Ian Paterson Claims ‘Cleavage-Sparing’ Mastectomy Figures Were ‘Inflated’

A former breast surgeon, previously disgraced, informed an inquest investigating the death of one of his patients that the reported figures for “cleavage-sparing mastectomies” he had conducted were “inflated”. Ian Paterson received a 20-year prison sentence in 2017 for causing injury to 10 patients by performing this unauthorized procedure, which involved leaving tissue behind. Ongoing inquests are examining the fatalities of 62 patients, including Elaine Turbill, who passed away in 2017 at the age of 63, twelve years after Paterson performed a mastectomy on her. Testifying remotely from prison, Paterson asserted that it would be “crazy” to leave breast tissue during such an operation. He further denied that the procedure he carried out was a new one, describing it instead as an “adaptation,” and also denied originating the phrase “cleavage-sparing mastectomy.” During Paterson’s trial seven years prior, it was revealed that the technique entailed retaining some breast tissue, thereby preserving patients’ cleavages. However, the current inquest has heard that this practice also heightened the risk of cancer recurrence – a claim the surgeon refuted on Thursday. He informed the coroner that he ceased performing his particular mastectomy method in 2007, immediately after hospital executives advised him that additional research was necessary. Speaking generally, he explained that breast surgeons aim to excise all breast tissue during mastectomies, though in practice, this is never achieved with 100% success. In his testimony, he differentiated between glandular breast tissue, which produces milk, and subcutaneous fatty tissue, some of which he would choose to retain. The inquest was previously informed that an examination of Elaine Turbill in 2010 showed 20% of her breast tissue had been left behind by Paterson. Nevertheless, he characterized this as “not an objective measure” and stated to the inquest that when performing these types of operations, he was “as near as possible certain that I wasn’t leaving behind glandular breast tissue.” He questioned why the residual tissue in Mrs. Turbill had not been detected earlier and proposed it might have been fat that had developed since the 2005 operation. He recounted to the inquest that he had discussed the option of cosmetic reconstructive surgery with her, but she had declined it. Paterson proceeded to state that it was not his usual custom to discuss the specifics of operations in extensive detail with his patients, as he believed it caused them fear. Instead, he mentioned that he delegated these discussions to nurses. When asked by Jonathan Jones KC, counsel to the inquest, whether patients should have been informed that he was not conducting a standard mastectomy, Paterson responded: “You’re making it sound flippant, but this is a lady losing her breast.” He continued: “The lady is entitled to know her cancer will be gone and the person operating will do everything they can to remove the cancer safely in its entirety.” Paterson added: “It was possible to give them a better cosmetic result. You haven’t spoken to the women who go home and won’t let their husbands near them, or the women who take down all the mirrors in the house because they can’t stand to look at themselves.” He concluded: “If you had seen that, you would want to do your level-best to make them feel better.” Paterson, who served as a consultant surgeon from 1998 until 2011, treated patients at Solihull Hospital, which was then part of the Heart of England Foundation NHS Trust. He also maintained a private practice at Parkway hospitals in Solihull and Little Aston in Sutton Coldfield; these facilities were operated by Bupa until 2007 and subsequently by Spire. The surgeon indicated that the Heart of England trust experienced a substantial workload, which contributed to tensions. The inquest heard that Andrew Stockdale, another surgeon, had voiced concerns regarding the quantity of residual tissue remaining after mastectomy operations performed at the trust, where both individuals were employed. Paterson acknowledged that his colleague had been compiling evidence on this matter, but noted that the issue had not been brought up during multi-disciplinary team meetings, which are forums where NHS colleagues convene to discuss patient treatment. Dr. Chris Fletcher, a radiologist and one of Paterson’s colleagues, testified at the inquest on Wednesday that the breast surgeon was a “nightmare” to collaborate with and that multi-disciplinary meetings were “always difficult” because Paterson “always tried to run the show.” The inquest remains ongoing.