Background: The incidence and mortality of breast cancer can differ significantly among racial and ethnic groups. African American (AA) women have a lower incidence of breast cancer, but higher mortality compared to other racial groups. Triple negative breast cancer (TNBC: negative for the expression of estrogen receptor, progesterone receptor and HER2), which is an aggressive type of breast cancer, occurs more frequently in AA women. The few studies addressing whether racial differences exist in the outcomes of patients with TNBC have yielded inconsistent results. Methods: The Washington University Medical Oncology Database captures the clinical information for all new patients (pts) seen at the Breast Oncology Clinic. Most of these pts reside in the St. Louis metropolitan area. Using this database, we performed a retrospective analysis to examine the association of race with the clinical presentation and outcome of TNBC in this geographically defined patient population. Results: Between May 2006 and March 2011, 506 pts with TNBC were entered in the database. Analysis was done on 499 patients for whom follow up data is available. The median follow up (F/U) time was 24.5 months and the median age at diagnosis was 53 (24 to 98) years. Thirty percent of pts were AA. Only 5% presented with stage IV at diagnosis and the majority of tumors (86%) were high grade. Neoadjuvant chemotherapy was administered in 151 pts, 22% of whom achieved a pathologic complete response (pCR). There was no significant difference between races in the age of diagnosis, F/U time, tumor stage, grade, frequency of receiving neo/adjuvant chemotherapy and pCR rate to neoadjuvant chemotherapy. There was no difference in disease free survival (DFS) and overall survival (OS) between AA and other racial groups by either univariate or multivariate analysis that took into account tumor stage, grade, patient age and menopausal status. The HR for OS was 1.154 (CI 0.772 – 1.725, p value 0.4860) and for DFS it was 0.947 (CI 0.650 – 1.380, p value 0.7764) in AA compared to other races. In the 92 pts who recurred, there was no racial difference in time from recurrence to death. Conclusions: Race does not significantly affect the clinical presentation or outcome of TNBC in the St. Louis metropolitan area.