Spiegel Daphna Y, Friesner Isabel D, Zhang William, Zack Travis, Yan Gianna, Willcox Julia, Prionas Nicolas, Singer Lisa, Park Catherine, Hong Julian C
Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, United States, 1 6176672345.
Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, United States.
JMIR Cancer. 2025 Jan 28;11:e52886. doi: 10.2196/52886.
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 sentiments and associated emotions in social media discussions 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. Overall, 105,231 paragraphs across 59,416 posts and comments from 2011 to 2021 were collected and analyzed. Paragraphs were processed through the Apache Clinical Text Analysis Knowledge Extraction System and identified as discussing BCS or mastectomy based on physician-defined Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) concepts. Paragraphs were analyzed with a VADER (Valence Aware Dictionary for Sentiment Reasoning) compound sentiment score (ranging from -1 to 1, corresponding to negativity or positivity) and GoEmotions scores (0-1) corresponding to the intensity of 27 different emotions and neutrality.
Of the 105,231 paragraphs, there were 7306 (6.94% of those analyzed) paragraphs mentioning BCS and mastectomy (2729 and 5476, respectively). Discussion of both increased over time, with BCS outpacing mastectomy. The median sentiment score for all discussions analyzed in aggregate became more positive over time. In specific analyses by topic, positive sentiments for discussions with mastectomy mentions increased over time; however, discussions with BCS-specific mentions 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 web-based community. While discussions surrounding mastectomy became increasingly positive, BCS discussions did not show the same trend. This mirrors national clinical trends in the United States, with the 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.
早期乳腺癌面临着复杂的挑战，多种治疗选择都有良好的预后，包括保乳手术（BCS）或乳房切除术。社交媒体越来越多地被用作患者的信息来源和决策工具，了解这些讨论对于患者咨询很重要。
本研究的目的是使用自然语言处理（NLP）比较社交媒体上围绕保乳手术和乳房切除术的讨论中的情感和相关情绪。
使用pushshift.io收集Reddit子版块r/乳腺癌的帖子、评论及相关元数据。总体而言，收集并分析了2011年至2021年期间59416个帖子和评论中的105231段内容。段落通过Apache临床文本分析知识提取系统进行处理，并根据医生定义的医学临床术语系统命名法（SNOMED CT）概念确定为讨论保乳手术或乳房切除术。段落用VADER（情感推理的效价感知词典）复合情感评分（范围从-1到1，分别对应消极或积极）和GoEmotions评分（0-1）进行分析，GoEmotions评分对应27种不同情绪和中立情绪的强度。
在105231段内容中，有7306段（占分析内容的6.94%）提到了保乳手术和乳房切除术（分别为2729段和5476段）。随着时间的推移，对两者的讨论都有所增加，保乳手术的讨论增长速度超过乳房切除术。总体分析的所有讨论的情感评分中位数随着时间的推移变得更加积极。在按主题进行的具体分析中，提及乳房切除术的讨论的积极情绪随着时间的推移有所增加；然而，提及保乳手术的讨论没有显示出类似的趋势，总体上仍保持中立。与保乳手术相比，关于乳房切除术的讨论往往有更积极的情绪。最常识别出的情绪包括中立、感激、关心、认可和乐观。随着时间的推移，保乳手术讨论中愤怒、烦恼、失望、厌恶和喜悦的情绪增加。
患者越来越多地参与基于网络社区的乳腺癌治疗讨论。虽然围绕乳房切除术的讨论越来越积极，但保乳手术的讨论没有显示出相同的趋势。这反映了美国的国家临床趋势，即早期乳腺癌中乳房切除术的使用超过保乳手术。认识到决策过程中的情感和情绪可以促进以患者为中心且情感敏感的治疗建议。
