I spoke not one word of Italian on my first trip there and had a ball. Honestly, my lack of language skills added to the fun I had. I did have a little phrase book with me which was helpful on occasion, but mostly I learned by listening, gesturing, trying, making mistakes, etc. 50 or so trips and one fiance later, I am much further along but still not fluent :depressed:
In the Northern cities, nearly everyone speaks English, many of them better than the average American. The official language in many global corporate offices is English. There are also tons of ex pat Brits in the North, hence the nickname "Chiantishire" for the Chianti Valley. Small towns are more charming and there will be fewer English speakers there.
The South still has a lot of people speaking not only Italian, but any one of a bazillion dialects. Still plenty of English speakers to be found in the cities, but not as ubiquitously as in the North.
Some advice?
1. BE VERY CAREFUL WHAT YOU DO WITH YOUR HANDS.

I kid you not. Google hand gestures and you will see that gestures which are positive or neutral to us may not be to an Italian. :shocked2:
2. DON'T say any FOOD words unless you are in the market or in a restaurant. Italians use a lot of food words to "stand in" for things they do not wish to say directly, like insults. :cool2:
3. They will love you for trying, so do try. Learn a few key words and phrases, and even if you butcher them you will be seen as "simpatico" for the effort.
4. Oh! And take your dive gear. I hear that the Portofino Marine Park is a good area for diving and it is in my favorite region (Liguria) of all!
Buona Fortuna!