Triple-negative breast cancer (TNBC) is a heterogeneous disease with an aggressive clinical course and worse outcomes than other breast cancer subtypes. Metastatic triple-negative breast cancer (mTNBC) is characterized by an aggressive clinical course and unfavorable outcomes, despite the pharmacological treatments used. The present clinical case describes a 35-year-old woman affected by TNBC characterized by rapid and subsequent local, cutaneous and lymph node progression of the disease. It was initially necessary to perform surgical treatment without the patient having completed neoadjuvant chemotherapy. 4 months after the end of adjuvant chemotherapy the patient underwent a second surgery. Then, she started the first line and, after 4 cycles, the second line with sacituzumab govitecan (SG) obtaining at the first instrumental re-evaluation a partial skin and lymph node response with a clear reduction in painful symptoms previously reported at the level of the right chest wall and axillary cavity. She continued treatment for a total of 9 cycles. The case confirms the clinical benefit and effectiveness of treatment with SG, in particular it underlines the good control of the disease characterized by a rapid and progressive course with exclusively locoregional extension and good control of symptoms with an improvement in quality of life.