Racial inequality in access to breast reconstruction surgery in the Brazilian Unified Health System: an interrupted time series study, Brazil, 2010-2024
Year: 2026
Type: article
Study design: Observational Study
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.
Institution: Universidade de São Paulo
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7202080477