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Chi-square statistical comparisons of detection method (patient (PtD)\/mammography (MamD), Stage (0-IV) and treatment by pre-pandemic time 1: 2019\u2009+\u2009Q1 2020; peak-pandemic time 2: Q2-Q4 2020; pandemic time 3: Q1-Q4 2021 (Q\u2009=\u2009quarter) periods and logistic regression for odds ratios were used.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>BC case volume decreased 22% in 2020 (N\u2009=\u2009533) (p\u2009=\u2009.001). MamD declined from 64% pre-pandemic to 58% peak-pandemic, and increased to 71% in 2021 (p\u2009&lt;\u2009.001). PtD increased from 30 to 36% peak-pandemic and declined to 25% in 2021 (p\u2009&lt;\u2009.001). Diagnosis of Stage 0\/I BC declined peak-pandemic when screening mammography was curtailed due to lock-down mandates but rebounded above pre-pandemic levels in 2021. In adjusted regression, peak-pandemic stage 0\/I BC diagnosis decreased 24% (OR\u2009=\u20090.76, 95% CI: 0.60, 0.96, p\u2009=\u2009.021) and increased 34% in 2021 (OR\u2009=\u20091.34, 95% CI: 1.06, 1.70, p\u2009=\u2009.014). Peak-pandemic neoadjuvant therapy increased from 33 to 38% (p\u2009&lt;\u2009.001), primarily for surgical delay cases.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The COVID-19 pandemic restricted health-care access, reduced mammography screening and created surgical delays. During the peak-pandemic time, due to restricted or no access to mammography screening, we observed a decrease in stage 0\/I BC by number and proportion. Continued low case numbers represent a need to re-establish screening behavior and staffing.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10549-023-06962-8","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T10:02:36Z","timestamp":1692180156000},"page":"105-115","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["COVID-19 related change in breast cancer diagnosis, stage, treatment, and case volume: 2019\u20132021"],"prefix":"10.1007","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6939-8828","authenticated-orcid":false,"given":"Judith A.","family":"Malmgren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boya","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary K.","family":"Atwood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Hallam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry G.","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"issue":"10","key":"6962_CR1","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1056\/NEJMoa2001191","volume":"382","author":"ML Holshue","year":"2020","unstructured":"Holshue ML, DeBolt C, Lundquist S et al (2020) Washington State 2019-nCoV Case Investigation Team. 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