Exploring the social media discussion of breast cancer treatment choices: A quantitative natural language process study (Preprint)

Abstract

Early-stage breast cancer has the complex challenge of carrying a favorable prognosis with multiple treatment options, including breast conserving surgery (BCS) or mastectomy. Social media is increasingly used as a source of information and as a decision tool for patients, and awareness of these conversations is important for patient counseling.

The goal of this study was to compare social media discussion surrounding BCS and mastectomy using natural language processing (NLP).

Reddit posts and comments from the Reddit subreddit r/breastcancer and associated metadata were collected using pushshift.io. 105,231 paragraphs across 59,416 posts and comments from 2015-2021 were collected and analyzed. Paragraphs were processed through the Apache clinical Text Analysis Knowledge Extraction System (cTAKES) and identified as discussing BCS or mastectomy based on physician-defined SNOMED concepts. Paragraphs were analyzed with a Valence Aware Dictionary for sEntiment Reasoning (VADER) compound sentiment score (ranging -1 to 1 corresponding to negativity or positivity) and GoEmotions scores (0-1) corresponding to the intensity of 27 different emotions and neutrality.

There were 7,306 paragraphs mentioning BCS or mastectomy (2,729 and 5,476, respectively). Discussion of both increased over time, with BCS outpacing mastectomy. The median sentiment score for all discussions became more positive over time. Positive sentiments for mastectomy mentions increased over time. Discussion surrounding BCS did not show a similar trend and remained overall neutral. Compared to BCS, conversations about mastectomy tended to have more positive sentiments. The most commonly identified emotions included neutrality, gratitude, caring, approval, and optimism. Anger, annoyance, disappointment, disgust, and joy increased for BCS over time.

Patients are increasingly participating in breast cancer therapy discussions with a virtual community. While discussions surrounding mastectomy became increasingly positive, BCS discussions did not show the same trend. This mirrors national clinical trends, with increasing use of mastectomy over BCS in early-stage breast cancer. Recognizing sentiments and emotions surrounding the decision-making process can facilitate patient-centric and emotionally sensitive treatment recommendations.