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Background <p>Breast reconstruction is a key component of comprehensive breast cancer care, yet access remains uneven in many middle-income countries. In Brazil, federal policies have sought to expand reconstruction within the public health system (SUS), but long-term national trends remain insufficiently characterized. This study aimed to evaluate temporal trends in breast cancer-related surgical procedures and breast reconstruction hospital admissions in Brazil and to examine temporal changes associated with major federal policy measures.</p> Methods <p>We conducted a nationwide ecological interrupted time-series study using administrative data from the Brazilian Hospital Information System (SIH/DATASUS) between 2008 and 2024. Annual aggregated hospital admissions for breast cancer-related surgical procedures and breast reconstruction funded by SUS were used as the unit of analysis. The primary outcome was the annual ratio of breast reconstruction hospital admissions to breast cancer-related surgical hospital admissions. Interrupted time-series analyses were performed using segmented negative-binomial regression models.</p> Results <p>Between 2008 and 2024, 312,375 hospital admissions for breast cancer-related surgical procedures and 30,049 breast reconstruction hospital admissions were recorded in the Brazilian public health system. The annual breast reconstruction admission ratio increased from 6.67% in 2008 to 19.23% in 2024, corresponding to a significant annual increase of 6.0% (<i>p</i> &lt; 0.001). Temporal changes were observed following both Law No. 12,802/2013 and Ordinance No. 127/2023. Despite this increase, breast reconstruction hospital admissions remained substantially lower than breast cancer-related surgical admissions throughout the study period, and marked regional disparities persisted.</p> Conclusions <p>Breast reconstruction hospital admissions increased substantially in Brazil’s public health system between 2008 and 2024. Temporal changes coincided with major federal policy measures; however, the persistent gap between breast reconstruction and breast cancer-related surgical hospital admissions suggests continuing challenges in access to reconstructive care. Ongoing monitoring and health policies remain important to improve equitable access to breast reconstruction within SUS.</p>

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Breast reconstruction and breast cancer surgery in Brazil’s public health system: a nationwide interrupted time-series analysis, 2008–2024

  • 期刊论文

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  • 发表日期：

    2026年8月5日

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  • Matheus Piccin Padilla,
  • Marina Martins Siqueira,
  • Felipe Mendes Delpino,
  • Julia Baroni Jardim de Freitas,
  • Sergio Podgaec,
  • Felipe Eduardo Martins de Andrade

摘要

Background

Breast reconstruction is a key component of comprehensive breast cancer care, yet access remains uneven in many middle-income countries. In Brazil, federal policies have sought to expand reconstruction within the public health system (SUS), but long-term national trends remain insufficiently characterized. This study aimed to evaluate temporal trends in breast cancer-related surgical procedures and breast reconstruction hospital admissions in Brazil and to examine temporal changes associated with major federal policy measures.

Methods

We conducted a nationwide ecological interrupted time-series study using administrative data from the Brazilian Hospital Information System (SIH/DATASUS) between 2008 and 2024. Annual aggregated hospital admissions for breast cancer-related surgical procedures and breast reconstruction funded by SUS were used as the unit of analysis. The primary outcome was the annual ratio of breast reconstruction hospital admissions to breast cancer-related surgical hospital admissions. Interrupted time-series analyses were performed using segmented negative-binomial regression models.

Results

Between 2008 and 2024, 312,375 hospital admissions for breast cancer-related surgical procedures and 30,049 breast reconstruction hospital admissions were recorded in the Brazilian public health system. The annual breast reconstruction admission ratio increased from 6.67% in 2008 to 19.23% in 2024, corresponding to a significant annual increase of 6.0% (p < 0.001). Temporal changes were observed following both Law No. 12,802/2013 and Ordinance No. 127/2023. Despite this increase, breast reconstruction hospital admissions remained substantially lower than breast cancer-related surgical admissions throughout the study period, and marked regional disparities persisted.

Conclusions

Breast reconstruction hospital admissions increased substantially in Brazil’s public health system between 2008 and 2024. Temporal changes coincided with major federal policy measures; however, the persistent gap between breast reconstruction and breast cancer-related surgical hospital admissions suggests continuing challenges in access to reconstructive care. Ongoing monitoring and health policies remain important to improve equitable access to breast reconstruction within SUS.