Introduction: The COVID-19 pandemic has brought about a new epidemiological reality worldwide that is responsible for altering the entire dynamics of addressing health issues globally. Cancer management policies were directly impacted, potentially leading to a decline in early case detection and a consequent increase in morbidity and mortality among patients with cancer. Objective: To analyze the impacts of the pandemic on breast cancer screening measures in the state of Piauí. Method: This epidemiological study used secondary data provided by the Department of Health Information of the Brazilian Unified Health System regarding the performance of mammograms and breast cancer diagnoses in the state of Piauí between 2017 and 2021. Results: Between 2017 and 2019, an average of 39,165 mammograms were performed annually, compared with an average of 22,367 exams in each year between 2020 and 2021. The data presented in this study indicate a significant decrease in the number of exams performed, associated with a decline in the absolute number of diagnoses, as well as delayed diagnoses. Conclusions: The scenario described in this study suggests the possibility of developing an epidemiological emergency related to breast cancer, both due to the structural incapacity of the state of Piauí to provide adequate assistance to patients and the increasing observation of more advanced cases. Therefore, we highlight the need for intensified efforts to strengthen breast cancer management and early diagnosis strategies in the state of Piauí.