Introduction: In 2020, a total of 2,510 new cases of breast cancer were estimated in Ceará State, 14% above the figures of 2019. In the context of the COVID-19 pandemic, postponing screening and assessing the risks and benefits of elective procedures was needed, rescheduled until after their control. Objective: We sought to identify the impact of the COVID-19 pandemic in the care of a Reference Service for Breast Cancer Diagnosis. Methods: Time series study, with analysis of the production of the consultations carried out from March to June of the current year in a service located in Fortaleza City, Ceará State. Results: There was a reduction of up to 84% in the services offered, with emphasis on mammography and ultrasound procedures, with 95 and 100%, respectively. The diagnosis of new cases and the performance of surgeries reduced by up to 60 and 56%, respectively. The months with the greatest impact were April and May, with a progressive resumption in June. Conclusion: The study evaluated a reference service of relevance in the state reality. Considering that many cases are identified during screening, postponing mammograms contributed to a delayed diagnosis. The findings are believed to pose severe consequences, considering the annual increase in the incidence of the disease, the low screening coverage, the high number of cases in advanced staging, the ascending mortality, and the low supply of diagnostic services. Diverting attention exclusively to the pandemic represents a worldwide challenge, but cancer is an important cause of morbidity and mortality, and cannot be neglected. There is concern that delaying screening, diagnosis, and treatment of breast cancer may cost more lives than COVID-19 itself. Post-pandemic requires planning to promote harm reduction resulting from the delay in the diagnosis and treatment of the repressed demand, in a disaggregated and overloaded system.

Introduction: Breast cancer remains the most prevalent in Brazilian women, with the exception of non-melanoma skin cases. Performing disease control uses awareness strategies, clinical criteria for suspected cases, and diagnostic confirmation in a single service (INCA, 2015). The Oncology Education and Studies Group (Grupo de Educação e Estudos Oncológicos – GEEON) is a Reference Service for Breast Cancer Diagnosis (SDM), located in Fortaleza, Ceará. Objectives: To identify the impact of GEEON's SDM on cancer diagnosis in Ceará. Method: Retrospective, evaluative study of the services provided at GEEON in the period from 2016 to 2019. The data underwent univariate statistical analysis. Results: The service grew by 256% in the number of visits, increasing from 6,758 to 17,301, with a total of 44,309. Mammographic screening is the most frequent procedure, evolving from 2,570 to 9,366 annual exams, with an average of 5,058. It showed a high rate of absenteeism, with an average of 31% per year. Of the 20,234 mammograms performed, 683 patients (3.4%) did not receive the result. The average of tests performed was classified as Bi-rads 4 and 5 and was approximately 2%. The mean positive rate of biopsies performed is 31%, resulting in an average of 176 diagnoses per year, which represents 8% of the total estimated for Ceará. Of these, about 40% are in women under 50 years of age. The organization of the service along the lines of patient navigation carries out an active search for suspected mammographic lesions for immediate diagnosis, as well as a reference for tertiary care in cases of positive biopsy, through telephone contact. Conclusions: The consultations performed at GEEON identify 8% of the estimated cases for each year, a high percentage in young women, outside the scope of the screening policies.