The clinical management of triple-negative breast cancer has been very difficult for a long time, being classical chemotherapy the only possible therapeutic approach given the absence of specific targets. However, the therapeutic armamentarium has recently been expanded thanks to the introduction of new molecules, in particular immunotherapy and antibody-drug conjugates (ADCs), which have made it possible to significantly improve the prognosis of this patient population both in the early and advanced settings. Since 2022, the ADC sacituzumab govitecan has been approved by the Italian Medicines Agency (Aifa) for the treatment of advanced/metastatic triple-negative breast cancer pretreated with at least two lines of systemic therapy, of which at least one for metastatic disease. In the collection of case reports, we delved into the available data on the efficacy profile and impact on quality of life of sacituzumab govitecan in several special populations of patients with triple-negative metastatic breast cancer.