Aims: 15-18% of Breast cancer is a “Triple Negative Breast Cancer”, without estrogen, progesterone and HER2 receptors. This type of tumour has an aggressive behaviour and does not respond to conventional hormonal or anti-HER2 therapies. In this article we examine different cases of Triple Negative Breast Cancer (TNBC) in the ederly in order to show a diagnostic-therapeutic algorithm. Materials and methods: In this paper there were examined three heterogeneous clinical case of Triple Negative Breast Cancer (TNBC). Results: TNBC has an aggressive behaviour and the only treatment that guarantees a response is chemotherapy. The first of the three patients was free relapse for 15 months; the second had a relapse in homolateral breast after 12 months with a liver meta- stases; the third patient, seven years after a TNBC, had a second breast tumour, but this time hormonal positive. Conclusion: TNBC is still a challenge for surgeons and oncologists but soon new knowledge helps in the diagnosis, in the surgical and in the pharmacological treatment of this disease