Triple-negative breast cancer (TNBC) exhibits high heterogeneity, leading to variable responses to neoadjuvant chemotherapy (NAC) among patients. Noninvasive quantification of intratumoral heterogeneity (ITH) may be valuable in predicting treatment response. This study aims to investigate whether fractal dimension (FD) based on pre-treatment contrast-enhanced magnetic resonance imaging (MRI), combined with clinicopathological data, can predict NAC response in TNBC patients.