BACKGROUND:The results of radiation on the local control of triple receptor‐negative breast cancer (negative estrogen [ER], progesterone [PR], and HER‐2/neu receptors) was studied.METHODS:Conservative surgery and radiation were used in 753 patients with T1‐T2 breast cancer. Three groups were defined by receptor status: Group 1: ER or PR (+); Group 2: ER and PR (−) but HER‐2 (+); and Group 3: triple‐negative (TN). Factors analyzed were age, menopausal status, race, stage, tumor size, lymph node status, presentation, grade, extensive in situ disease, margins, and systemic therapy. The primary endpoint was 5‐year locoregional recurrence (LRR) isolated or total with distant metastases.RESULTS:ER‐ and PR‐negative patients were statistically significantly more likely to be black, have T2 disease, have tumors detectable on both mammography and physical examination, have grade 3 tumors, and receive chemotherapy. There were no significant differences noted with regard to ER− and PR− patients by HER‐2 status. There was a significant difference noted in rates of first distant metastases (3%, 12%, and 7% for Groups 1, 2, and 3, respectively; P = .009). However, the isolated 5‐year LRR was not significantly different (2.3%, 4.6%, and 3.2%, respectively; P = .36) between the 3 groups.CONCLUSIONS:Patients with TN breast cancer do not appear to be at a significantly increased risk for isolated LRR at 5 years and therefore remain appropriate candidates for breast conservation. Cancer 2009. © 2009 American Cancer Society.