Although malignancies during pregnancy are relatively rare, breast cancer emerges as the most common neoplasm affecting pregnant women. Diagnostic workup and multimodal treatment of breast cancer during pregnancy must be weighed against the potential risk to the fetus. With the increasing number of breast cancer diagnoses during pregnancy, this narrative review aimed to outline the epidemiological and molecular background, followed by presenting available therapeutic options. Surgery remains the treatment of choice among patients with breast cancer during pregnancy. However, systemic therapy based on anthracyclines, fluoropyrimidines, taxanes and platinum derivatives is possible after 12 weeks gestation and can be administered in both neoadjuvant and adjuvant settings. Novel diagnostic and therapeutic directions are investigated. Due to its complexity, the treatment process should be managed by multidisciplinary team.