Breast cancer comprises a heterogeneous group of diseases that vary in morphology, biology, behaviour and response to therapy. Triple-negative (TN) breast cancer is a subtype of tumours with aggressive clinical behaviour which currently lacks effective targeted therapies. The majority of TN breast cancers possess a basal phenotype and show varying degrees of basal marker expression (basal-like tumours). The importance of recognising these tumours came to light largely as the result of global gene expression profiling studies that categorised breast cancer into distinct molecular classes. These studies showed that basal-like tumours are molecularly different from hormone receptors and HER2 positive tumours. Although both TN and basal-like tumours share many molecular and morphological features, equating both tumour classes may be misleading. A better understanding of the molecular and histopathological features of TN and basal-like cancers is of paramount importance, in particular for unravelling the heterogeneous nature of these tumour subgroups and for the identification of prognostic biomarkers, ideal systemic therapy regimens and novel therapeutic targets for these aggressive tumours. In this review, we discuss the difference between TN and basal-like tumours, pathological and clinical features of basal-like cancer and hence explore the criteria that can be used to identify these tumours in routine practice.
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