Reconstruções mamárias pós-cirurgia oncológica no sistema único de saúde: panorama epidemiológico nos Estados da região sul de 2013 a 2023

Abstract

Introduction: Breast cancer is the second most common malignant neoplasm among women in Brazil and poses substantial challenges to the Unified Health System (SUS), not only in delivering oncologic breast surgeries but also in ensuring equitable access to reconstructive procedures. Given the significant physical and psychosocial consequences of mastectomy, it is essential to assess whether the availability of breast reconstruction keeps pace with oncologic surgical demand. Methods: This ecological, retrospective, and descriptive study used secondary data from the Hospital Information System of the SUS (SIH-SUS), obtained through the TabNet/DATASUS platform. We analyzed records of oncologic and reconstructive breast surgeries performed between 2013 and 2023 in the states of Paraná (PR), Rio Grande do Sul (RS), and Santa Catarina (SC). Data were organized in spreadsheets and presented as absolute numbers, percentages, and means. Results: Over the study period, 79,228 oncologic breast surgeries and 7,724 reconstructions were recorded, with reconstructive procedures representing an average of 9.7% of all surgeries. Oncologic procedures increased by 59%. Conservative techniques accounted for 59.9% of oncologic surgeries, while implant-based reconstruction comprised 96.7% of all reconstructive interventions. Reconstructive procedures increased by 117%, with the highest proportion relative to oncologic surgeries observed in 2023 (12.7%). Marked regional discrepancies were noted: RS exhibited the highest reconstruction proportion (14.3%), whereas PR showed the lowest (3.8%). Conclusion: Despite the growth in reconstructive surgery, a substantial gap remains between the demand for and the availability of breast reconstruction, highlighting persistent logistical and organizational barriers. Expanding access requires structural investment, workforce training, and strengthened integration between oncology and plastic surgery services to ensure comprehensive care for women undergoing mastectomy.