TEMPORAL EVOLUTION OF BREAST SURGERIES IN ONCOLOGY PERFORMED IN THE PUBLIC HEALTH SYSTEM (SUS) BETWEEN 2008 AND 2014 IN BRAZIL

Ruffo Freitas-Junior, Pollyana A. Gouveia, oão Wesley C. de M. Filho, Rosemar M. S. Rahal, Régis R. Paulinelli, Paola F. de Freitas, Cicero de A. Urban, Clécio Ê. M. de Lucena

Institution: Programa de Mastologia do HC/UFG

“Objective: To analyze the evolution of the number of breast surgeries in oncology performed in the Unified Health System (SUS) in Brazil, from 2008 to 2014. Methods: This is a time series ecological study based on the Information System of DATASUS.We have used the codes related to surgical procedures registered for malignancy diagnoses of breast in all of the public service in Brazil. The analysis of the absolute number of surgeries was performed using Poisson regression, through the Jointpoint Regression and the trend calculated the annual percentage change (APC), with a confidence interval of 95% and statistical significance at p <0.05. Results: The data analysis showed a reductionin the number of simple mastectomies (APC -4.4%; 95% CI -7.4 to -1.4; p <0.05); Stabilization for both radical mastectomy with lymphadenectomy (APC -1.0%; 95% CI -2.4 to 0.5; p=0.1) and conservative treatment (APC 0.4%; 95% CI -1.6 to 2.4; p=0.6). A reduction of axillary lymphadenectomy (APC -16.8%; 95% CI: -26.8 to -5.4; p <0.05); significant increase in breast reconstructive surgery with prosthesis implantation between 2011 and 2014 (APC 9.1%, 95% CI 0.1 to 18.8%; p<0.05) also for reconstructions withflaps after 2012 (APC 61.3%; 95% CI 41.3 to 84.0; p<0.05).The overall rate of patients with breast reconstruction increased from 15% in 2008 to 29.2% in 2014. Conclusions: We found a significant increase in breast reconstructive surgeries, a significant reduction in simple mastectomy and axillary lymphadenectomy and stabilization of the radical mastectomy with lymphadenectomy and treatment with breast conservation.Keywords: Breast neoplasms.Therapeutics.Mastectomy.Breast reconstruction.Brazil.”