.

Name: EnfemaninoWebsite: foro.enfemenino.com

Volume: 13 (8)

Contact: jorge.segado@enfemenino.

com

Country: Mexico

Description:A womens lifestyle site that provides news and hosts discussions on female

issues and interests including fashion, celebrities and health.

Name: Yahoo Respuestas

Website: es.answers.yahoo.com

Volume: 12 (9)

Contact: N/A

Country: Global

Description: Yahoos spanish language general purpose question and answer forum.

Participants can ask questions on topics of interest and receive answers from other site

users.

Name: Zocalo Staltillo

Website: www.zocalo.com.mx/

Volume: 12 (10)

Contact: N/A

Country: Mexico

Description: Mexican national news site providing regular updates on a range of general

interest issues, with a focus on nance and security news.

Financial News



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3. How are patients, caregivers and physicians

interacting online?

INTERACTING

ONLINE

Commentators were categorized by their interest in ABC or MBC, in 185 of the relevantresults used in this analysis. The interest groups are dened as follows, along with the groups

percentage as a proportion of the 185 identied:

41.62% of those identied were patients

28.65% were family members of patients

16.76% were physicians

12.97% were friends of patients

Notably, physicians were the only healthcare professionals identied among results, accounting

for a total of 31 separate relevant results.

The graph below reects the website categories (dened in question one) that the above

groups frequented to discuss ABC and MBC, by volume of relevant results:

Volume of commentators identied in posts

As the graph demonstrates, all identiable stakeholder groups used medical

discussion websites to talk about advanced or metastatic breast cancer.


n = 185

0 10 20 30 40 50 60

Patient

Family

Physician

Friend Financial newsIndividual

Medical News

Medical Discussion

50

216

404

8

1

723

1

172

5Social media

platform



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Each of the 2,195 results used in this analysis were sorted by a trained analyst, and a topic

(or multiple topic) values applied to each. This generated 3,638 separate topic mentions

amongst relevant results.

Those mentions were ascribed to one of eleven categories to provide an overview of the

principal topics of conversation in the discussion, as dened in the table below:

n = 3,638

Each topic category is examined in detail henceforth, or, if denoted by an asterisk in

the above table, as part of its own separate question later in this report.

Relevant results:

2,195

4. What are the topics that are being discussed?

FREQUENTLY

DISCUSSED

TOPICS


Total volume of individual

topic mentions:

3,638

Topics of conversation

identied:

11

Topic of conversationVolume of

results

% Overall

discussion

Education 572 15.72%

Risk factors and Prevention 515 14.16%

Treatment* 480 13.19%

Clinical trial 455 12.51%

Drug mention* 419 11.52%

Diagnosis and Symptoms 359 9.87%

Influencer* 285 7.83%

Support 213 5.85%

New or media story (including Novartis) 192 5.28%

Unmet needs* 90 2.47%

Cost 39 1.07%

Pink ribbon 19 0.52%

- notable people or groups

News or media story

Pink Ribbon



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FREQUENTLY

DISCUSSED

TOPICS


In-depth ndings on each topic of discussion

Education

The graph overleaf is used (as a template) throughout the remainder of the analysis, and

highlights multiple pieces of information.

In all instances henceforth, the blue columns represent each countrys proportion of total

relevant results used in this analysis (% of total relevant results), which was introduced in the

executive summary.

The red column (the color of which changes in each graph henceforth to highlight changes in

topic) indicates the proportion of each countrys relevant results for the topic being analyzed

(% of total education mentions), in this case education.

The gure that appears under each country name is an indexed comparison of total relevant

results for that country, to the topics relevant results (in this case education). In all cases,

a result of 100 indicates an exact mirroring of the topic mentions for the country, to the

proportion of total results that country generated for this study in other words, 100 reects

an anticipated outcome.

However, most gures deviate from 100. Where a number is less than 100, discussion of the

topic is less than would be anticipated. Where the number is higher than 100, discussion of

the topic is higher than would be anticipated. The greater the difference between the result

and 100, the greater the degree of emphasis that should be placed on that result.

Thus, the graph overleaf tells us that conversations regarding education accounted for a

greater than anticipated percentage of conversations in Mexico and Chile, and a less than

anticipated percentage of conversations in Argentina, Columbia and Venezuela, though it

should be noted that the sample sizes are small in the two latter countries, which increases

the likelihood of large variations in the index score.

In Brazil, the volume of conversations about education in the context of ABC or MBC were

broadly in line with all conversations regarding ABC or MBC in that country.

http://saudeweb.com.br/voce-informa/5-de-fevereiro-dia-nacional-da-mamograa/

Research indicates that rates of mortality from the disease remain high, most likely

because it is still diagnosed in advanced stages. In the world population, the median survival afterve years is 61%.

http://www.farolcomunitario.com.br/saude_000_0369-

instituto-avon-divulga-pesquisa-sobre-o-cancer-de-mama.

Avon has launched a campaign against the

Avon Breast Cancer. October is the month dedicated to

the global debate on breast cancer and ways of early

detection of disease. To mark the occasion, the Institute

presented on Wednesday (29), the national study,

entitled Avon Research Institute / Ipsos - Perceptions

of breast cancer - myths and truths about the disease.

The analysis was performed with a thousand Brazilianwomen to understand the myths and truths of them

regarding the disease.



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0%

5%

10%

15%

20%

25%

30%

35%

40%

Argentina Brazil Chile Colombia Mexico Venezuela

64.29 95.00 133.33 33.33 146.15 25.00

14%

40%

9%

3%

26%

8%9%

38%

12%

1%

38%

2%

% of total relevant results % of total education mentions


FREQUENTLY

DISCUSSED

TOPICS

Education

The majority of discussions included in education conversations consisted of factual information on breast cancer. These were divided between sharing and discussing

facts of the disease and raising awareness.

Proportion of total education mentions, by country

n = 572 (education mentions)

n = 2,195 (total relevant results)

* Numbers lower than 100 indicated the discussion of the topic is less than what would be anticipated; number over 100 mean the discussion of the topic is more than what would be anticipated

While the majority of the

ndings in education are

consistent with the overall

distribution of results,

Mexico and Chile did have

a greater emphasis on

education conversations,

more than would be

expected. Notably there was

a national campaign in Chile

to promote self-examination

as a preventative strategy to

assist early detection.


@ Adrianogomes_

Half of the

cases of breast cancer are

diagnosed each year in an

advanced stage

Indexed

comparison*



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n = 572

Medical discussion

Medical news

Social media platform

FREQUENTLY

DISCUSSED

TOPICS


Education

Categories of websites hosting conversations about education


Discussions regarding educational topics were most commonly generated on medical

discussion or news sites, which accounted for 95.89% of the total relevant results usedthroughout this analysis.

http://grupomamacancer.wordpress.com/2007/05/06/perguntas-frequentes/

What are the stages of cancer? The cancer has four stages

or phases. Phase I is the starting when the tumour is localized and not

compromised tissues. Phases II and III are considered intermediate,

and occur when the tumour has spread to nearby structures. In stage IV,

cancer has spread to other organs, characterizing metastasis.



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FREQUENTLY

DISCUSSED

TOPICS


Education

Raising awareness of breast cancer accounted for 45.00% of discussions within

education, with all Latin American countries discussing:

Month Against Breast Cancer - championed worldwide each October

The critical need to raise awareness of breast cancer so that it can be detected earlier

Specic country discussions included:

Avon (the cosmetics company) in Colombia was very active at raising awareness

Governments in Mexico and Chile initiated a national Program for prevention

and control of breast cancer and to raise awareness

In Brazil, Chile and Venezuela male breast cancer was discussed

- For every 100 cases of breast cancer in women, one case is diagnosed

in a male (Brazil and Venezuela)

- Male breast cancer more likely to be detected in advanced stages (Chile)

Sentiment was rarely seen in Latin American education conversations, with only nine

sentiment laden comments found among results. The graph below, which excludes instances

of no sentiment (as do all other sentiment graphs found in this report), largely reectsnegative sentiment that stemmed from discussions regarding late stage diagnosis.

Sentiment expressed within education discussions

n = 9




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FREQUENTLY

DISCUSSED

TOPICS

Risk factors and prevention

Combined, prevention and risk factor conversations accounted for 14.00% of all data used in this analysis. Of these, prevention conversations accounted for two-thirds

of the discussions and commentators often listed more than one prevention strategy in their comments.

Proportion of total prevention mentions, by country

n = 289 (prevention mentions)



Venezuela, Argentina and

Mexico had a lower level ofprevention conversations than

expected, highlighting the need

to raise awareness of these

strategies. Brazil and Chile were

actively discussing prevention

strategies at a higher level than

expected. Colombia was at its

anticipated level.


http://journalmex.wordpress.

com/2009/10/25/%C2%A1no-mas-victimas-por-cancer-de-mama/

This disease kills

one woman every two hours

and is the leading cause of

cancer death in Mexican

women In Mexico, only 20%

of cases are diagnosed early.

Timely help some women to

have a better prognosis for

cure and treatment of breast

cancer. It is therefore calls

on all Mexican women forself-examination monthly and

see a doctor at the slightest

sign and especially scanning a

mammogram annually after 35

of age

Indexed

comparison*



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Prevention

Prevention conversations by category

n = 289

Medical

news

Medical

discussion


FREQUENTLY

DISCUSSED

TOPICS



As the graph

demonstrates,

prevention

conversations

were almost

entirely generated

by people using

medical discussion

and medical news

websites. Where

identied, physicians

were seen to be

using the sites to

assist others in better

understanding the

disease.

http://www.necessaire.com.br/cancer-de-mama-mulheres-se-deixam-inuenciar-por-mitos/php

According to research Breast Cancer - experiences and perceptions

held by Pzer, says most women informed about the disease, but they mistakenlysuggest, for example, stress as a risk factor for this tumor type and do not do

routine mammography

Already 81% of healthy women do self-examination without knowing that alone could hardly detect a

tumor in the breast, especially in early stage. One fact that may indicate the habit of not female exams notes that in

Brazil, less than 10% of women are diagnosed with ductal carcinoma, a type of breast cancer in early stage, this is

the stage most likely to cure and more easily diagnosed by mammography - and often is not palpable

Sergio Simon, coordinator of research and clinical oncologist Albert Einstein Hospital in Sao Paulo



27/73

0

10

20

30

40

50

60

70

Self examination Mammogram Healthy Diet and

exercise

Avoid excessive

alcohol intake

Taking regular aspirin

4 2 3 2

34 33

18

4 8

1311

9

2

1

3

3

914

3

1

1 2

1

Venezuela

Mexico

Colombia

Chile

Brazil

Argentina


Prevention

The graph below represents the top ve prevention strategies reported in the ndings:

n = 181

FREQUENTLY

DISCUSSED

TOPICS



Among results it was found that people in all examined Latin American countries

discussed:

- Self-examination being crucial for early detection of the disease

- Regular mammograms, annually once over the age of 40

- Mentions of mammograms and self-examination accounted for 60.00% of

the overall discussions on prevention

- Engaging in a healthy lifestyle with a good diet and regular exercise

- Keep alcohol intake to a minimum (not mentioned in Venezuela)


- Not smoking was discussed in

Chile and Brazil

- Taking regular Aspirin was

discussed in Brazil

- Breast feeding was discussed in

Brazil, Chile and Mexico



28/73


FREQUENTLY

DISCUSSED

TOPICS


Risk factor conversations accounted for the remaining third of the prevention and risk factor total. As with prevention, commentators frequently listed more than one risk

factor in their comments.

Proportion of total risk factor mentions, by country

n = 226 (risk factor mentions)



Overall risk factor

conversations were

consistent with their

expected volume in Chile

and Brazil. Mexico was a

little lower than anticipated,

with Venezuela and

Argentina slightly greater.

However, volumes in

Colombia was twice the

anticipated level, due to

well reported risk factors,

indicating that the level of

knowledge in conversations

was high.


http://www.

panoramabrasil.com.br/

According to a study

published this month in the

journal Radiology, patients with

a history of breast cancer in the

family, who are at high risk for

the disease

Indexed

comparison*



29/73

Medical discussion

Medical news


Risk factors

Risk factor conversations by category

n = 226

FREQUENTLY

DISCUSSED

TOPICS



Risk factors you cannot change include: Age and gender:

the risk of breast cancer increases as you age. Most cases of

advanced breast cancer is in women over 50 years. Women are

100 times more likely to develop breast cancer than men.

http://angieestherparedessanchez.blogspot.com/

The breakdown of

website categories

for risk factors was

identical to those

found for prevention,

with 99.00% ofmentions occurring

on medical discussion

and news sites.

Age and gender: as with most cancers, age is a very important factor.

In fact, 77% of new cases and 84% of deaths from breast cancer occur in

women 50 years or more. Over 80% of all cases occur in women over 50 years

and less than 1% occur in men. The risk of breast cancer is clearly related

to hormonal inuences, but it is unclear how these affect the disease and

particularly the types of disease. Genetic factors and family history of breast

cancer: Some families seem to have a genetic tendency for metastatic breast

cancer. We have found two genes that appear to be involved variants, BRCA1

and BRCA2

http://www.estudiagratis.com/cursos-gratis-online-Cancer-mama-curso-31118.html



30/73

0

10

20

30

40

50

60

Late detection of the

disease

Ageing women Family history Obesity Having children later in life

6

1418

3 2

36

13

13

26

1

2

1

51

1

23

4

15 6

54

4

3

1

Venezuela

Mexico

Colombia

Chile

Brazil

Argentina

FREQUENTLY

DISCUSSED

TOPICS



Risk factors

The graph below identies the top ve mentions of risk factors:

n = 171

All Latin American countries discussed:

- Late detection of the disease, which was noted as the biggest risk factor to the

development of advanced or metastatic breast cancer (if not already at that

stage)

- Aging women and family history


- Obesity was mentioned in all countries except Colombia and Venezuela

- Having children later in life was mentioned in Argentina, Chile, Mexico and Brazil

- Excessive alcohol intake was mentioned in all countries except Colombia and

Venezuela

The reporting of the prevention and risk factors

on medical news and discussion facts kept

sentiment to a minimum as commentary was

overwhelmingly fact based. When

sentiment was expressed, it was negative

(ve mentions).

Aging women



31/73


FREQUENTLY

DISCUSSED

TOPICS

Clinical trial

Clinical trial conversations generated 12.51% of the overall data identied in this report. As the graph below demonstrates, mentions of clinical trials were generally lower

than would have been anticipated, with the exception of results for Argentina and Brazil.

Proportion of total clinical trial mentions, by country

n = 455 (clinical trial mentions)



This chart signies that

clinical trial discussions in

Latin America were lower

than would be anticipated,

with the exception of Brazil,

where discussions on gene

therapy were prominent.


Indexed

comparison*



32/73

Clinical trial

Category of website hosting clinical trial discussions

n = 455

As with prevention and risk factor discussions, information on clinical trials was most often

shared on medical news and discussion sites.

There was no sentiment conveyed in discussions about clinical trials. These discussionswere entirely factual.

The ten most frequently discussed type of clinical trials accounted for 33.64% of all clinical

trial discussions.

FREQUENTLY

DISCUSSED

TOPICS



http://noticias.lainformacion.com/salud/cancer/avanza-la-supervivencia-de-las-mujeres-con-metastasis-en-cancer-de-mama_

ZvlzqpleVBnYu4s43PTUK3/

Thus, from this trial, which aims to keep the disease under control as long as possible, patients

with the disease continue their normal lives without the tumour progressing, as explained Cortes. Patients

do not cure yet, but much longer maintain control of the disease, insists Cortes, who has said that

approximately half of patients who previously lived with metastatic disease 12 to 14 months have gone to

live 4 and even 5 years with this very aggressive tumour.

Medical news

Medical discussion




33/73


FREQUENTLY

DISCUSSED

TOPICS

n = 455

Clinical TrialDetails

Description AR BR CH CO ME VE Total

% total

mentions ofclinical trials

Various genetherapies

ADAM33 gene is inactive. DCC gene

COX2 EREG

HB-EGF MMP1 MMP2

ST6GALNAC5

12 35 0 0 1 3 51 11.21%

Cannabis

Cannabis could cure breastcancer active components ofmarijuana and its derivativescould reduce tumor growth ofbreast cancer and metastasis

2 10 13 0 7 3 35 7.69%

Cleopatra

CLEOPATRA -A Study toevaluate Pertuzumab +

Trastuzumab +Docetaxel vs.Placebo + Trastuzumab +

Docetaxel in previously

untreated HER2-positivemetastatic breast ancer patient

1 12 0 0 8 1 22 4.84%

VariousBiomarkersTrials and

clinicalresearch

Prediction of response to

treatments and genetics3 7 0 0 2 1 13 2.86%

Protein basedresearch/trials

Discovery of protein 1 7 0 2 0 0 10 2.20%

Moleculeresearch

Blockinga molecule thatdrives metastasis, Discoveryof Peptide molecule.

Research into ways to slowmetastatis through moleculesThey discovered how cells of

breast cancer using aparticular type of molecule,

called TGF beta, to promotemetastasis, ie, expansion of

cancer cells in the body, whichprocess causes approximately

90% of deaths from the

disease.

1 5 0 0 0 0 6 1.32%

Belero 2 Trial

Bolero 2 Researchers at the

University of Texas MDAnderson Cancer Center,

USA, found that thecombination of the drug

everolimus exemestane withhormone therapy dramatically

improves survival of patientswith breast cancer.

0 3 0 0 2 0 5 1.10%

VaccinneResearch

Vaccinesto improve prognosis 0 2 0 0 3 0 5 1.10%

lapatinib and

trastuzumab

Combination of lapatinib and

trastuzumab0 3 0 0 0 0 3 0.66%

Aspirin

Aspirin reduces chances ofmetastsisin BC patients and

reduces risk of dying from

tumor

2 1 0 0 0 0 3 0.66%

Country total 22 85 13 2 23 8 153

This table presents the most frequently discussed topics among clinical trial discussions.

BOLERO

cancer patient



34/73


FREQUENTLY

DISCUSSED

TOPICS

Diagnosis and symptoms

Diagnosis

Diagnosis discussions included mentions of specic diagnostic techniques alongside discussions of what actually triggered the need to conrm the diagnosis, such as

nding a lump or pain in a specic part of the body.

Proportion of total diagnosis trial mentions, by country

n = 243 (diagnosis mentions)



As with results for clinical trials,

conversations regarding diagnosis

were largely lower than would

be anticipated, with one marked

exception Venezuela, which

generated almost ve times the

volume of anticipated results.

An explanation of this upturn in

conversation volume is related

to commentators reporting

ultrasounds being ineffective as a

diagnostic tool, specically, being

unable to detect inammatory

breast cancer.


Breast cancer is a

silent disease advanced and very

aggressive, so the self is the main

tool to diagnose it early

http://todo-en-salud.com/2010/12/dia-mundial-contra-el-cancer

Indexed

comparison*



35/73


Diagnosis

Diagnosis conversations, by website category

n = 243

FREQUENTLY

DISCUSSED

TOPICS



35.00%

Medical

discussion

65.00%

Medical

news

Results for diagnosis

conversations by website

category follow the previous

trend of high yields from

medical news and discussion

sites; a trend which is itself

likely the result of the high

volume of results yielded from

medical news and discussion

sites throughout this report,

and all relevant results used.

http://laprimeraplana.com.mx/2011/10/06/cancer-de-mama-%c2%bfque-es-y-como-detectarlo/#post-71985

There are basically two ways to detect breast cancer. One is when the disease results insymptoms , through one or any change in the characteristics of the breast. In an advanced stage of disease

symptoms can be observed as nipple retraction, changes in skin color, itching or scaly lesions in the area.

Moreover, it is possible to detect in its early asymptomatic when the lesion is still palpable, or is minimally

palpable, and this is done through a mammogram



36/73

0

10

20

30

40

50

60

70

80

Mammogram Self

examination

Biospy Ultrasound MRI

12 4 2

42

18

8 2

8

4

2

4

2

2

10

18

4

3

4

10

8

Venezuela

Mexico

Colombia

Chile

Brazil

Argentina


FREQUENTLY

DISCUSSED

TOPICS



Diagnosis conversations by country

The graph below lists the top 5 most mentioned diagnostic techniques:

n = 167

n = 17

All six Latin American countries discussed the

following points in relation to diagnosis:

Mammograms, the most frequently suggested

technique to diagnose breast cancer

Self-examination as a rst step towards seeking

help, and to conrm a diagnosis if a lump was

found; diagnostic tests including MRI scan, biopsy

and radiography were also mentioned


Venezuelans had conversations regarding reports

that ultrasounds are not an effective diagnostic

tool, specically because they were unable to

detect Inammatory Breast Cancer

Sentiment expressed within diagnosis

conversations

When sentiment was negative it was often referring to personal experiences of either

the patient, family member or friends being diagnosed with advanced breast cancer.



37/73


FREQUENTLY

DISCUSSED

TOPICS


Symptoms

Symptom and diagnosis conversations accounted for 9.87% of all data used in this report.

Proportion of total symptom mentions, by country

n = 116 (symptoms mentions)



As the graph demonstrates,

comments in Brazil that

related to symptoms

were substantially lower

than anticipated, while

those in Colombia were

signicantly higher. Apart

from there being a low level

of discussions relevant in

Colombia there was no clear

rationale for this.


The symptoms of

advanced breast cancer may

include: Bone painPain or

discomfort in the breast skin

ulcers, swelling of one arm

(next to breast with cancer)and w eight loss. Men can

develop breast cancer and

symptoms include breast

lump and pain and breast

tenderness

http://www.videoblogs.com/visor_

youtube.php?in=lista&id=FXTKKP_

Indexed

comparison*



38/73

Medical

discussion

69.00%

Medical

news

31.00%

FREQUENTLY

DISCUSSED

TOPICS




Symptoms

Symptoms conversations, by website category

n = 116

Again, the spread of results by website category reects a division found in all relevant

results.

http://tomaateloapecho.blogspot.com/

The symptoms of advanced breast cancer may include: Bone Pain Pain or

discomfort in the breasts Skin ulcers swelling one arm (next to breast cancer) Weight

loss breast self-examination breast. Self-examination is a simple, albeit with a low degree of

reliability, to detect breast cancer.



39/73


Symptoms conversations by country

The graph below represents the top ve symptom mentions:

Sentiment expressed within discussions around

symptoms

n = 70

n = 17


FREQUENTLY

DISCUSSED

TOPICS


All six Latin American countries examined herein discussed

the following symptoms:

Bone and breast pain was the most frequently mentioned

symptom in relation to advanced or metastatic breast

cancer, particularly in Mexico

Swelling, itching or color change including the swelling of

arms next to affected breasts, redness and the itching of the

skin

Armpit or breast lumps


No symptoms until disease reaches an advanced stage

or that advanced breast cancer has no symptoms. This was

discussed in Argentina, Brazil and Mexico

Weight loss discussed in Mexico and Colombia

Nipple changes retraction, discharge and skin

irregularities were discussed in Argent ina, Brazil Chile, and

Mexico

Though low in total volume, in instances where sentiment was expressed in relation to symptoms it was

largely negative, particularly due to the aggressive nature of symptoms in ABC or MBC patients.

When late stage diagnosis was made, it was often with no symptoms recognized, therefore adding to the

negative tone of the discussion.

0

5

10

15

20

25

30

35

Bone and breast

pain

Change in breast

shape, colour

Breast or armpit

lump

Swelling - arms,

breasts

No symptoms

2 1 2 1 1

5

3 11 2

3

11

2

4

11

3

19

22

1

3

1

33 1

Venezuela

Mexico

Colombia

Chile

Brazil

Argentina



40/73


FREQUENTLY

DISCUSSED

TOPICS

Support

Proportion of total support mentions, by country

n = 213 (support mentions)



Supportive conversations

identied in this research

constituted 5.85% of all

data, and as the graph

opposite demonstrates,

when compared to other

results in this report, were

not entirely dissimilar from

anticipated volumes.


Indexed

comparison*



41/73

Support conversations, by website category

n = 213

Support - related commentary also yielded the largest volume of identied commentators,

accounting for 76.76% of 185 found throughout this report.

FREQUENTLY

DISCUSSED

TOPICS


Support


Notably, a substantial portion

of support conversations

were generated on social

media platform websites,

underlining the personalnature of these forums and

the one-to-one relationships

they can generate, would

be conducive to support

conversations.

Social media

platform

16.00%

Medical

discussions

61.00%

Medical

news

23.00%



42/73

FREQUENTLY

DISCUSSED

TOPICS


Support

The following is a breakdown of commentators by category, found in support discussion

results.

Supportive discussions in all countries included:

Personal accounts of the disease, either by the patient or the person affected by breast

cancer including:

- Diagnosis, disease progression and death Many discussions were negative in nature as they were related to the

disease being diagnosed at a late stage

Medical discussions sites which shared encouraging conversations, such as:

- Fundraising or charitable events

- Living and coping with breast cancer

- Sharing stories of hope

Medical news stories were shared offering support and news of new treatments and ways

of coping with cancer

- Tributes to Daniela Romo, a public gure in Mexico suffering from advancedbreast cancer

Sentiment expressed within support conversations


Sentiment was largely negative as

there were many conversations relating

to personal experiences of coping with

diagnosis, living with the disease and

death as a result of the disease.

Commentators identied during supportive conversations

n = 142

,

Family 35.00%

Friend 11.30% Physician 0.70%

Patient 53.00%

142 commentators were identied within

support discussions.

76 patients were identied (53.00%)

50 family members (35.00%)

15 friends (11.30%)

1 physician (0.70%)



43/73


FREQUENTLY

DISCUSSED

TOPICS


Support

Sentiment expressed within support conversations by country

n = 110

http://www.cancertratamiento.

com/2009/06/viviendo-en-paz-

con-el-cancer.html

In another test

soon after, they found that

the cancer had metastasized

into several parts in my

bones. The diagnosis

was that the cancer had

developed to the fourth stage

and they said they only had

one or two years. After my

discharge from the hospital,

I continued to ght to not be

defeated by my illness. At

the same time, my husband

and I continue to look for

medicines and effective

treatments for cancer while I

was still receiving treatment

in hospital.

0

5

10

15

20

25

30

35

40

45

50

Argentina Brazil Chile Colombia Mexico Venezuela

83

15 4

6

11

93

36

2

3

3

6

3 2

2

2

1strongly positive

Positive

Balanced

Negative

Strongly negative

Strongly positive



44/73


FREQUENTLY

DISCUSSED

TOPICS

News or media stories posted online

In total, news stories accounted for 5.28% of all topic data. News stories typically included mentions of pharmaceutical updates, clinical trial reports and governmental

news relating to breast cancer.

Proportion of total news story mentions, by country

n = 192 (news story mentions)



The table demonstrates a diversity

of results in this section, with three

countries (Argentina, Colombia and

Mexico) recording higher than anticipated

results, and the remaining three countries

(Brazil, Chile and Venezuela) recording

lower than anticipated results. Mexico,

Argentina and Colombia mentions include

interest in the US FDA withdrawal of

Avastin for the treatment of advanced

breast cancer.


Spanish researchers have

identied a gene, cyclin E, which is

responsible for treatment resistance

in breast cancer HER2-positive

subtype, according to scientists

announced. The study, led by Dr.

Joseph Baselga of Vall dHebron

hospital, Institute of Oncology in

Barcelona, in collaboration withMassachusetts General Hospital

Cancer Center (MGH-CC) of

Boston, could lead to improved

treatment can to prevent patients

with this subtype of cancer develop

resistance to current medical

treatment

http://www.rosario3.com/salud/noticias.

aspx?idNot=86570

Indexed

comparison*



45/73

News or media story

News and media story mentions, by website category

n = 192

Mentions of breast cancer related news stories were generally conned to medical news and

discussion websites.

FREQUENTLY

DISCUSSED

TOPICS



Medical news

Medical discussion




46/73

FREQUENTLY

DISCUSSED

TOPICS



News or media story

All Latin American countries discussed:

Current treatment options

- 20.00% of discussions related to the US FDA withdrawal of the previously

approved Avastin in the treatment of advanced breast cancer


11.00% mentioned clinical trial information on:- Gene therapies in Argentina, Brazil and Mexico

- Biomarkers to predict response in Brazil and Mexico

Treatments

- 4.0% of the discussions related to Pertuzumab and its use in conjunction

with Herceptin and docetaxel in Brazil and Mexico

- 1.0% related to an oral treatment option for advanced breast cancer or metastatic

from GlaxoSmithKline Oncology in Brazil

- 1.0% commented on non-generic drugs being made in Chile

- 1.0% AstraZeneca launch new drug Fulvestrant in Mexico

An early detection campaign was discussed in Chile and Argentina

Avastin is not effective for breast cancer AFP | WASHINGTON | Posted on

June 29, 2011 - 4:14 pm 1/1 Avastin is not effective against breast cancer COURTESY A

reference group of independent experts convened by the U.S. Food Administration andDrug Administration (FDA) today endorsed the recommendation made months ago to ban

the sale of anticancer Avastin.

http://m.eluniversal.com.co/cartagena/vida-sana/avastin-no-es-efectivo-para-el-cancer-de-mama-31645



47/73


FREQUENTLY

DISCUSSED

TOPICS

Cost

Only 1.07% of the overall results related to conversations around cost. Most of the discussions were categorized under nancial news and were linked to stories about

the economic and treatment costs of breast cancer. Costing discussions were only identied in Argentina, Brazil, Chile and Mexico .

Proportion of total cost mentions, by country

n = 39 (cost mentions)

n = 2,195 (total relevant menions)


Conversations in Colombia and

Venezuela did not make reference

to cost. Argentina and Brazil weresignicantly lower than anticipated;

while volumes in Mexico were double

the expected level. Conversations in

Mexico discussed the additional costs

to the healthcare system of treating

advanced or metastatic breast cancer.


40%

Patients with

advanced-stage tumors

have 80% chance of

relapse In Mexico there is

an upward trend in breast

cancer, and according

to the Programme of

Action Breast Cancer of

the Ministry of Health to

sufferers and their families,

as well as health services,this type of tumor has a

signicant impact due to

the high emotional cost,

social and economic

involved in the care

http://journalmex.wordpress.com/2010/05/10/el-cancer-

de-mama-se-puede-curar-cuando-se-detecta-en-su-

inicio/

Indexed

comparison*



48/73

Cost

Mentions of cost, by website category

n = 39

In a result that like support bucked the dominant trend of medical news and discussion sites

generating the majority of results, conversations around the costs of ABC and MBC stemmed

overwhelmingly from nancial news websites.

Discussions in these four countries included:

83% were related to the nancial costs of

treatment of advanced breast cancer including:

- The nancial burden on families

- The cost of treatment

Country specic discussions included:

Lack of a social security system in Argentina

Herceptin was not covered by insurance in

Chile due to its expense

FREQUENTLY

DISCUSSED

TOPICS



Financial news

Medical discussion

Medical news

90.90%



49/73


PINK RIBBON

CAMPAIGN

Pink Ribbon campaign

Conversations relating to the Pink Ribbon movement accounted for 0.52% of the overall discussions.

Proportion of total Pink Ribbon mentions, by country

n = 19 (total Pink Ribbon mentions)


* Numbers lower than 100 indicated the discussion of the topic is less than what would be anticipated; number over 100 mean the discussion of the topic is more than

what would be anticipated

The table demonstrates a

diversity of responses to the

Pink Ribbon movement, with

three countries (Argentina,

Chile and Mexico) recording

lower levels than anticipated

results, and the remaining

three countries (Brazil,

Colombia and Venezuela)

recording higher than

anticipated results. Brazil,

Colombia, and Venezuela

all discussed awareness

campaigns in their countries.

Discussions in Colombia

referred to the research

collaboration between the

University of Colombia and

Avon Cosmetics.

5. How does this community talk about the mainstream pink or Pink Ribbon movement?

Indexed

comparison*



50/73

Pink Ribbon campaign

Topics discussed in relation to the Pink Ribbon movement:

37.00% of discussions related to the raising awareness campaign that took place during

the month of October.

- The Brazilian airline Azuls use of a pink plane in its eet was only mentioned in

Brazil

- The pink lighting of the Christ the Redeemer statue in Rio de Janeiro was

discussed in Mexico only

- Breast cancer research collaborations between Avon (the cosmetics company)

and Colombia University

Sentiment was positive in Latin America when discussing the pink branding, however it was

only apparent in ve discussions.

PINK RIBBON

CAMPAIGN


Pink Ribbon conversations by category

n = 19

http://curarelcancerdemama.blogspot.com/2011_06_01_archive.html

Pink ribbon pins and other products of consciousness have become very popular in recent

years. This is due in part to a growing trend of elements by a cause, proceeds donated often to research

foundations or charitable organizations. Pink ribbon pins, pink purses and other items for breast cancer

awareness are also popular because of the overwhelming amount of lives affected by the disease.

Medical discussion

Medical news



51/73


PRIMARY

CONCERNS /

FRUSTRATIONS

Unmet needs

2.47% of topic mentions related to primary concerns, frustrations and unmet need conversations.

Proportion of total unmet need mentions, by country

n = 90 (total unmet need mentions)



This graph illustrates that Chile

had a higher level of unmetneeds, frustrations or concerns

than would be expected. The

governments decision to refuse

access to Herceptin in Chile

for advanced breast cancer

patients has caused concern.

Mexico also had marginally

higher than anticipated levels

of conversation about this topic,

based on the number of patients

presenting early in the disease

cycle thus avoiding advanced or

metastatic stage disease.

Brazil, Colombia and Venezuela

had lower levels of anticipated

conversations, suggesting

they have fewer unmet needs

to share, or discuss it in other

channels.

6. What are the primary concerns, frustrations or unmet needs discussed among this community?

FranmenaG is a

shame that the state of Chile

denies choice to women with

breast cancer just because they

have metastasized.

@FranmenaG

Clara_Bella_ This

is disgraceful. NO Minsal drug

delivery to women with breast

cancer that has metastasized. @

Jmanalich

@Clara_Bella_

Indexed

comparison*



52/73

PRIMARY

CONCERNS /

FRUSTRATIONS


Unmet needs

Unmet need conversations by category

n = 90

Discussions in the ve countries that generated results included:

Conversations that related to the psychological impact of breast cancer, which constituted

26.0% of the total unmet needs mentions, included discussion of:

Losing the womanly feeling after a mastectomy

Depression

Fear of the unknown

Country specic discussions included:

Commentary regarding the Chilean governments decision not to subsidise use of

Herceptin, which constituted 24% of unmet need comments

Brazil and Mexico jointly generated 19.0% of unmet need results, in discussions relating

to raising awareness for early diagnosis

Similarly, Brazil and Mexico generated a further 5% of unmet need topic results via

discussion of women failing to seek healthcare advice due to embarrassment.

Sentiment expressed within unmet needs in conversations

n = 30

In a result that near mirrors

the outcomes in the support

section of this analysis,

individual category websites

gained prominence among

unmet needs mentions. Like

conversations regarding

support, this is possibly due to

the personal nature of these

forums and the one-to-onerelationships they can generate.

Overall sentiment around unmet

need discussions was negative,

largely due to the psychological

impact of the disease, and the

Chilean governments decision

regarding Herceptin.

Medical discussion

Medical news

Individual



53/73

7. What brand treatment conversations

are occurring and what is the share of voice for

current competitors?

BRAND

TREATMENT

CONVERSATIONS

The relevant search results used in this analysis contained 419 conversations mentioning at

least one product, and a total of 502 mentions of drugs throughout.

The table below is list of all brand mentions captured in this analysis:

n = 502 Table continued overleaf

Please note that cells left blank in the table indicate involvement in clinical trials.


http://pharma-jonpi.blogspot.com/2010/10/19-

octubre-dia-mundial-cancer-de-mama.html

This drug, known as T-DM1, combines the monoclonalantibody trastuzumab, marketed by the company as Herceptin,

and DM antimicrotubule chemotherapeutic agent, has been shown

to be as effective as the standard treatment with trastuzumab and

chemotherapy but with fewer side effects. ...

Trade name Volume% of

discussion Generic namePharmaceutical

company

Herceptin 121 24.10% Trastuzumab Genentech/Roche

Avastin 91 18.13% Bevacizumab Genentech/Roche

Nolvadex 44 8.76% Tamoxifen AstraZeneca

Tykerb 33 6.57% Lapatinib GSK

Xeloda 22 4.38% Capecitabine Genentech/Roche

Halaven 21 4.18% Eribulin EisaiTaxotere 15 2.99% Docetaxel Sanofi

Abraxane 13 2.59% Paclitaxel Celgene

Aromasin 13 2.59% Exemestane Pfizer

Arimidex 12 2.39% Anastrozole AstraZeneca

Aspirin 12 2.39% Acetylsalicylic acid Bayer

Omnitarg 11 2.19% Pertuzamab Genentech/Roche

Faslodex 9 1.79% Fulverstrant AstraZeneca

Femara 9 1.79% Letrozole Novartis

Ixempra 8 1.59% Ixabepilone Bristol-Myers

8 1.59% AnthracyclineAfinitor 7 1.39% Everolimus Novartis

Taxoterer 7 1.39% Docetaxel Sanofi

Gemzar 4 0.80% Gemcitabine Eli Lily

Premarin 4 0.80% Conjugated estrogens Pfizer

Taxol 4 0.80% Paclitaxel Bristol-Myers

Navelbine 3 0.60% Vinorelbine Pierre Fabre

Nexavar 3 0.60% Sorafenib Bayer

Prolia 3 0.60% Denosumab Amgen

Zometa 3 0.60% Zoledronic Acid (Zometa) Novartis

Doxil 2 0.40% Doxorubicin Doxil patentParaplatin 2 0.40% carboplatin Bristol-Myers



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BRAND

TREATMENT

CONVERSATIONS


What brand treatment conversations are occurring?

n = 502

The table below specically focuses on the breast cancer only products:

n = 240

Please note that cells left blank in the table indicate involvement in clinical trials.

Trade name Volume% of

discussion Generic namePharmaceutical

company

Sutent 2 0.40% Sunitinib Pfizer

Diamox 1 0.20% AcetazolamideBarr

Pharmaceuticals

Erubitux 1 0.20% Cetuximab ImClone

Gleevec 1 0.20% Imatinib Novartis

Glucophage 1 0.20% Metformin Bristol-Myers

Lupron 1 0.20% Leuprorelin Abbott

Neupoge 1 0.20% Filgrastim Amgen

Neuvenge 1 0.20% DendreonNovantrone 1 0.20% Mitoxantrone Serono

Tomtovok 1 0.20% AfatinibBoehringerIngleheim

Xalkori 1 0.20% Crizotinib Pfizer

Aredia 1 0.20% Pamidronic acid Novartis

1 0.20%Docetaxel trihydrate

Docetere

1 0.20% CimaVax-EGF

1 0.20% Antimicrotubule

1 0.20% Aromatase inhibitor

Eulexin 1 0.20% Flutamide Schering-Plough

Tradename Volume

% ofdiscussion

Genericname

Pharmaceuticalcompany

Herceptin 121 50.42% Trastuzumab Genentech/Roche

Tykerb 33 13.75% Lapatinib GSK

Halaven 21 8.75% Eribulin Eisai

Aromasin 13 5.42% Exemestane Pfizer

Abraxane 13 5.42% Paclitaxel Celgene

Arimidex 12 5.00% Anastrozole AstraZeneca

Omnitarg 11 4.58% Pertuzamab Genentech/Roche

Femara 9 3.75% Letrozole Novartis

Afinitor 7 2.92% Everolimus Novartis



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WHO IS

PARTICIPATING IN

CONVERSATIONS

Treatment discussions constituted 13.19% of the total topic mentions,

and as the graph below highlights, most generated an anticipated

volume of results when compared to their share of total relevant results

used in this analysis.

Proportion of total treatment mentions, by country

n = 480 (total treatment mentions)



Argentina and Venezuela

both had a slightly lower

level share of discussions

on treatments than expected

for no clear reason as both

countries mentioned the top

ten identied overall.

Chile and Colombia

presented slightly higher

than average conversation

volumes. Colombia

frequently mentioned

combination therapies

including Trastuzumab,

Bevacizumab and Xeloda.

Chile mentions include

higher levels of discussionson chemotherapy.

8. Who is participating in conversations about treatment?

Blocking Snail-G9a-DNMT binding may pave way for novel therapeutic approaches

targeting metastatic breast cancer http://bit.ly/yGuxjD@bkmacy

Indexed

comparison*



5

Documents

Generic Latin America Report