29/03/2017 13:14 BST | Updated 29/03/2017 21:27 BST

Breast Op Doctor Denies Telling Patient She Had Cancer 'Ticking Time Bomb'

A surgeon accused of carrying out unnecessary operations has denied telling a patient she risked a "ticking time bomb" of cancer in her breast, a court has heard.

Ian Paterson, who prosecutors have alleged wrongly carried out a mastectomy on Patricia Welch, said biopsies had uncovered "four risk factors" of the disease.

But the 59-year-old surgeon, giving evidence in his defence at Nottingham Crown Court on Wednesday, said: "This is where Mrs Welch said the ticking time bomb analogy.

"I've never used that analogy in my life, it is a frightening analogy."

He is standing trial after denying 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".

Other alleged victims have included a mother who is said to have agreed to two "unnecessary operations" leaving her unable to breastfeed and a woman who had a "significant deformity in her visible cleavage area" after a pair of unneeded operations on her left breast, the court heard.

At the time of the operation Mrs Welch, then 48, was undergoing six-monthly check-ups at the Little Aston Hospital, West Midlands, after being told pre-cancerous cells had been found.

Paterson said he had given Mrs Welch and her husband Michael Welch all the options, ranging from continuing surveillance of the left breast to a double mastectomy.

Following a biopsy earlier in 2001, he said the pathology report was clear, adding it "gave us four risk factors in her breast".

He added: "So now, she has four cancer markers in her left breast."

Continuing his testimony, he told jurors that after the successful mastectomy in May 2001, tests on the removed tissue had revealed Mrs Welch had one "unstable breast", while the other seemed unaffected.

The surgeon said: "It's an unstable breast, it had a variety of rick factors and the conclusion of the pathological specimen is there's a background of breast disease.

"This whole breast is active.

"It's interesting to then compare it to the other information from the other breast - which is completely silent."

Paterson described the decision to remove a benign lump of fatty tissue from another alleged victim, retired landlady Carole Johnson in 2002, as "entirely appropriate" and the "patient's choice".

He said: "Well it's (the lump) bigger, she's concerned about it. It's entirely benign. She wants it removed.

"Patient's choice is a correct and valid reason for removing a lump from a breast."

"It was entirely appropriate to accede to her wishes and have it removed," he added.

By 2006, he said Mrs Johnson had had more than 10 appointments with him for several lumps, describing her as a patient "very anxious about her breasts".

In her own evidence, she told jurors she believed cells found in her breast were "borderline cancer" claiming Paterson told her they needed to be "whipped out".

But a mention by Paterson of one such breast cancer marker included in a letter about Mrs Johnson, written after surgery, was an "error", he said.

"It doesn't represent any desire to be misleading, you can re-produce an error easily," he said.

Paterson, of Castle Mill Lane, Ashley, Altrincham, Greater Manchester, was formerly employed by Heart of England NHS Trust and also practised at Spire Healthcare.