The jailed breast surgeon Ian Paterson has said he did not tell women if he was going to perform an unauthorised cleavage-sparing mastectomy on them because “it was frightening and they didn’t need to or want to know”.
Giving evidence for the first time at an inquest into the deaths of 62 of his former patients, Paterson said he considered a cleavage-sparing mastectomy to be an “adaptation of a standard operation” that did not require separate consent.
After previously refusing to give evidence in the hearings, Paterson spoke on Thursday at the inquest of Elaine Turbill, who died, aged 63, in 2017 when her cancer returned after undergoing a mastectomy carried out by Paterson in 2005.
The inquest heard that at a recall clinic in 2010, it was recorded that 20% of her breast tissue had been left behind after the operation.
Speaking via video link from prison, where he is serving a 20-year sentence for multiple counts of wounding linked to unnecessary operations he carried out on patients, Paterson said he did not explain the procedure in detail to his patients.
“Most ladies know what a mastectomy is. I never went into great detail, it scares them and I don’t think they hear it, they just hear the word cancer,” he said. “This lady [Turbill] would have been taken into a separate room with a breast care nurse and would have discussed things in more detail.”
He later said: “It was frightening and [patients] didn’t need to or want to know.”
A cleavage-sparing mastectomy involved leaving tissue behind for cosmetic reasons. National guidelines state all tissue should be removed to reduce the risk of cancer returning.
Paterson said he did not know how many patients he had performed this procedure on, adding that he did not think it was a “new or special operation” and that he did not “coin the term” used to describe it.
“I didn’t think it was a different operation, it was simply an adaptation. I never kept any figures,” he said. “It was a safe oncology procedure and as soon as someone suggested it might not be, I stopped doing it.”
He insisted there was no further risk to patients than during a standard mastectomy, where there was always a risk of some tissue being left behind.
Paterson said he did not tell his colleagues he was performing the cleavage-sparing procedure as he “didn’t think it was anything other than a better cosmetic result”.
Earlier in the week, Balapathiran Balasubramanian, a surgeon who carried out some of the recall checks on Paterson’s patients, said Turbill decided against further surgery to remove the left-behind breast tissue and instead opted for regular checkups.
He told the court she did not mind her follow-ups being carried out by Paterson but he was suspended before she could see him again, so she saw other surgeons instead.
A CT scan in December 2013 found Turbill’s cancer was metastatic and had spread to her bones, brain and liver.
In a statement, Turbill’s daughter Gemma said her mother was a “kind, loving and friendly” person whose smile “could light up the room”.
“It was very hard to see her deteriorate. The day she died is still very painful for me to remember,” she said. “Still, seven years on the pain never goes away. I have a feeling in my stomach that her death could have been prevented.
“No breast surgeon aims to leave breast tissue after breast surgery. That’s just crazy.”
