2390 - Quality and Content of YouTube Videos on Breast Cancer Radiation Therapy Side Effects: A Cross-Sectional Study

Purpose/Objective(s):

Patients with breast cancer increasingly use YouTube to understand radiation therapy–related side effects, often before or alongside consultations with radiation oncologists. Professional societies such as ASTRO play an important role in setting standards for patient education and addressing misinformation, yet the quality of publicly available video content remains uncertain. This study evaluated the content, information quality, and engagement metrics of YouTube videos addressing breast cancer radiation therapy side effects and compared professionally recorded and non-professional videos.

Materials/Methods:

We conducted a cross-sectional analysis of 69 YouTube videos focused on breast cancer radiation therapy side effects. Videos were assessed for symptom coverage, content characteristics, and engagement metrics (duration, views, likes, and comments). Information quality was evaluated using the DISCERN instrument (score range 16–80), with higher scores indicating better quality (very poor to excellent). Videos were classified as professionally recorded or non-professional based on production characteristics. Blank engagement fields were interpreted as disabled and coded as zero. Video availability duration was calculated from upload date to data extraction (10 February 2026). As data were non-normally distributed, results are presented as median and interquartile range (IQR), and comparisons were performed using the Mann–Whitney U test.

Results:

Most videos originated from the United States (48/69; 69.5%) and focused on breast cancer radiation therapy (68/69; 98.5%). Acute effects were discussed in 55/69 (79.7%), late effects in 50/69 (72.5%), and skin reactions in 50/69 (72.5%). Fatigue (41/69; 59.4%), fibrosis (37/69; 53.6%), and lymphedema (27/69; 39.1%) were inconsistently addressed. Psychosocial concerns were mentioned in only 15/69 (21.7%), and evidence-based references were cited in 2/69 (2.9%). Videos had been available online for a median of 45.1 months (IQR, 26.5–65.6). DISCERN ratings were moderate in 36/69 (52.1%), poor in 16/69 (23.2%), very poor in 12/69 (17.4%), and good in 5/69 (7.2%); none were rated excellent. Professionally recorded videos had significantly higher DISCERN scores than non-professional videos (44 [IQR, 40–46] vs 33 [IQR, 16–40]; p < 0.001). Engagement metrics were similar, except for higher comment counts in professional videos (p = 0.040).

Conclusion:

YouTube videos on breast cancer radiation therapy side effects frequently discuss treatment toxicities but often lack evidence-based information and psychosocial support content. Professional video production is strongly associated with higher information quality, independent of viewership. These findings highlight a clear opportunity for ASTRO and radiation oncology departments to develop society-endorsed, evidence-based educational video resources to improve patient understanding and counter misinformation.