Surgeon tells jury ‘patient had a choice’

A BREAST surgeon accused of carrying out unnecessary operations yesterday told a court that surgery was ‘the patient’s choice’.

Ian Paterson said he laid out ‘all the options’ for Joanne Lowson before removing a lump he described as ‘a little suspicious’.

Giving evidence to Nottingham Crown Court, he said: ‘The lady was given a series of options. It’s silly to give people a series of options if you think they’re the wrong ones. She reverted to her no-risk default strategy she had had all along. Those were her options and she chose. It was the patient’s choice.’

During her evidence, Mrs Lowson, a mother then aged 44, said the operation in September 2010 left her with a ‘deformity in the visible cleavage area’ in her left breast.

Glasgow-born Paterson admitted that in his pre-operative notes he made an error, stating Mrs Lowson had cells that were on the ‘borderline’ of being a possible breast cancer indicator – atypical ductal hyperplasia (ADH). He said: ‘I have written borderline ADH, which was incorrect.’

The ‘error’ was then reproduced in Mrs Lowson’s mammogram and ultrasound report by another clinician.

But Paterson said: ‘Although it’s an error, the only upshot of that is she’d have got a more serious scan and it certainly wouldn’t change her [treatment] management.’ Paterson previously told the jury he made two other clerical errors in notes of two other patients on whom he is accused of carrying out unnecessary surgery.

But he said that those mistakes would affect his patients’ treatment ‘not at all’.

The surgeon denies 20 counts of wounding with intent against nine women and one man relating to procedures he carried out between 1997 and 2011.

Jurors have previously heard claims he carried out completely unnecessary operations for ‘obscure motives’ which may have included a desire to ‘earn extra money’.

After an operation to remove a lump that turned out to be benign in March 2009, Mrs Lowson returned ‘concerned’ about another lump in the same area.

Paterson said scans and his assessment of the lump had proven ‘discordant – they don’t agree with each other’.

He said: ‘Clinically and ultrasonically, it’s a little suspicious. I’ve clearly told her the only pathology we have for this lump is benign. She knew, though, that I was concerned about the lump and she is obviously concerned because she got to me before the GP’s letter [of referral] arrived.

‘She was that concerned, and the options are clearly laid out for her.’

He said: ‘It appears in my letter she was very determined to have it definitively removed and that’s what happened.’

Post-operative tests on the tissue showed it was benign.

Paterson, of Altrincham, Cheshire, was formerly employed by Heart of England NHS Trust and also practised at Spire Healthcare.

‘The options are clearly laid out for her’