Mother whose cancer returned after ‘cleavage-sparing’ op ‘told she was unlucky’

A mother who found out she had breast cancer again after undergoing a “cleavage-sparing” mastectomy carried out by Ian Paterson was told she was just “exceptionally unlucky”, an inquest into her death has heard.

Chloe Nikitas, who was diagnosed with grade two invasive ductal carcinoma in 2002, would never have agreed to the procedure, carried out by disgraced surgeon Paterson at the Little Aston Hospital, 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 in Birmingham on Tuesday.

The inquest into the death of Ms Nikitas, 43, at the Priory Hospital in April 2008, is the first of 62 that are scheduled to be heard at Birmingham and Solihull Coroner’s Court over the next eight months touching on the deaths of former patients of Paterson.

Paterson is serving a 20-year custodial term after being convicted of multiple counts of wounding in 2017.

Mr Strohle told the court no other surgical options were offered to Ms Nikitas, an environmental consultant from Tamworth, and they assumed the “cleavage-sparing mastectomy” on her left breast was the “best course of action” as it was touted as a “pioneering” surgery.

After undergoing the mastectomy, reconstructive surgery and chemotherapy and radiotherapy, Ms Nikitas discovered a lump in the same breast in April 2005 and was initially told there was nothing to worry about until a PET scan in October that year revealed grade two ductal breast cancer – the same cancer as before.

Mr Strohle said they were aware that 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.”

When Ms Nikitas was first diagnosed with breast cancer in 2002 after noticing discomfort, Mr Strohle, a company director, said they saw Paterson on June 25 and discussed the cleavage-sparing mastectomy.

He said: “When you get a diagnosis of cancer, it is pretty harrowing. It was very difficult.

“Mr Paterson mentioned a cleavage-sparing mastectomy and we saw it as a positive.

“He explained what it was, he said it would leave skin behind so it would look normal and would be barely noticeable.

“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. We assumed it was a new methodology for treating breast cancer. We were given no other options for surgery.

“You trust doctors and that they are going to do the best thing for you – they are the experts in their field.

“We were sure everything was done in a multi-disciplinary fashion and that there were many eyes on Chloe’s case, so why would we question it?

“We assumed this was the best course of action.”

After her surgery and reconstruction in 2002, Ms Nikitas was referred to Dr Tal Latief, consultant oncologist, to arrange chemotherapy.

Giving evidence via video-link at the inquest on Tuesday, Dr Latief, now retired, said 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.

He said he believed from everything he had seen that Paterson was a “good surgeon” and that he was “shocked” when he found out in the media that the breast surgeon was being investigated.

He told the inquest: “I was really shocked, because I had never heard about a cleavage-sparing mastectomy. No one ever mentioned it to me or did it. I had never heard about it.

“(Paterson) never mentioned it to me in his correspondence or discussions, he only referred to mastectomy, so I treated patients as having had mastectomies. I had no reason to doubt it.”

Paterson is expected to give evidence remotely later on Tuesday afternoon.

The inquest continues.