Abstract The management of patients with breast cancer during pregnancy is very demanding and it should be better performed in highly qualified and experienced centers. Refer-ral to institutes and physicians trained in this special clinical scenario allows reducing the risk of both overtreating and undertreating the patients. Moreover, patients can receive
appropriate information regarding safety of treatmentswithout old-fashionedtaboo. The purpose of the current paper is to discuss the main issues concerning surgical management and in general locoregional treatment of patients diagnosed with breast cancer and treated during gestation, focusing on those women who chose to continue their pregnancy. We cover the issues regarding type of breast surgery, radiation therapy, immediate reconstruction during mastectomy, and manage-ment of the axilla.