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Audiência Pública - Debater a aplicabilidade legal da reconstrução mamária no Brasil. Dep. Tereza NelmaPSDB - AL

Analogies highlight non-compliance with laws ensuring breast reconstruction for women with cancer – News

10/28/2021 – 15:48

Rila Maria / House of Representatives

Theresa Nelma: “It is possible to undergo breast reconstruction at the time of mastectomy”

Participants in a public hearing in the Chamber of Deputies highlighted Brazil’s failure to comply with laws ensuring breast reconstruction in cases of breast cancer. The topic was discussed on Thursday (28) at special commission Created to monitor actions against cancer in Brazil, jointly with the Committees for the Defense of Women’s Rights, Social Security and the Family and with the Secretariat of the Chamber for Women’s Affairs.

Four laws in Brazil deal with breast reconstruction. The Lei 9.797 / 99 Women who have suffered from partial or complete breast distortion as a result of cancer treatment are guaranteed the right to plastic-reconstructive surgery in the Unified Health System (SUS). actually Lei 10.223/01 Ensures that the costs of reconstructive plastic surgery are paid by the private HMOs.

a mine 12.802 / 13In turn, he decides that if technical conditions exist, the reconstruction will be performed at the same surgical time as the mastectomy. and the me 13.770 / 18Finally, he demonstrates that procedures for obtaining breast symmetry and reconstructing the nipple and areola complex are part of reconstructive plastic surgery.

Disclosure of laws
vice Theresa Nelma (PSDB-AL)M., a cancer patient and advocate of the discussion, noted that many women do not even know that they have the right to breast reconstruction through SUS and there are cases of women who have waited up to 18 years for surgery. “I, as a cancer patient, know how hard it is to look in the mirror and see your breast without a nipple,” he said. As an MP, she struggles to get the laws published. “It’s possible to have breast reconstruction at the time of the mastectomy, and SUS pays. This is our reality. We want to live it,” he said.

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Jose Pedrini, head of the pest science service at Conceição Hospital, in Rio Grande do Sul, wondered who would pay for the suffering of the woman who had waited 18 years for reconstruction. He noted that immediate plastic surgery, including prosthetic surgery, does not affect the treatment, and defended the need to perform it in the same surgical procedure, with one hospital admission.

Pedrini stressed that breast reconstruction at the time of surgery to remove the tumor takes only 40 minutes, and in 90% of cases, from a medical point of view, it can be performed simultaneously. In his opinion, a woman should be able to make this choice.

Daniela Katunda was one of the cancer patients who, in the discussion, reported her difficulties: “I have a group called We Choose to Live, where 95% of girls had a mastectomy and 95% were unable to have surgery. (Reconstruction) It’s too long, the delay is too big, and we have to deal with public policies, so that these women can get their self-esteem back,” she defended.

Rila Maria / House of Representatives

For Carmen Zanotto, spending caps limit the federal health budget

vice Carmen Zanotto (Citizenship-SC), who proposed the debate, stressed that the bottleneck lies in funding. According to it, the constitutional amendment to the spending ceiling (EC 95) limits the federal health budget, which leads states and municipalities to allocate more resources to the region.

Karemim Zanotto noted that in the field of health services, it is claimed that it is not possible to perform plastic surgery with the sums paid by the SUS. “What SUS pays does not pay for the prosthesis. If it does not pay for the prosthesis, how are you going to pay for the fees and hospital expenses? That should be the discussion between us,” he said.

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Alain Lyall-Lopez, technical expert in the General Coordination of Specialized Care at the Ministry of Health, confirmed that SUS ensured comprehensive treatment for women with breast cancer, including breast plastic surgery.

“In 2019, 1,456 breast reconstructions were performed by SUS. We had a negative impact as already known in many studies and our surveys in performing these surgeries in 2020, on behalf of Covid-19. In 2020, Until August we had 530 detainees across Brazil.”

Aline Lopez added it Ministry Decree, as of December 2020, providing R$150 million to states to fund screening, early detection and control of breast and cervical cancer in SUS during the pandemic. But he stressed that health funding is triangular, with resources from the federal budget, but that it is necessary to have a counterpart at the state and municipal levels. According to her, each country has its own “issues”.

Breast specialist and coordinator of the Ame-se program of the Alagoas Department of Health, Francisca Beltrão da Matta, reports that in the state a maximum of five breast reconstructions are performed per year. In an effort to reverse this reality, the program was created a year ago, with the support of Parliamentary amendments from Congresswoman Theresa Nelma, and 15 women have already begun breast reconstruction.

The discussion was part of the Pink October programme, promoted by the Chamber’s Women’s Secretariat.

Report – Lara Hajj
Edition – Roberto Cibra