Paterson medics did not spot breast tissue, inquest hears

The inquest also heard evidence from radiologist Dr Arpan Banerjee, who previously worked both at Heartlands Hospital in Birmingham and also privately.

He did an ultrasound on Ms Nikitas in April 2005 when she discovered a new lump under her left arm.

He said he detected a “tiny lump” in her armpit during a “very thorough ultrasound examination” but it did not worry him at the time.

When asked by counsel to the inquest Jonathan Jones whether the scan would have identified breast tissue, Dr Banerjee said the back tissue used for her reconstruction made it impossible to tell.

“If there is fat that has been left behind following a mastectomy, there is no way one can distinguish one from the other,” he said.

“Also, when you examine a reconstructed breast following a mastectomy you’re not expecting to find left-behind breast tissue,” he added.

He told Mr Jones it would have been Paterson’s job to decide whether to investigate the node further.

“When the node is that small you cannot detect it with certainty and that is the difficulty,” he said.

“Back then teaching was, usually if a node is under a centimetre and there is no abnormal shape it would be acceptable to follow it up.”

The court heard on Tuesday a biopsy six months later found a Grade 2 ductal cancer, the same grade as Ms Nikitas’s original cancer.

She died at the Priory Hospital in Edgbaston in 2008.