三阴性乳腺癌 (TNBC) 是一组异质性、侵袭性肿瘤，其定义为缺乏雌激素和孕激素受体以及缺乏 ERBB2（以前称为 HER2 或 HER2/neu）过表达。 TNBC 占乳腺癌的 8%-13%。此外，与老年女性相比，年轻女性患乳腺癌的比例更高，而且对非西班牙裔黑人女性的影响尤为严重。 TNBC具有高转移潜力，确诊后5年内复发风险最高。 TNBC 比其他乳腺癌亚型更频繁地表现出良性形态学影像特征。由于这种癌症的快速生长、年轻女性的乳房X线照相密度增加以及成像时缺乏恶性肿瘤的典型特征等因素，乳房X线照相术对于TNBC的早期检测可能不是最佳选择。对于 TNBC 检测，超声检查优于乳房 X 光检查，但良性特征可能导致误诊。乳腺 MRI 是 TNBC 检测最敏感的方式。大多数 TNBC 病例均采用新辅助化疗，然后进行手术和放疗。 MRI 是评估新辅助化疗反应的首选方式。 TNBC 患者的生存率低于激素受体阳性和人表皮生长因子受体 2 阳性癌症患者的生存率。诊断时患有局部、区域和远处疾病的患者的 5 年生存率分别为 91.3%、65.8% 和 12.0%。免疫疗法的早期成功给开发个性化 TNBC 治疗策略带来了希望。影像学和肿瘤生物标志物可能在预测未来 TNBC 治疗反应和 TNBC 患者生存中发挥至关重要的作用。 ©RSNA，2023 本文的测验问题可在补充材料中找到。

Triple-negative breast cancer (TNBC) is a heterogeneous and aggressive group of tumors that are defined by the absence of estrogen and progesterone receptors and lack of ERBB2 (formerly HER2 or HER2/neu) overexpression. TNBC accounts for 8%-13% of breast cancers. In addition, it accounts for a higher proportion of breast cancers in younger women compared with those in older women, and it disproportionately affects non-Hispanic Black women. TNBC has high metastatic potential, and the risk of recurrence is highest during the 5 years after it is diagnosed. TNBC exhibits benign morphologic imaging features more frequently than do other breast cancer subtypes. Mammography can be suboptimal for early detection of TNBC owing to factors that include the fast growth of this cancer, increased mammographic density in young women, and lack of the typical features of malignancy at imaging. US is superior to mammography for TNBC detection, but benign-appearing features can lead to misdiagnosis. Breast MRI is the most sensitive modality for TNBC detection. Most cases of TNBC are treated with neoadjuvant chemotherapy, followed by surgery and radiation. MRI is the modality of choice for evaluating the response to neoadjuvant chemotherapy. Survival rates for individuals with TNBC are lower than those for persons with hormone receptor-positive and human epidermal growth factor receptor 2-positive cancers. The 5-year survival rates for patients with localized, regional, and distant disease at diagnosis are 91.3%, 65.8%, and 12.0%, respectively. The early success of immunotherapy has raised hope regarding the development of personalized strategies to treat TNBC. Imaging and tumor biomarkers are likely to play a crucial role in the prediction of TNBC treatment response and TNBC patient survival in the future. ©RSNA, 2023 Quiz questions for this article are available in the supplemental material.