Ian Paterson: Cancer surgeon denies antibiotics could have avoided surgery

Ian Paterson, 59, is on trial at Nottingham Crown Court and denies 20 counts of wounding with intent

A cancer surgeon accused of carrying out unnecessary mastectomies rushed a woman into an operation instead of exploring whether antibiotics could treat her, a court heard.

Breast surgeon Ian Paterson denies 20 counts of wounding with intent against nine women and one man.

He assumed Rachel Butler had already been offered them by her GP and said she had "no alternative" to surgery.

She "seemed of a mind to get on with it", he told Nottingham Crown Court.

The court heard the 59-year-old said Mrs Butler was suffering "chronic inflammation" in her left nipple, near an area where he had carried out an operation on her six years earlier.

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He was asked by prosecutor Julian Christopher QC why there was no mention of antibiotics in a letter he had written to Ms Butler's GP.

"Well, antibiotics are a natural GP's reaction to any infection," Mr Paterson said.

"Perhaps I assumed the GP had explored conservative measures before referring the patient for consideration of a surgical procedure."

He said he had offered Mrs Butler a "wait-and-see" approach, suggesting she stopped smoking.

'Pleased with outcome'

But when asked by Mr Christopher if the operation was "rushed into" six days after he saw her, Mr Paterson said he had been honest with her and she seemed like she wanted to get on with it.

He denied scaring her into stopping smoking "the moment" she left his office.

Continuing to give evidence on other alleged cases, Mr Paterson said he was not calling his patients liars but suggested his contemporaneous notes were more reliable.

"I just think they remember what they remember now, 10 years after the fact," he said.

He also denied "deliberately exaggerating" the condition of landlady Carole Johnson to her insurance company to ensure it would pay for her operation.

Regarding another patient, Judith Conduit, Mr Paterson said it had been "her idea" to have a mastectomy and she was pleased with the outcome of her breast reconstruction.

Ms Conduit, who claims the surgeon told her she might have a rare condition causing benign lumps, required 94 follow-up appointments after complications from the second operation in 2001.

Mr Paterson, Ashley, Altrincham, Greater Manchester, worked at hospitals run by the Heart of England NHS Trust and Spire Healthcare. The charges relate to procedures he carried out between 1997 and 2011.

The trial continues.