Supplementary Appendix 2: Detailed voting results

Topics and questions / % Yes / % No / % Abstain
  1. Safety of OPS

Compared to conventional BCS, OPS does
  • Increase the risk of complications
/ 76.2 / 23.8 / 0
  • Increase the risk of local recurrence
/ 0 / 95.5 / 4.5
Compared to oncoplastic mastectomy, OPS does
  • Increase the risk of complications
/ 9.5 / 81 / 9.5
  • Increase the risk of local recurrence
/ 26.3 / 63.2 / 10.5
  1. Goals and Indications of OPS

Compared to conventional breast conserving surgery, OPS can be used to
  • Improve aesthetic outcomes
/ 95.2 / 0 / 4.8
  • Improve quality of life
/ 54.5 / 22.7 / 22.7
  • Reduce reoperation rates for positive margins
/ 54.5 / 22.7 / 22.7
  • Reduce local recurrence rates
/ 31.8 / 54.5 / 13.6
  • Broaden the indication to larger or multifocal tumors as alternative to mastectomy
/ 100 / 0 / 0
  1. There is a need for standardization of OPS

  • Nomenclature
/ 95.5 / 4.5 / 0
  • Indications
/ 78.9 / 4.5 / 0
  • Contraindications
/ 95.2 / 4.8 / 0
  • Reconstruction choice selection
/ 45 / 40 / 15
  • Outcome assessment
/ 95.5 / 4.5 / 0
  • In clinical practice
/ 73.7 / 15.8 / 10.5
  • In clinical research
/ 95.5 / 4.5 / 0
  1. The following specific procedures are considered current standards in OPS

  • Mastopexy
/ 95.5 / 0 / 4.5
  • Tumor adaptive reduction mammoplasty
/ 100 / 0 / 0
  • Fat grafting in immediate breast reconstruction
/ 5.3 / 94.7 / 0
  • Pedicled flaps
/ 76.2 / 22.8 / 0
  • Free flaps
/ 14.3 / 85.7 / 0
  1. In general, every OPS procedure should be tailored to the individual patient
/ 100 / 0 / 0
  1. The Clough bi-level classification and quadrant per quadrant atlas are useful for standardization of OPS

  • In clinical practice for indicating, planning and performing the procedure
/ 71.4 / 14.3 / 14.3
  • In clinical practice for classifying the procedure in the operative report
/ 26.3 / 63.2 / 10.5
  • In clinical practice for billing purposes
/ 9.5 / 76.2 / 14.2
  • In clinical research
/ 42.8 / 47.6 / 9.5
  1. The Tübingen complexity-based classification system for breast surgery is useful for standardization of OPS

  • In clinical practice for indicating, planning and performing the procedure
/ 50 / 50 / 0
  • In clinical practice for classifying the procedure in the operative report
/ 77.3 / 22.7 / 0
  • In clinical practice for billing purposes
/ 90.9 / 0 / 9.1
  • In clinical research
/ 77.3 / 22.7 / 0
  1. Standardization of BCS and OPS nomenclature into the four categories conventional tumorectomy, oncoplastic mastopexy, oncoplastictumorectomy and oncoplastic reduction mammoplasty is useful

  • In clinical practice for distinguishing BCS from OPS
/ 68.2 / 27.3 / 4.5
  • In clinical practice for classifying the procedure in the operative report
/ 71.4 / 28.6 / 0
  • In clinical research
/ 45.5 / 54.5 / 0
  1. The Basel indication algorithm is useful for standardization of the indication for OPS

  • In clinical practice for indicating, planning and performing the procedure
/ 47.6 / 47.6 / 4.8
  1. The Basel reconstruction algorithm is useful for standardization of partial breast reconstruction (PBR) during OPS

  • In clinical practice for indicating, planning and performing PBR
/ 47.6 / 52.4 / 0
  • In clinical practice for classifying PBR in the operative report
/ 36.4 / 59.1 / 4.5
  • In clinical practice for billing purposes
/ 27.3 / 59.1 / 13.6
  • In clinical research
/ 45 / 55 / 0
  1. Which one of the three proposed classification systems is most useful:

In clinical practice for indicating, planning and performing the procedure
  • The Tübingen complexity-based classification
/ 18.2 / N/A / N/A
  • The Clough bilevel classification and quadrant per quadrant atlas
/ 68.2 / N/A / N/A
  • The Basel nomenclature, indication and reconstruction algorithms
/ 13.6 / N/A / N/A
In clinical practice for classifying the procedure in the operative report
  • The Tübingen complexity-based classification
/ 40.9 / N/A / N/A
  • The Clough bilevel classification and quadrant per quadrant atlas
/ 36.4 / N/A / N/A
  • The Basel nomenclature, indication and reconstruction algorithms
/ 22.7 / N/A / N/A
In clinical practice for billing purposes / N/A / N/A
  • The Tübingen complexity-based classification
/ 76.2 / N/A / N/A
  • The Clough bilevel classification and quadrant per quadrant atlas
/ 0 / N/A / N/A
  • The Basel nomenclature, indication and reconstruction algorithms
/ 23.8 / N/A / N/A
In clinical research / N/A / N/A
  • The Tübingen complexity-based classification
/ 47.1 / N/A / N/A
  • The Clough bilevel classification and quadrant per quadrant atlas
/ 17.6 / N/A / N/A
  • The Basel nomenclature, indication and reconstruction algorithms
/ 35.3 / N/A / N/A
  1. Do we need other classification systems?

  • We need another classification system other than theses three in clinical practice for indicating, planning and performing the procedure
/ 36.8 / 57.9 / 5.3
  • We need another classification system other than theses three in clinical practice for classifying the procedure in the operative report
/ 16.7 / 83.3 / 0
  • We need another classification system other than theses three in clinical practice for billing purposes
/ 5.6 / 83.3 / 11.1
  • We need another classification system other than theses three in clinical research
/ 42.1 / 52.6 / 5.3
  1. Outcome assessment of OPS should be standardized in clinical practice

  • To include patient-reported outcome measurements
/ 90.9 / 4.5 / 4.5
  • To include all scales of the BreastQ-Breast Conserving Therapy Module
/ 22.7 / 72.7 / 4.5
  • To include selected scales of the BreastQ-Breast Conserving Therapy Module (e.g., Satisfaction with breasts scale +/- psychosocial well-being)
/ 72.7 / 22.7 / 4.5
  • To include pre- and postoperative pictures
/ 81.8 / 18.2 / 0
  • To include the use of BCCT.core software
/ 9.1 / 68.2 / 22.7
  • To include the use of the Breast Analyzing Tool / breast symmetry index 2007?
/ 4.5 / 77.3 / 18.2

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