Triple-Negative Breast Cancer: What Crucial Information can Imaging Add to the Diagnosis, Treatment and Prognosis?

Breast cancer is a heterogeneous disease, with many distinct subtypes having extremely different presentations, biological aggressiveness, and response to therapy. Triplenegative breast cancer is a subtype with significant clinical implications because of its poor prognosis and aggressive behavior. It has distinct imaging features, often presenting as a mass with typically benign features on mammography and ultrasound and more suspicious findings on magnetic resonance imaging. Triple-negative breast cancer also has unique treatment limitations, with these cancers lacking molecular therapeutic targets expressed by other breast cancer subtypes. Fortunately, Triple-negative breast cancer is very responsive to neoadjuvant chemotherapy, which is the mainstay of treatment for these patients. Patients with triple-negative breast cancer are more likely to achieve pathologic complete remission, which is associated with improved survival. Despite this, patients with triple-negative breast cancer have an overall poorer prognosis compared to other subtypes, especially in the first few years after diagnosis. As this subtype accounts for up to one-fifth of all breast cancer cases, a thorough understanding of the unique imaging features of triple-negative breast cancer, as well as the role of imaging in predicting response to therapy and long term patient prognosis, will allow all involved clinicians to more effectively care for these patients.