Triple-Negative Breast Cancer: A Retrospective Study of 23 Cases in Morocco

Introduction  Triple-negative breast cancer (TNBC) is characterized by the absence of estrogen and progesterone hormone receptor expression in tumor cells, and the lack of human epidermal growth factor receptor 2 (HER2) growth factor expression on immunohistochemistry. It is considered an aggressive subtype with limited treatment options, based mainly on chemotherapy, surgery, and radiotherapy. Materials and methods This retrospective study examines the epidemiological, clinical, pathological, and therapeutic characteristics of TNBC. It is based on a series of 23 cases collected from the Medical Oncology Department of the Cheikh Khalifa Ibn Zaid Al Nahyan International University Hospital in Casablanca, Morocco, over a period of three years and six months. The study focuses on newly diagnosed patients with TNBC, with data collected from the medical records of patients who were diagnosed and treated during this period. Follow-up data were analyzed to assess disease progression and treatment response, but all cases included were diagnosed during the study period. Results Of the total 242 breast cancer cases, 12.4% (30 cases) were diagnosed with TNBC. Due to missing data, only 23 cases were included in the final analysis. The average age of patients was 51.35 years, and 26.09% (six patients) had a family history of breast cancer. Invasive ductal carcinoma (IDC) was the most common histological type, accounting for 91.30% (21 cases) of cases, with a mean tumor size of 40.69 mm. Histoprognostic grades II and III were predominant, representing 30.43% (seven cases) and 52.17% (12 cases) of cases, respectively. Surgical treatments included conservative lumpectomy in 43.48% (10 patients), radical mastectomy according to the Patey technique in 26.09% (six patients), and no surgery for 30.43% (seven patients). Chemotherapy was administered to 69.6% (16 patients) of patients, with 39.1% (nine patients) receiving adjuvant therapy and 30.4% (seven patients) undergoing neoadjuvant treatment. Lymph node involvement was present in 63.64% (14 patients) of cases, with bone metastasis in 45.45% (10 patients) and lung metastasis in 27.27% (six patients). The disease course was considered unfavorable in 55% (13 patients) of cases, with disease progression observed in these patients. Specifically, 35% developed local recurrence, and 35% experienced metastatic progression. The average recurrence-free survival was 22.74 months post-diagnosis. Conclusion TNBC is a highly aggressive form of breast cancer, associated with a poor prognosis due to its high metastatic potential and frequent recurrence, particularly within the first two years after diagnosis. Current therapeutic options remain limited, highlighting the ongoing need for improved treatment strategies and early detection efforts.