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Triple-Negative Breast Cancer

Megan Kruse, MD, Adam Brufsky, MD, and Shannon Puhalla, MD

Triple-negative breast cancer (TNBC) is defined by lack of expression of the estrogen and progesterone receptors (ER and PR), as well as non-amplified HER2 status. TNBC accounts for approximately 15–20% of newly diagnosed breast cancer cases in the US each year and presents a particular challenge for clinicians, given its unique molecular and clinical characteristics, including associations with younger age at diagnosis, early risk of recurrence, and propensity for visceral metastasis [1–3]. Importantly, TNBC is typically associated with a poorer prognosis than breast cancer of other phenotypes [3–5]. Given that many advances in the treatment of breast cancer have occurred in accordance with the development of therapies directed against specific molecular targets such as ER, PR, and HER2, it may not be surprising that treating an entity defined by the lack of traditional molecular targets has proven to be challenging. The classification of breast cancer gene-expression profiles and recent characterization of molecular heterogeneity present within the TNBC category have begun to pave the way for new approaches to treatment [6–10]. This article will present an overview of the current understanding of TNBC and a discussion of the commercially available treatment options, with brief mention of novel therapeutic agents being investigated.

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