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Triple negative breast cancer represents multiple genomic and transcriptomic heterogeneities. Genetic and epigenetic changes emerging in TNBC help it in acquiring resistance against immunological response. Distant metastasis, lack of clinically targeted therapies and prognostic markers make it the most aggressive form of breast cancer. In this review, we showed that driver alterations in targeted genes AR, ERR, TIL, TAM, miRNA, mTOR and immunosuppressive cytokines are predominantly involved in complicating TNBC by inducing cell proliferation, invasion and metastasis, and by inhibiting apoptosis. The role of node status, cathepsin-D, Ki-67 index, CD3+TIL, BRCA1 promoter methylation value and p53 as an efficient prognostic factor have also been studied to predict the disease free and overall survival rate in TNBC patients. The present review article is an attempt to gain an insight with a new vision on the etiology of TNBC, its treatment strategies and prognostic marker to identify the outcome of standard therapies and to re-design future treatment strategies to provide maximum benefit to patients.

Triple-negative breast cancer presents an aggressive form of breast cancer subtype, which further lacks efficient treatment strategies and prognostic markers. Genomic heterogeneity in TNBC has led to the relapse of tumor and cancer stem cells with a higher likelihood of distal metastasis. Several studies supported the notion that miRNAs may act as oncogene or tumor suppressors in TNBC. miRNAs may function as a global regulator of TNBC by targeting post-transcriptional regulation of several genes involved in influencing metastatic events, but the exact mechanism involved in inducing the effect is yet to be elucidated. In this review, we summarized miRNA expression, which can functionally suppress metastatic cascade in TNBC by targeting epithelial to mesenchymal transition, metastatic colonization, cancer stem cells, invasion, migration and metastasis. miRNAs may appear as a metastatic biomarker to predict distal reoccurrence of TNBC in lungs, brain and lymph nodes. miRNA can act as a prognostic marker in metastatic TNBC, thereby predicting overall survival, disease-free survival and distant metastasis-free survival in affected patients. The present review article is an attempt to gain an insight into the repertoire of miRNA that may emerge out as an effective treatment strategy, novel biomarker of distal reoccurrence and prognostic marker in metastatic TNBC.