Background: Triple Negative Breast Cancer (TNBC) is a biologically aggressive subtype of breast cancer characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) expression. It accounts for 15–20% of breast cancers globally but is disproportionately prevalent in younger women, women of African descent, and patients in low- and middle-income countries (LMICs). TNBC is associated with rapid progression, early recurrence, and limited targeted treatment options.
Objective:To provide a comprehensive review of TNBC, focusing on epidemiology, molecular biology, clinicopathological features, diagnostic approaches, management strategies, recent therapeutic advances, and regional disparities.
Methods:A narrative review was conducted using PubMed, Scopus, Web of Science, and African Journals Online (2013–2025). Eligible studies addressing TNBC incidence, biology, clinical presentation, diagnostics, treatment, and emerging therapies were included, with emphasis on comparative global and Sub-Saharan African data.
Results:TNBC exhibits marked geographic and ethnic variation, with prevalence rates of 12–15% in Western populations and up to 46% in West Africa. Molecular profiling reveals heterogeneity across basal-like, mesenchymal, immunomodulatory, and luminal androgen receptor (LAR) subtypes. Standard treatment remains chemotherapy, particularly in the neoadjuvant setting, where pathologic complete response predicts improved outcomes. Recent advances include PARP inhibitors in BRCA-mutated TNBC, immune checkpoint inhibitors for PD-L1–positive disease, and antibody-drug conjugates such as sacituzumab govitecan, which have demonstrated survival benefit. However, in LMICs, late presentation, limited access to immunohistochemistry, and high treatment costs remain major barriers.
Conclusion:TNBC continues to represent a global oncological challenge. While novel therapies are improving outcomes in high-resource settings, substantial gaps in diagnosis and treatment persist in LMICs. Future efforts should prioritize equitable access to molecular diagnostics, affordable targeted therapies, and global collaborations to reduce disparities in TNBC outcomes.