For a second ipsilateral breast tumor event, salvage mastectomy is the standard of care while second conservative treatment is a possible option. However, level 1 proofs are missing, leading to perform salvage mastectomy for patients who could receive second conservative treatment and consequently avoid psychological/quality of life salvage mastectomy deleterious impacts. A phase 3 randomized trial comparing salvage mastectomy to second conservative treatment is needed. Here we discuss what would be to us the optimal design of such trial to confirm the non-inferiority between the two salvage options, with a focus on methodological aspects in terms of patient characteristics and statistical issues.
Keywords: Brachytherapy; Breast cancer recurrence; Breast-conserving surgery; Chirurgie mammaire conservatrice; Curiethérapie; Mastectomie; Mastectomy; Radiation therapy; Radiothérapie; Randomized clinical trial; Rechute de cancer du sein; Étude randomisée.
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