‘Crazy’ to leave behind breast tissue during mastectomy, rogue surgeon tells inquest

It would be ‘crazy’ to leave breast tissue behind during a mastectomy, disgraced surgeon Ian Paterson has told an inquest into the death of one of his patients.

The jailed former consultant, who is serving a 20-year prison sentence for injuring ten patients after being convicted in 2017, was speaking at the inquest of Elaine Turbill, who died in 2017 aged 63 after her breast cancer returned despite undergoing treatment of a mastectomy by Paterson. in 2005.

Paterson performed an unauthorized ‘cleavage-sparing’ mastectomy on Ms Turbill and other cancer patients, which left behind breast tissue for cosmetic reasons but increased the risk of the cancer returning.

Giving evidence remotely from prison to the inquest, the second of 62 to be heard at Birmingham and Solihull Coroner’s Court over the next eight months, Paterson claimed it was not he who coined the term ‘cleavage-sparing mastectomy’ coined and said that the phrase “caused the hysteria”.

When asked by inquest counsel Jonathan Jones QC whether he believed he had been a good breast surgeon, Paterson, who wore a light blue shirt with a poppy attached to it for the hearing, said: “I don’t think people walking around judging themselves, but hey, if I thought I was a bad breast surgeon, I shouldn’t be doing it, right?

“You seek help from colleagues if you feel that something is wrong with your technique. You trust your colleagues to tell you if they think something is wrong with your technique – that’s what MDTs (multidisciplinary team meetings) are for.”

One of Paterson’s colleagues, radiologist Dr Chris Fletcher, told the inquest on Wednesday that the breast surgeon was a ‘nightmare’ to work with and that multidisciplinary meetings between NHS colleagues to discuss the treatment of their patients were ‘always difficult’ because Paterson was “always trying to run the show.”

Asked Thursday what his memory of the meetings was, Paterson admitted there were “tensions” but said they were largely related to the heavy workload they were under.

He added that there were also tensions between himself and colleague Dr Andrew Stockdale, who raised concerns about the amount of residual tissue Paterson left behind during his mastectomies.

He said: “(Dr Stockdale) expressed his views outside the MDT, he decided that he would gather a cohort of patients who he felt showed his concerns and rather than share them with me or the MDT, he shared them with a third party.”

When asked if he agreed with Dr. Stockdale that residual tissue was left behind during the mastectomies he performed, Paterson said, “We are beginning to understand the concept of the cleavage-sparing mastectomy.

“I wasn’t the one who came up with that phrase, I think he did. A CSM is the thing that seems to have caused the hysteria, the furor, whatever you want to call it.

“For a limited number of patients, if the cancer was central or lateral and they had a larger than average breast, it was possible to leave slightly thicker flaps.

“A thicker flap leaves no breast tissue behind. No breast surgeon will ever tell you that a mastectomy removes 100% of the breast tissue, that’s nonsense. No mastectomy is ever completely completed.

“No surgeon has the ambition to leave behind breast tissue after a mastectomy, that is simply insane.”

Paterson said he did not remember Ms Turbill specifically, but was asked by Mr Jones if he would have explained to her what a mastectomy was.

He said: “Most ladies know what a mastectomy is, I’ve never gone into detail, it scares them and I don’t think they hear it, they just hear the word cancer.

“Not long after the diagnosis and the plan, this lady would have been admitted to a separate room with a breast nurse and discussed matters further.

“We relied a lot on our breast nurses to provide information.”

Mr Jones asked: “Would you have told Elaine it was not possible to do a full mastectomy?”

Paterson replied: “No, because we all do our best to remove all visible breast tissue, but it is a disturbing and frightening detail to tell them that there may be deposits of breast tissue left behind that could cause a local recurrence (of cancer). .

“The nurses would have mentioned it as a possibility in the future as part of the preparation.”

The investigation continues.