Triple-negative breast cancers (TNBCs) are defined as lack of expression of estrogen, progesterone, and Her2neu receptors by immunohistochemistry. 1 This subgroup has an aggressive clinical behavior. 2 JAK2 (V617F) exon 14 is a most probable mutation in occurring in pseudo kinase domain with loss of intrinsic auto inhibitory activity and can result in malignant transformation and uncontrolled proliferation leading to TNBC. It is because of this reason for particularly choosing this mutation for study. 3 Recent studies suggest that an amplification of JAK2 gene on somatic chromosome 9p24.1 region in patients with TNBC. 4 Ruxolitinib is an orally available JAK2 inhibitor that can be useful in this subgroup of patients. 5 A total of two hundred and fifty consecutively selected premenopausal, pretreatment female patients at CMH Lahore between 25 and 60 years diagnosed during past 2 years (Jan 2017Jan 2019) as triple-negative breast cancer (estrogen, progesterone, and Her 2 neu negative) in stage M1 on immuno histochemistry examination of breast tissue were included in the study. The presence of myeloproliferative neoplasms (MPN) was ruled out in all patients. Informed consent was obtained from all patients involved in the study. All the blood samples were taken before the start of treatment in TNBC cases. A cohort of age-matched consecutively selected female volunteers (n = 100) was included as unpaid healthy controls after written informed consent. Permission for the study was taken from hospital ethical committee. Real-time polymerase chain reaction was done on all the samples. Real-time polymerase chain reaction was used for amplification of DNA and was carried out in thermal cycler Rotor-Gene-Q (Corbett Research) having quality of rapidly heating and cooling of samples. The results of RT-PCR were recorded as cycle threshold (C t ), and C t < 20 was taken as positive and rest was taken as negative. Positive and negative control DNA samples for JAK2 V617F mutations were included in all batches. Positive samples were further tested for additional mutations that affect signaling pathway notably JAK2 exon12, STAT, KRAS, NRAS, CBL1, PTPN11, RAF, MAP, MYC, and PI3K mutations by Sanger sequencing. JAK2 exon 14-positive DNA of an age-matched MPN negative TNBC patient was taken as positive control while exon 14-negative DNA of an age-matched MPN negative TNBC patient was taken as negative control for PCR. To check the robustness of JAK2 V617F exon 14 mutation assays, quantitative results performed were found to be reliable across all mutation loads with moderate variability at low allele burden (0.1 and 1%; CV = 0.45 and 0.76, respectively). The percentage of samples correctly identified as positive and negative for the JAK2 V617F exon 14 mutation in both groups was calculated. The kappa value (k) was used to determine the level of agreement between each alternative assay and the PCR sequencing. All healthy controls (n = 100) were negative (DNA) for JAK2 V617F exon 14 mutation by real-time PCR. A total of twenty-five (n = ...