Jailed surgeon removed breast tissue, inquest told

Ian Paterson, pictured in 2017, is serving a 20-year jail sentence after being convicted of multiple counts of wounding

Jailed surgeon Ian Paterson has told an inquest into the death of one of his patients he completely removed all the breast tissue at her first mastectomy.

Christine Baker died in 2015, aged 59, after her cancer returned following surgery by the medic, currently serving a prison term for wounding linked to operations.

Hers is the third of 62 Paterson patient deaths to be probed by a coroner, with proceedings so far focusing on so-called cleavage-sparing mastectomies and the extent to which any leftover breast tissue may have led to cancer's return.

Giving evidence at the Birmingham hearing, Paterson said Mrs Baker's tumour was removed.

The inquiry previously heard she had a first mastectomy in 2005, but went on to have a second after again being diagnosed with cancer in 2007.

Paterson was employed by the Heart of England NHS Foundation Trust in Birmingham and practised in the independent sector at Spire Parkway in Solihull and Spire Little Aston near Sutton Coldfield.

Christine Baker, a teacher, died in 2015 at the age of 59

The inquest has heard Mrs Baker, a Birmingham secondary school teacher who was born in Stoke-on-Trent and lived in Solihull, had a “skin-sparing” mastectomy in 2005, after being advised there was no additional risk to the reconstructive part of the procedure.

Asked whether he had intended to carry out a cleavage-sparing mastectomy on Mrs Baker, Paterson replied: “It’s nonsense to suggest that anyone having immediate reconstruction would require any residual tissue or former cleavage. That tissue is going to be provided by reconstruction or an implant.”

Then asked whether it was his intention to remove all the breast tissue, Paterson replied “yes”.

The inquest heard 209g of tissue was removed which a multi-displinary team considered to be “a small amount” for someone with a 34B-cup breast, which would normally weigh 350g.

Paterson said: “The weight is the weight. Whether it’s too light or too heavy isn’t going to change the fact that the operation is complete.”

He added: “The weight is the weight and entirely commensurate with the removal of all the tissue.”

The hearing was shown a pathology report which said the tumour reached the excision margin, with Paterson asked: “Does it indicate the tumour hadn’t been completely removed?”

He replied: “No.”

Second mastectomy

The inquest was later shown Mrs Baker’s records from 8 February 2007, after she complained of a lump in her right reconstructed breast. She went on to be diagnosed with “carcinoma recurrence”, or a return of her cancer.

Papers shown to the court showed that in her second mastectomy, tissue weighing 387g was removed.

Paterson was asked if that could indicate that he had “left a significant amount of breast tissue at the original operation”.

However, the medic said 387g was an inaccurate weight.

The inquest heard two experts had taken the view Mrs Baker’s death was not related to the recurrence of the 2005 cancer, to which Paterson responded: “I agree with that. She unfortunately had an aggressive disease.”

He was then told the multi-disciplinary team claimed excessive tissue had been left.

The medic said not only did he disagree with that, but there was “a lot of evidence that completely disproves it”.

Paterson is serving a 20-year jail term for wounding.

Mrs Baker's inquest continues.

Evidence has already been heard in the cases of Chloe Nikitas and Elaine Turbill.