A mother whose breast cancer returned after being operated on by disgraced surgeon Ian Paterson was told she was just "exceptionally unlucky", an inquest into her death has heard.
Chloe Nikitas, 43, died in 2008 after undergoing a controversial "cleavage-sparing" mastectomy carried out by Paterson.
The 66-year-old Scottish surgeon is currently serving a 20-year prison sentence for wounding 10 of his patients during procedures between 1997 and 2011.
Ms Nikitas, who was diagnosed with grade two invasive ductal carcinoma in 2002, would never have agreed to the procedure, carried out by Paterson at the Little Aston Hospital in Sutton Coldfield, Birmingham, if she had known it would have left breast tissue behind and risked her cancer returning, her partner of 18 years Klaus Strohle told an inquest on Tuesday.
Her inquest is the first of 62 into the deaths of Paterson's patients that are scheduled to be heard at Birmingham and Solihull Coroner's Court over the next eight months.
Paterson is expected to give evidence remotely later on Tuesday afternoon, after coroner Richard Foster said he must give evidence after the rogue surgeon launched a last-minute bid to have his witness summons revoked.
The Ministry of Justice (MoJ) confirmed last week that his planned move to an open prison – which caused outrage among his victims and their families – has been cancelled after a risk assessment.
Who is Ian Paterson and what did he do?
Originally from Glasgow in Scotland, Paterson grew up in Co Down in Northern Ireland, and worked at the Spire Parkway Hospital and Spire Little Aston Hospital in Birmingham and NHS hospitals run by the Heart of England NHS Foundation Trust.
Paterson, a breast surgeon, performed "extensive, life-changing operations for no medically justifiable reason" on his victims and made them wrongfully believe they had cancer.
The doctor would carry out "cleavage-sparing mastectomies" on his victims, a controversial practice that left breast tissue behind after the removal of cancerous cells, putting them at greater risk of cancer returning.
Concerns were first raised about Paterson in 2003 but not followed up, before he was told in 2007 to stop performing cleavage-sparing mastectomies.
GPs and patients then made complaints about his methods, and in 2011 he was suspended by the NHS, but continued to perform breast surgery and general surgery for weeks afterwards.
In 2017, Paterson, who was living in Altrincham, Greater Manchester, was convicted at Nottingham Crown Court of 20 counts of wounding which were committed during surgical procedures on 10 private sector patients between 1997 and 2011.
Read more: Coroner pledges to use all powers to ensure disgraced surgeon gives evidence (PA Media)
However, it is thought the number of victims may be more than 1,000, with the NHS already paying out a total of £37m in compensation to about 750 people in the months after his conviction.
Paterson was initially jailed for 15 years, but the Court of Appeal later increased his sentence to 20 years a few months later, following an application by then solicitor general Robert Buckland, who argued the original sentence was unduly lenient.
An independent inquiry, chaired by the former Bishop of Norwich, the Right Rev Graham James, ruled in February 2020 that Paterson had carried out hundreds of unnecessary operations on scores of patients, exaggerating or inventing cancer risks.
More than 560 patient deaths have been considered so far by a multi-disciplinary team of medical experts, leading to the opening of 62 inquests. Another 20 inquests are set to open later. The inquests are expected to run for two years.
Paterson has refused to take part in the inquest process, claiming he cannot attend because of health reasons, lack of legal representation and a lack of facilities to prepare.
Earlier this month, the Sunday Times reported that health secretary Wes Streeting is to strip Paterson of his £1m pension.
He has decided to remove Paterson’s taxpayer-funded pension under rules that allow NHS benefits to be forfeited in the case of criminal, negligent or fraudulent acts, the newspaper said.
Chloe Nikitas
An environmental consultant from Tamworth, Staffordshire, Chloe Nikitas died at the Priory Hospital on 13 April 2008 after being operated on by Paterson.
She was diagnosed with breast cancer in 2002, and underwent a cleavage-sparing mastectomy, as well as reconstructive surgery, chemotherapy and radiotherapy.
Her partner, Klaus Strohle, told the inquest that no other surgical options were offered to her, and that they assumed the cleavage-sparing mastectomy on her left breast was the “best course of action”, as it was touted as a “pioneering” surgery.
However, she discovered a lump in the same breast in April 2005 and a PET scan that October revealed grade two ductal breast cancer – the same cancer as before.
Mr Strohle, a company director, said they were aware her diagnosis was now terminal, leaving them devastated. He told the inquest: “How could it be that she had cancer again in the reconstructed breast?
“Chloe had had a mastectomy, the whole point of that is to remove tissue so it doesn’t come back, what was the point in her going through it?
“We were told we were just exceptionally unlucky, that it was a one in a million chance, that it was sheer bad luck.
“We were under no illusion that this was a death sentence. It was metastatic, and it was terminal.”
They saw Paterson on 25 June 2002 after her first diagnosis and discussed the cleavage-sparing mastectomy.
“He gave no warnings about the surgery, we weren’t made aware that there would be an increased risk of reoccurrence, absolutely not. If we were, I can assure you we wouldn’t have chosen that option."
After her surgery and reconstruction in 2002, Ms Nikitas was referred to consultant oncologist Dr Tal Latief to arrange chemotherapy.
But he told the inquest he had no idea Paterson had been performing partial mastectomies, as they were simply labelled as “mastectomies” on medical notes and correspondence, and said he had never heard of a cleavage-sparing mastectomy.
The inquest continues.
Victims' reaction
Shirley Moroney's sister Marie Pinfeld, 49, died from cancer in 2008 after being operated on twice by Paterson.
Speaking ahead of the inquests, Moroney, 61, said Paterson should face more criminal charges. Ahead of the inquests, she told the Daily Record: "He is going to be out in 2027 and I want him to serve more time.
Read more: Sister of butcher surgeon Ian Paterson victim calls for more jail time for medic (Daily Record)
"The worst thing about it, is this is still just the tip of the iceberg, there are still so many people that were harmed by him and they will never have their day in court. If we can get him more time in prison I will be a very happy woman and that's my main aim in all this. He stole my sister."
Debbie Douglas, who was given an unnecessary mastectomy by Paterson, told The Guardian ahead of the inquests: “What we hope from this is that those that have died get their voices heard, and that the families and victims that Paterson harmed get answers.
"We just don’t want this to happen to anyone else, and we want patient safety at the forefront.”
Read more: Inquest to open over deaths of patients treated by breast surgeon Ian Paterson (The Guardian)