The role and prospects of the Fudan classification in precision medicine for triple-negative breast cancer.

Triple-Negative Breast Cancer (TNBC) remains a major challenge in oncology because of its significant heterogeneity and the lack of established therapeutic targets. Conventional diagnostic and treatment methods often fall short in addressing this complexity, which creates a need for molecular subtyping frameworks to guide precision therapy. Here, we systematically review the evolution of TNBC molecular subtyping, with a focus on the "Fudan Classification" as a powerful and integrative system. This classification offers a systematic perspective for deciphering the biological essence of TNBC and for designing treatment strategies. Its four principal subtypes-immunomodulatory (IM), luminal androgen receptor (LAR), basal-like immunosuppressed (BLIS), and mesenchymal (MES)-uncover distinct disease entities driven by unique oncogenic pathways, thereby providing a rationale for aligning specific treatments like targeted agents and immunotherapies with the most likely-to-benefit patient subgroups. In parallel, we examine emerging treatments that go beyond traditional subtyping, including TROP-2-targeting Antibody-Drug Conjugates (ADCs). These ADCs, together with subtyping-guided approaches, are expanding the scope of precision medicine. This article aims to demonstrate that a more robust and comprehensive precision therapy system for TNBC can be built on a dual logic of "subtype-driven" and "target-driven" strategies, offering insights for future work on overcoming drug resistance and optimizing combination therapies.