OBJECTIVES: to evaluate changes in breast cancer care among women assisted at a public hospital in Paraíba, Brazil, during the COVID-19 pandemic.
METHODS: retrospective cohort of women using the Sistema Único de Saúde (SUS) (Brazilian Public Health Service) at Hospital Napoleão Laureano (PB), and were diagnosed with in situ or invasive ductal carcinoma in the pre-pandemic (2017-2018) and pandemic (2020) periods. Sociodemographic, clinical and care-related data were collected. Differences between periods were assessed using chi-square or Fisher's exact test for categorical variables and Student's t or Mann-Whitney tests, for continuous variables (p<0.05).
RESULTS: among 218 women included, 114 were treated before the pandemic and 104 during. Most cases were palpable tumors and invasive carcinoma. Mastectomy was the predominant procedure, with immediate reconstruction in 24.8%. The interval between histopathological diagnosis and the first consultation with a specialist increased during the pandemic (p=0.04), and few women outside the capital could access the service (RR=0.63; 95%CI= 0.4-0.9; p=0.01). Delays on the appointment and abandonment of treatment were also higher during the pandemic, whereas immediate breast reconstruction decreased.
CONCLUSION: the pandemic hindered breast cancer care, increasing delays, interruptions of treatment, and reducing immediate reconstructions. These findings highlight the vulnerability of patients dependent of the public health services during health crises.

Palavras-chave: Neoplasias da mama, SARS-CoV-2, Pandemia, Diagnóstico tardio, Tempo para o tratamento