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Review
. 2025 Feb 1;15(1):13.
doi: 10.1186/s13578-025-01359-0.

Classifications of triple-negative breast cancer: insights and current therapeutic approaches

Ziqi Chen  1   2 , Yumeng Liu  1   2 , Minchuan Lyu  1   2 , Chi Ho Chan  1   2   3   4 , Meiheng Sun  1   2 , Xin Yang  2   3 , Shuangying Qiao  1   2 , Zheng Chen  1   2 , Sifan Yu  1   2   3   4 , Meishen Ren  1   5 , Aiping Lu  1   2   3   4 , Ge Zhang  1   2   3   4 , Fangfei Li  1   2   3   4 , Yuanyuan Yu  6   7   8   9
Affiliations
Review

Classifications of triple-negative breast cancer: insights and current therapeutic approaches

Ziqi Chen et al. Cell Biosci. .

Abstract

Triple-negative breast cancer (TNBC) is an aggressive and challenging type of cancer, characterized by the absence of specific receptors targeted by current therapies, which limits effective targeted treatment options. TNBC has a high risk of recurrence and distant metastasis, resulting in lower survival rates. Additionally, TNBC exhibits significant heterogeneity at histopathological, proteomic, transcriptomic, and genomic levels, further complicating the development of effective treatments. While some TNBC subtypes may initially respond to chemotherapy, resistance frequently develops, increasing the risk of aggressive recurrence. Therefore, precisely classifying and characterizing the distinct features of TNBC subtypes is crucial for identifying the most suitable molecular-based therapies for individual patients. In this review, we provide a comprehensive overview of these subtypes, highlighting their unique profiles as defined by various classification systems. We also address the limitations of conventional therapeutic approaches and explore innovative biological strategies, all aimed at advancing the development of targeted and effective therapeutic strategies for TNBC.

Keywords: Classification; Neoadjuvant therapy; Subtype; Triple-negative breast cancer; Tumor heterogeneity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Consensus guidelines for TNBC treatment. This figure illustrates the biomarker-driven approaches for managing mTNBC as outlined in various clinical practice guidelines. It emphasizes the role of PD-L1 expression and gBRCA mutations as critical predictive biomarkers, reflecting a shared consensus among leading guidelines in optimizing treatment strategies for mTNBC
Fig. 2
Fig. 2
Characteristics of TNBC subtypes and associated treatment options. This figure summarizes four distinct characteristics of TNBC subtypes, along with their corresponding treatment options
Fig. 3
Fig. 3
Consistency and differences in LAR characteristics. Venn diagram illustrates the consistency and differences among four TNBC classification systems regarding LAR subtype characteristics. Controversial points for the typologies are highlighted in bold brown
Fig. 4
Fig. 4
Consistency and differences in immunomodulatory characteristics. Venn diagram illustrates the consistency and differences of four TNBC classification systems regarding immunomodulatory active characteristics
Fig. 5
Fig. 5
Consistency and differences in immunomodulatory characteristics. Venn diagram illustrates the consistency and differences of four TNBC classification systems regarding immunomodulatory suppressive characteristics
Fig. 6
Fig. 6
Consistency and differences in MES characteristics. Venn diagram shows the consistency and differences of four TNBC classification systems regarding Mesenchymal subtype characteristics. Controversial points for the typologies are highlighted in bold brown
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