I would imagine 3 years later in the contralateral breast that this would be a new primary.  We would want to treat this as its own separate cancer.    I would avoid anthracycline as she has already received this but what specific chemotherapy I would pick depends on the tumor size ...

How do you know it is recurrent and not a new De novo TNBC?Since TNBC spread is likely to be hematogenous ,three years later a lesion in the contralateral breast in absence of wide spread mets elsewhere has to be seen as a "new" cancer and all guidelines for a new TNBC apply.Unless you have molecula...