Jailed breast surgeon Ian Paterson has said he did not tell women whether he was going to perform an unauthorized cleavage-sparing mastectomy on them because “it was scary and they didn’t need 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 regarded a cleavage-sparing mastectomy as a “modification of a standard operation” that did not require separate consent.
After previously refusing to give evidence at the hearings, Paterson spoke Thursday at the inquest of Elaine Turbill, who died in 2017 at the age of 63 when her cancer returned following a mastectomy by Paterson in 2005.
The inquest heard that a recall clinic in 2010 found that 20% of her breast tissue was left behind after the operation.
Speaking via video link from prison, where he is serving a 20-year sentence for multiple injuries related to unnecessary operations he performed on patients, Paterson said he had not explained the procedure in detail to his patients.
“Most ladies know what a mastectomy is. “I never went into 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 admitted to a separate room with a breast nurse and discussed matters further.”
He later said, “It was scary and (patients) didn’t need or want to know.”
With a cleavage-sparing mastectomy, tissue is left behind for cosmetic reasons. National guidelines state that all tissue should be removed to reduce the risk of cancer returning.
Paterson said he did not know how many patients he had performed the procedure on, adding that he did not think it was a “new or special operation” and that he had not coined “the term” to describe it.
“I didn’t think it was a different operation, it was just an adjustment. I never kept numbers,” he says. “It was a safe oncology procedure and as soon as someone suggested it might not be so, I stopped doing it.”
He emphasized that there is no further risk to patients than with a standard mastectomy, which always involves the risk of leaving some tissue behind.
Paterson said he did not tell his colleagues he was performing the cleavage-sparing procedure because he “didn’t think it was anything other than a better cosmetic result.”
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Earlier this week, Balapathiran Balasubramanian, a surgeon who performed some of the recall checks on Paterson’s patients, said Turbill decided against further surgery to remove the breast tissue left behind and opted instead for regular checkups.
He told the court she didn’t mind having her follow-ups done by Paterson, but he was suspended before she could see him again, so she saw other surgeons instead.
A CT scan in December 2013 revealed that Turbill’s cancer had metastasized, spreading 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 difficult to watch her deteriorate. The day she died is still very painful for me to remember,” she said. “Yet the pain never goes away after seven years. I have a feeling in my stomach that her death could have been prevented.
“No breast surgeon aims to leave behind breast tissue after breast surgery. That’s just crazy.”