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Educational quality of YouTube videos on breast oncoplasty: A cross-sectional observational study
, Sabaretnam Mayilvaganan1,, Shagun Misra2, Gyan Chand1, Anjali Mishra1, Gaurav Agarwal1
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Received: ,
Accepted: ,
How to cite this article: Sah RK, Mayilvaganan S, Misra S, Chand G, Mishra A, Agarwal G. Educational quality of YouTube videos on breast oncoplasty: A cross-sectional observational study. South Asian J Cancer. 2026;15:30-5. doi: 10.25259/SAJC_81_2025
Abstract
Objectives:
Breast oncoplasty is rapidly evolving, but contemporary postgraduate training resources remain limited. Surgeons and patients increasingly turn to YouTube for accessible educational content. However, the quality and reliability of these videos remain unclear. The objective is to evaluate the quality, reliability, and engagement characteristics of YouTube videos related to breast oncoplasty.
Material and Methods:
A cross-sectional observational study was conducted in May 2025. A systematic YouTube search using relevant keywords was performed in incognito mode. Eligible videos (English, >1 minute, directly related to breast oncoplasty) were analysed. Video characteristics and engagement metrics were extracted using TubeBuddy, Hamphy, and the YouTube interface. Quality was assessed independently by two researchers using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). Engagement was quantified by likes, dislikes, views, comments, SEO score, and Video Power Index (VPI). Statistical analysis included ANOVA/Kruskal–Wallis tests and Pearson/Spearman correlations.
Results:
A total of 104 videos met the inclusion criteria. The mean DISCERN score was 50.8 ± 6.7, the mean JAMA score was 3.36 ± 0.6, and the mean GQS was 3.45 ± 0.5, indicating moderate overall educational quality. Academic discussion and advocacy videos demonstrated significantly higher DISCERN scores compared with self-promotional content (p = 0.020). Patient-uploaded videos achieved the highest audience engagement, with median views of 8953 compared with 2192 among physician-uploaded videos (p = 0.039). DISCERN scores showed strong correlations with JAMA (r = 0.574, p <0.001) and GQS (r = 0.604, p <0.001). Video age demonstrated significant negative correlations with DISCERN (r = –0.404, p <0.001) and VPI (r = –0.251, p = 0.011), indicating that newer videos were associated with higher quality and greater viewer approval.
Conclusion:
YouTube serves as a widely used platform for breast oncoplasty education, but the overall quality is variable. Videos from academic and advocacy sources were superior, while self-promotional content scored lowest. There is a need for professional societies and academic bodies to create and promote high-quality, evidence-based content to enhance global breast surgery education.
Keywords
Breast oncoplastic surgery
Breast cancer surgery
DISCERN instrument
Patient education
YouTube
INTRODUCTION
Breast oncoplasty is an essential component of contemporary breast surgical practice, yet structured training opportunities remain limited, leading surgeons to increasingly rely on online video-based educational resources.[1–5] YouTube, as a widely accessed platform for surgical learning, offers extensive content on breast oncoplasty, though its educational quality, reliability, and accuracy are inconsistent and not peer-reviewed.[6–10] This study aimed to systematically evaluate YouTube videos on breast oncoplasty using validated quality assessment tools (DISCERN, JAMA benchmark criteria, and Global Quality Score) and to analyse viewer engagement characteristics.
MATERIAL AND METHODS
Study Design: This cross-sectional observational study was conducted in May 2025. Only publicly available data were used; hence, ethical approval was not required. Video Selection: Searches were performed on YouTube in incognito mode using keywords including 'breast surgery,' 'breast oncoplasty,' 'breast cancer surgery,' and 'breast conserving surgery.' For each keyword, the first 10 results were screened. Inclusion criteria: English language, duration >1 minute, and direct relevance to breast oncoplasty. Exclusion criteria: duplicate, non-English, anonymous channels, advertisements, poor audiovisual quality, or non-health-related content. Data Extraction: Engagement metrics included likes, dislikes (Hamphy), views, comments, SEO (Search Engine Optimisation) score (Tube Buddy), video duration, and age (months). Uploader type (physician, academic, society, patient, media, device company, healthcare group, non-physician), and video type (patient education, patient experience, academic discussion, operative, advocacy, self-promotion) were recorded. Quality Assessment: Two researchers independently rated videos using DISCERN (16–80), JAMA benchmark criteria (0–4), and Global Quality Score (1–5). Cohen’s kappa assessed inter-rater agreement, with disagreements resolved by consensus. Outcome Measures: Primary outcomes included DISCERN, JAMA, and GQS scores. Secondary outcomes were likes, dislikes, comments, views, SEO score, and Video Power Index (VPI).Statistical Analysis: Descriptive statistics were used. Group comparisons: one-way ANOVA for normal data, Kruskal–Wallis for non-parametric. Correlations between quality scores and engagement metrics were analysed using Pearson’s or Spearman’s tests. Significance was set at p <0.05.
RESULTS
Overall characteristics of the videos
A total of 104 YouTube videos related to breast oncoplasty were included in the analysis. The descriptive statistics are summarised in [Table 1]. The mean DISCERN score was 50.84 ± 6.67 (range 33–64), indicating that most videos demonstrated moderate reliability and quality. JAMA benchmark scores showed a mean of 3.36 ± 0.58 (range 2–4), reflecting partial adherence to essential transparency criteria. The Global Quality Score averaged 3.45 ± 0.50 (range 3–4), consistent with fair-to-good educational utility but also suggesting that videos often lacked comprehensive coverage of core clinical concepts.
| Mean | Median | Std. deviation | Minimum | Maximum | Range | |
|---|---|---|---|---|---|---|
| DISCERN SCORE | 50.84 | 51.00 | 6.67 | 33.00 | 64.00 | 31.00 |
| JAMA | 3.36 | 3.00 | 0.58 | 2.00 | 4.00 | 2.00 |
| GQS | 3.45 | 3.00 | 0.50 | 3.00 | 4.00 | 1.00 |
| Duration (min) | 18.95 | 5.00 | 36.48 | 1.00 | 211.00 | 210.00 |
| View | 11268.39 | 1404.00 | 39718.08 | 11.00 | 271000.00 | 270989.00 |
| Age (months) | 59.92 | 50.00 | 36.72 | 1.00 | 156.00 | 155.00 |
| Comment | 39.74 | 0.00 | 305.44 | 0.00 | 3050.00 | 3050.00 |
| Like | 95.74 | 13.00 | 341.11 | 0.00 | 2100.00 | 2100.00 |
| Dislike | 1.95 | 0.00 | 7.30 | 0.00 | 47.00 | 47.00 |
| SEO | 35.20 | 30.00 | 31.15 | 0.00 | 100.00 | 100.00 |
| VPI | 97.06 | 100.00 | 11.66 | 0.00 | 100.00 | 100.00 |
JAMA: Journal of American Medical Association, GQS: Global Quality Score, SEO: Search engine optimisation, VPI: Video Power Index.
Video duration varied widely, with a mean of 18.95 minutes but a median of only 5 minutes, and an extreme range from 1 to 211 minutes, demonstrating a strongly positively skewed distribution. Viewer engagement also showed substantial skewness: while the median number of views was 1404, some videos had extremely high visibility, reaching up to 271,000 views. SEO scores were highly variable (mean 35.20 ± 31.15), suggesting inconsistent optimisation practices across channels. Despite this, VPI remained consistently high at a mean of 97.06 ± 11.66, indicating high audience approval independent of the actual educational value or reliability of content.
Comparison according to video type
When stratified by video type, several statistically significant differences were observed [Table 2]. DISCERN scores differed meaningfully between categories (p = 0.020). Patient experience videos demonstrated the highest mean DISCERN score (55 ± 6.21), followed by academic discussion or teaching content (53.30 ± 4.5), whereas self-promotion videos scored lowest (40.33 ± 9.45), reflecting their limited educational rigour.
| Type of video | Patient experience (n= 4) | Patient education (n= 37) | Academic discussion/Teaching (n= 23) | Operative procedure (n= 23) | Advocacy (n= 10) | Self-Promotion (n= 3) | p-value |
|---|---|---|---|---|---|---|---|
| Median (Range) | |||||||
| JAMA Score | 3.5 (3-4) | 3 (2-4) | 4 (3-4) | 3 (2-4) | 4 (2-4) | 3 (3-3) | 0.358 |
| GQS | 3.5 (3-4) | 3 (3-4) | 4 (3-4) | 3 (3-4) | 4 (3-4) | 3 (3-3) | 0.592 |
| Duration (min) | 3 (2-19) | 4 (1-18) | 16 (3-211) | 7 (1-177) | 18 (2-94) | 4(2-4) | <0.001* |
| View | 2536 (595-8953) | 1074 (130-271000) | 1140 (95-160423) | 2192 (238-190982) | 1058 (11-4010) | 1498 (268-4352) | 0.049 |
| Age (months) | 82 (14-84) | 40 (11-156) | 49 (24-154) | 72 (3-144) | 48 (1-108) | 96 (52-108) | 0.572 |
| Comment | 1 (0-41) | 0 (0-329) | 0 (0-79) | 0 (0-3050) | 0 (0-2) | 0 (0-1) | 0.592 |
| Like | 13 (4-243) | 10 (0-1820) | 16 (0-991) | 19 (0-2100) | 3 (0-63) | 0 (0-18) | 0.185 |
| Dislike | 0 (0-2) | 0 (0-33) | 0 (0-47) | 0 (0-40) | 0 (0-2) | 0 (0-0) | 0.866 |
| SEO | 62.5 (25-80) | 50 (0-100) | 5 (0-90) | 20 (0-80) | 35 (0-90) | 65 (10-75) | <0.001* |
| VPI | 100 (66.7-100) | 100 (66.7-100) | 100 (85.8-100) | 100 (0-100) | 100 (96.9-100) | 100 (100-100) | 0.762 |
| Mean (SD) | |||||||
| DISCERN | 55(6.21) | 49.89(6.79) | 53.30(4.5) | 50.43(7.43) | 51.09(5.08) | 40.33(9.45) | 0.020* |
Video duration varied significantly across categories (p <0.001). Academic videos and advocacy-related content were longer, with median durations of 16 and 18 minutes, respectively, while patient experience and self-promotional videos were much shorter, typically around 3–4 minutes. Total views also differed significantly (p = 0.049), with patient education videos occasionally reaching extremely high view counts (up to 271,000), although the majority remained modest.
SEO scores showed significant variation (p <0.001), with self-promotion and patient experience videos demonstrating higher optimisation than academic or operative videos. In contrast, JAMA and GQS scores did not significantly differ across video types (p = 0.358 and 0.592, respectively), suggesting that reliability and overall educational utility remained relatively consistent regardless of content style.
Comparison according to physician involvement
When grouped by the involvement of different physician specialities or non-physician presenters, there were no statistically significant differences in DISCERN, JAMA, or GQS scores (all p >0.05) [Table 3]. Mean DISCERN scores were similar among general surgeons (50.08 ± 6.7), oncosurgeons (51.37 ± 6.14), breast surgeons (51.28 ± 7.01), and plastic surgeons (50.45 ± 5.289). Non-physician creators had a slightly lower mean DISCERN score (48.40 ± 13.05), but this was not statistically significant.
| Physician involvement | General surgeon (n= 11) | Onco-surgeon (n= 30) | Breast surgeon (n= 32) | Plastic surgeon (n= 22) | Non-physician (n= 5) | p-value |
|---|---|---|---|---|---|---|
| Median (Range) | ||||||
| JAMA Score | 3.5 (3-4) | 3 (2-4) | 3 (2-4) | 3 (2-4) | 3 (3-4) | 0.668 |
| GQS | 3.5 (3-4) | 3(3-4) | 3 (3-4) | 3 (3-4) | 3 (3-4) | 0.983 |
| Duration (min) | 6.5 (1-102) | 8 (1-211) | 5 (1-32) | 5.5 (1-61) | 4 (3-19) | 0.361 |
| View | 1022 (130-36511) | 1408 (129-130802) | 1343.5 (11-271000) | 1601.5 (208-190982) | 1498 (595-8953) | 0.661 |
| Age (months) | 47.5 (17-156) | 48 (12-144) | 39 (3-144) | 84 (1-150) | 80 (14-96) | 0.12 |
| Comment | 0.5 (0-2) | 0 (0-79) | 0 (0-3050) | 0 (0-211) | 0 (0-41) | 0.988 |
| Like | 12 (2-103) | 16.5 (0-657) | 15.5 (0-1820) | 12.5 (0-2100) | 7 (0-243) | 0.985 |
| Dislike | 0 (0-17) | 0 (0-47) | 0 (0-33) | 0 (0-40) | 0 (0-0) | 0.023 |
| SEO | 27.5 (0-100) | 32.5 (0-80) | 27.5 (0-100) | 25 (0-100) | 70 (10-80) | 0.782 |
| VPI | 100 (85.8-100) | 100 (0-100) | 100 (84.6-100) | 100 (66.7-100) | 100 (100-100) | 0.021 |
| Mean (SD) | ||||||
| DISCERN | 50.08 (6.7) | 51.37 (6.14) | 51.28 (7.01) | 50.45 (5.289) | 48.40 (13.05) | 0.879 |
JAMA: Journal of American Medical Association, GQS: Global Quality Score, SEO: Search engine optimisation, VPI: Video Power Index, SD: Standard deviation.
Engagement metrics such as views, likes, and comments also did not differ significantly across physician categories (p >0.05), indicating that audience interaction patterns were similar regardless of the uploader’s professional background. Dislike counts and VPI showed statistically significant differences (p = 0.023 and p = 0.021, respectively), though the absolute values remained low and the magnitude of difference was not clinically meaningful.
Comparison according to type of user account
Uploader account type significantly influenced several indicators of video quality and engagement [Table 4]. DISCERN scores differed significantly (p = 0.028), with patient-uploaded content achieving the highest possible mean score (64), followed by academic teaching or society channels (53.14 ± 7.0). Device company videos showed the lowest DISCERN score (33), suggesting minimal reliability or quality oversight.
| Patient (n= 1) | Physician (n= 31) | Healthcare group (n= 27) | Non-physician provider (n= 21) | Academic teaching/Society (n= 13) | Medical journal (n= 4) | Device company (n= 1) | Media account (n= 2) | p-value | |
|---|---|---|---|---|---|---|---|---|---|
| Median (Range) | |||||||||
| JAMA | 4 (4-4) | 3 (2-4) | 3 (2-4) | 4 (2-4) | 3.5 (3-4) | 3 (3-4) | 3 (3-3) | 3 (3-3) | 0.298 |
| GQS | 4 (4-4) | 3 (3-4) | 3 (3-4) | 4 (3-4) | 4 (3-4) | 3.5 (3-4) | 3 (3-3) | 3 (3-3) | 0.567 |
| Duration (min) | 19 (19-19) | 4 (1-177) | 4 (1-57) | 8.5 (1-111) | 29 (3-211) | 6.5 (4-15) | 4 (4-4) | 4.5 (2-7) | 0.002 |
| View | 8953 (8953-8953) | 2192 (130-130802) | 1275 (173-271000) | 1214 (11-190982) | 1076 (95-5310) | 597 (110-160423) | 4352 (4352-4352) | 749.5 (474-1025) | 0.039 |
| Age (months) | 14 (14-14) | 58 (3-154) | 48 (12-156) | 60 (1-108) | 46 (7-105) | 71 (27-120) | 96 (96-96) | 108(96-120) | 0.175 |
| Comment | 41 (41-41) | 1 (0-3050) | 0 (0-329) | 0 (0-211) | 0 (0-2) | 0 (0-58) | 1 (1-1) | 0 (0-0) | 0.064 |
| Like | 243 (243-243) | 19 (0-1820) | 10 (0-1800) | 9 (0-2100) | 14.5 (0-105) | 4 (2-991) | 18 (18-18) | 2.5 (0-5) | 0.047 |
| Dislike | 0 (0-0) | 0 (0-47) | 0 (0-6) | 0 (0-40) | 0 (0-0) | 0 (0-18) | 0 (0-0) | 0 (0-0) | 0.718 |
| SEO | 80 (80-80) | 30 (0-100) | 35 (0-100) | 35 (0-85) | 0 (0-65) | 50 (25-90) | 75 (75-75) | 12.5 (0-25) | 0.011 |
| VPI | 100 (100-100) | 100 (0-100) | 100 (72.7-100) | 100 (66.7-100) | 100 (100-100) | 100 (98.3-100) | 100 (100-100) | 100 (100-100) | 0.693 |
| Mean (SD) | |||||||||
| DISCERN | 64 (0) | 50.16 (7.12) | 49.93 (6.06) | 52.10 (5.5) | 53.14 (7.0) | 51 (2.8) | 33 (0) | 46.50 (0.70) | 0.028* |
JAMA: Journal of American Medical Association, GQS: Global Quality Score, SEO: Search engine optimisation, VPI: Video Power Index, SD: Standard deviation.
Video views varied markedly by uploader type (p = 0.039).
Patient-uploaded videos recorded extremely high engagement (median 8953 views), substantially exceeding that of physicians, medical journals, academic societies, or non-physician providers. Likes also differed significantly (p = 0.047), again with patient-uploaded content attracting disproportionately higher interaction. SEO scores showed significant variation across groups (p = 0.011), reflecting notable disparities in promotional strategy and channel sophistication.
Correlation analysis
Correlation analysis revealed strong associations among the three quality metrics [Table 5]. DISCERN demonstrated significant positive correlations with JAMA (r = 0.574, p <0.001) and GQS (r = 0.604, p <0.001), indicating that videos scoring well in one domain generally scored well across other measures of accuracy, transparency, and educational value. Video age showed a significant negative correlation with DISCERN (r = –0.404, p <0.001), JAMA (r = –0.214, p = 0.031), and GQS (r = –0.269, p = 0.007), suggesting that newer videos tend to be more reliable and of higher educational quality.
| DISCERN | JAMA | GQS | Duration (min) | view | Age | comment | like | dislike | SEO | VPI | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DISCERN | r | 1 | .574** | .604** | 0.152 | 0.098 | -.404** | 0.143 | 0.126 | 0.021 | 0.083 | -0.053 |
| p | 0.000 | 0.000 | 0.132 | 0.331 | 0.000 | 0.154 | 0.208 | 0.838 | 0.408 | 0.598 | ||
| JAMA | r | .574** | 1 | .763** | 0.111 | 0.020 | -.214* | 0.114 | 0.034 | 0.090 | 0.116 | -0.051 |
| p | 0.000 | 0.000 | 0.273 | 0.842 | 0.031 | 0.256 | 0.736 | 0.371 | 0.249 | 0.616 | ||
| GQS | r | .604** | .763** | 1 | 0.112 | 0.052 | -.269** | 0.125 | 0.065 | -0.043 | 0.145 | -0.072 |
| p | 0.000 | 0.000 | 0.266 | 0.609 | 0.007 | 0.213 | 0.520 | 0.667 | 0.147 | 0.476 | ||
| VPI | r | -0.053 | -0.051 | -0.072 | 0.087 | -0.028 | -.251* | 0.029 | 0.025 | -0.082 | -0.036 | 1 |
| p | 0.598 | 0.616 | 0.476 | 0.389 | 0.783 | 0.011 | 0.775 | 0.800 | 0.415 | 0.724 | ||
VPI also correlated negatively with video age (r = –0.251, p = 0.011), implying greater audience approval for more recent uploads. Importantly, there were no significant correlations between quality scores and raw engagement metrics such as views, likes, or comments, indicating that popularity is not a reliable predictor of video educational value.
DISCUSSION
This cross-sectional analysis provides valuable insights into the quality, reliability, and engagement of YouTube videos on breast oncoplasty. Overall, the mean DISCERN, JAMA, and GQS scores reflected moderate educational value, with significant heterogeneity depending on video type and uploader source. Academic and advocacy-related videos demonstrated the highest quality, whereas self-promotional and device-related content consistently scored lower.
Comparison with Existing Literature: Our findings align with prior evaluations of surgical YouTube content, which consistently show variable and often suboptimal educational quality. Jaffar demonstrated that anatomy videos on YouTube lacked depth, referencing, and peer review. Fischer et al.[9] reported similar concerns for arthrocentesis videos. Koller et al.[11] showed that YouTube videos on knee arthroplasty were unsuitable for patient education, while Drozd et al.[7] highlighted general shortcomings in health-related YouTube resources. In contrast, some improvements have been reported in recent years with increasing professional engagement.[8]
Implications: For trainees, YouTube can supplement formal training, but without peer review, risks misinformation. For patients, engagement with personal narratives emphasises the importance of authentic experiences but raises concerns about the oversimplification of complex surgical decisions.[6]
Strengths:
Use of validated scoring instruments[12–14], inclusion of hidden dislikes, and categorisation by uploader and video type strengthen the study.
Limitations:
English-only focus, cross-sectional design, single-platform analysis, and inherent subjectivity of scoring tools limit generalizability.
Future directions:
Professional societies should contribute peer-reviewed video content. Quality assurance mechanisms[13], patient-centred educational resources[15], and longitudinal studies tracking engagement trends are needed.
Clinical relevance:
YouTube has great potential for democratizing breast oncoplasty education, but its unregulated nature requires surgeons and learners to critically appraise available content.[6,7]
TAKE HOME MESSAGE
YouTube has emerged as an important supplementary resource for learning about breast oncoplasty; however, the educational quality and reliability of available videos remain inconsistent. Videos produced by academic institutions and advocacy organizations tend to demonstrate higher educational value, whereas self-promotional or commercial content often lacks scientific rigor. Importantly, viewer engagement does not necessarily correlate with video quality, highlighting the risk of misinformation. Greater participation from professional surgical societies and academic centers is needed to develop and promote high-quality, evidence-based digital educational resources for both surgeons and patients.
Ethical approval:
The research/study approved by the Institutional Review Board at Sanjay Gandhi Postgraduate Institute of Medical Sciences, number 2024-60-MCh-EXP-57, dated 17th January 2024.
Declaration of patient consent:
Patient's consent not required as there are no patients in this study.
Conflicts of interest:
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation:
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
Financial support and sponsorship: Nil
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