Triple-Negative Breast Cancer on the Rise: Breakthroughs and Beyond

Triple-negative breast cancer (TNBC) represents a particularly aggressive and heterogeneous subtype of breast cancer, associated with poor prognosis and limited treatment options. This review delves into the rising incidence of TNBC, particularly among younger women, and explores the significant demographic disparities that contribute to variations in incidence, treatment access and survival outcomes. We provide a discussion of TNBC's molecular and genetic landscape, including key pathways revolving around TP53, BRCA1/2 mutations, and PI3K/AKT signaling, which have informed the development of targeted therapies. Recent practice-changing studies are highlighted, which have resulted in the integration of immune checkpoint inhibitors in both early-stage and metastatic settings, the application of PARP inhibitors for BRCA-mutated TNBC and the introduction of antibody-drug conjugates as valuable new therapeutic options. We also review the role of neoadjuvant chemotherapy, novel biomarkers such as tumor-infiltrating lymphocytes, and advancements in diagnostic tools, including machine learning-based imaging and spatial transcriptomics, which are all driving shifts towards personalized approaches. This review synthesizes emerging research and major changes in clinical practice to provide a concise overview of the recent innovations and upcoming trends in TNBC diagnosis and therapy.