The management of breast cancer during pregnancy (PrBC) is a relatively rare indication and an area where no or little evidence is available since randomized controlled trials cannot be conducted. In general, advances related to breast cancer (BC) treatment outside pregnancy cannot always be translated to PrBC, because both the interests of the mother and of the unborn should be considered. Evidence remains limited and/or conflicting in some specific areas where the optimal approach remains controversial. In 2022, the European Society for Medical Oncology (ESMO) held a virtual consensus-building process on this topic to gain insights from a multidisciplinary group of experts and develop statements on controversial topics that cannot be adequately addressed in the current evidence-based ESMO Clinical Practice Guideline. The aim of this consensus-building process was to discuss controversial issues relating to the management of patients with PrBC. The virtual meeting included a multidisciplinary panel of 24 leading experts from 13 countries and was chaired by S. Loibl and F. Amant. All experts were allocated to one of four different working groups. Each working group covered a specific subject area with two chairs appointed: Planning, preparation and execution of the consensus process was conducted according to the ESMO standard operating procedures.

Breast Cancer Center School of Medicine Tecnologico de Monterrey San Pedro Garza Garcia Nuevo Leon Mexico

Cancer Institute Queen Mary University London London UK

Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin Institute of Clinical Pharmacology and Toxicology Embryotox Center of Clinical Teratology and Drug Safety in Pregnancy Berlin Germany

Cooper Medical School at Rowan University Camden USA

Department of Anesthesiology 'Alexandra' General Hospital Athens Greece

Department of Gynecology and Obstetrics Poissy Saint Germain Hospital Poissy; UMR 1198 BREED INRAE Paris Saclay University RHuMA Montigny Le Bretonneux France

Department of Medical Epidemiology and Biostatistics Karolinska Institutet Stockholm Sweden; Cancer Registry of Norway Oslo Norway

Department of medical oncology Centre Léon Bérard Lyon France

Department of Obstetrics and Gynaecology 3rd Faculty of Medicine Charles University Prague and Universital Hospital Kralovske Vinohrady Prague Czech Republic

Department of Obstetrics and Prenatal Medicine University Hospital Brussels Brussels Belgium

Department of Oncology University General Hospital of Larissa Larissa Greece

Department of Radiology University Hospitals Leuven Leuven Belgium

Division of Early Drug Development European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico Milan; Department of Oncology and Hemato Oncology University of Milan Milan Italy

Division of Oncology Department of Clinical Sciences Lund University Lund; Department of Hematology Oncology and Radiation Physics Skåne University Hospital Lund Sweden

European Society for Medical Oncology Lugano Switzerland

GBG c o GBG Forschungs GmbH Neu Isenburg; Centre for Haematology and Oncology Bethanien Frankfurt am Main Frankfurt; Goethe University Frankfurt Frankfurt am Main Frankfurt Germany

Gynecologic Oncology Antoni van Leeuwenhoek Netherlands Cancer Institute Amsterdam; Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam UMC University of Amsterdam; Princess Maxima Center for Pediatric Oncology Utrecht The Netherlands

Gynecologic Oncology Antoni van Leeuwenhoek Netherlands Cancer Institute Amsterdam; Division Gynaecologic Oncology UZ Leuven Belgium

Gynecologic Oncology Department European Institute of Oncology IRCCS Milan Italy

Iridium Netwerk Antwerp; University of Antwerp Antwerp Belgium

Medical Oncology Department Vall d'Hebron University Hospital Vall d'Hebron Institute of Oncology Barcelona Spain

Philipps University Marburg and Marburg University Hospital Marburg Germany

Placenta Lab Department of Obstetrics Jena University Hospital Jena Germany

Princess Máxima Center for Pediatric Oncology Utrecht

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