Although rare, breast cancer is the most commonly diagnosed cancer during pregnancy. Its prevalence is expected to rise as maternal age at first pregnancy increases. This condition presents unique challenges in diagnosis and management, especially considering the safety of the developing fetus. Breast cancer in pregnancy typically manifests at advanced stages and displays aggressive tumor characteristics. Breast ultrasound is the first-line imaging modality; if a suspicious mass is identified, mammography with abdominal shielding is recommended. Contrast-enhanced MRI should be avoided in pregnancy. Core biopsy is the gold standard for histological assessment. Surgery is considered safe at any stage of pregnancy, but the second trimester is preferred. Breast conserving surgery and modified radical mastectomy are both reasonable options. Sentinel lymph node biopsy using 99m-Tc sulfur colloid is considered safe. Chemotherapy, if indicated, should be initiated after the first trimester, following standard indications for non-pregnant patients, with some modifications to minimize fetal risks. Radiotherapy, endocrine therapy, and Trastuzumab are contraindicated in pregnancy.