Peer-reviewedCC BYEpidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil24 Jul 2026

Racial inequality in access to breast reconstruction surgery in the Brazilian Unified Health System: an interrupted time series study, Brazil, 2010-2024.

Alana Ramos da Silva¹
Fernando Antonio Slaibe Postali¹

¹Universidade de São Paulo, Faculdade de Economia, Administração e Contabilidade, São Paulo, SP, Brazil Universidade de São Paulo Faculdade de Economia Administração e Contabilidade São PauloSP Brazil.

Abstract

Objective

To estimate the differential in access to breast reconstruction surgery in the Brazilian Unified Health System according to race/skin color nationwide and in the country's regions.Methods

This was an observational study of interrupted time series, which used monthly microdata from the Hospital Information System for the period 2010-2024. The differentials in the proportion of breast reconstruction surgeries according to race/skin color were estimated before and after the implementation of Ordinance No. 127/2023, with respective 95% confidence intervals (95%CI).Results

We identified 565,234 surgeries, of which 404,944 (71.6%) were mastectomies and 160,290 (28.4%) were breast reconstructions. The proportion of reconstructions was, on average, 12.9 percentage points (95%CI -16.8; -8.9) lower for Black women compared to White and Asian women. After the Ordinance No. 127/2023 intervention, the differential increased to 28.6 percentage points (95%CI -44.1; -13.0). The largest differentials were observed in the Northern region, with 15.4 percentage points (95%CI -20.9; -10.8), and in the Northeast, with 11.7 percentage points (95%CI -15.8; -7.5).Conclusion

There is a significant differential in access to breast reconstruction surgery according to race/skin color, and the effects are heterogeneous across the Brazilian regions.

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Cite

BibTeX RIS

BibTeX

@article{silva2026racial,
  title = {{Racial inequality in access to breast reconstruction surgery in the Brazilian Unified Health System: an interrupted time series study, Brazil, 2010-2024.}},
  author = {Alana Ramos da Silva and Fernando Antonio Slaibe Postali},
  journal = {Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil},
  year = {2026},
  month = jul,
  doi = {10.1590/s2237-96222026v35e20250496.en},
  url = {https://europepmc.org/article/MED/42922928},
  note = {CC BY},
}

RIS

TY  - JOUR
TI  - Racial inequality in access to breast reconstruction surgery in the Brazilian Unified Health System: an interrupted time series study, Brazil, 2010-2024.
AU  - Alana Ramos da Silva
AU  - Fernando Antonio Slaibe Postali
PY  - 2026
DA  - 2026/07/24
JO  - Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil
DO  - 10.1590/s2237-96222026v35e20250496.en
UR  - https://europepmc.org/article/MED/42922928
AB  - Objective  To estimate the differential in access to breast reconstruction surgery in the Brazilian Unified Health System according to race/skin color nationwide and in the country's regions.Methods  This was an observational study of interrupted time series, which used monthly microdata from the Hospital Information System for the period 2010-2024. The differentials in the proportion of breast reconstruction surgeries according to race/skin color were estimated before and after the implementation of Ordinance No. 127/2023, with respective 95% confidence intervals (95%CI).Results  We identified 565,234 surgeries, of which 404,944 (71.6%) were mastectomies and 160,290 (28.4%) were breast reconstructions. The proportion of reconstructions was, on average, 12.9 percentage points (95%CI -16.8; -8.9) lower for Black women compared to White and Asian women. After the Ordinance No. 127/2023 intervention, the differential increased to 28.6 percentage points (95%CI -44.1; -13.0). The largest differentials were observed in the Northern region, with 15.4 percentage points (95%CI -20.9; -10.8), and in the Northeast, with 11.7 percentage points (95%CI -15.8; -7.5).Conclusion  There is a significant differential in access to breast reconstruction surgery according to race/skin color, and the effects are heterogeneous across the Brazilian regions.
SN  - 1679-4974
SN  - 2237-9622
ER  -

Abstract

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