A woman has claimed she was "conned" into having an unnecessary mastectomy by a surgeon after he advised her it would avoid "full-blown breast cancer", a court has heard.

Frances Perks described the period after Ian Patterson carried out the surgery as "horrendous" and "painful".

Ms Perks said: "I was advised by Mr Paterson it would be in my best interest to have a double mastectomy and there seemed to be an urgency to have it before the end of the year because they didn't want me to end up with full-blown breast cancer."

Breaking down in the witness box of Nottingham Crown Court on Friday, she claimed to jurors: "I was conned by Mr Paterson that I was high risk."

She described how there was a tragic family history of breast cancer, with the disease claiming her mother's life in the 1990s and that of her older sister who was just 40 when she died.

Ms Perks said: "Mr Paterson played quite heavily on the family history - that I was in a high-risk category."

She first went to see Paterson as a private patient in 1994, then aged 35, following a referral from her GP.

She said: "I found him very nice. He said he would be straight with me and if there was anything that he found, he would be honest and truthful.

"I started seeing him on a regular basis, every three or six months, with a yearly mammogram and an ultrasound every six months."

Paterson removed several lumps from her breasts over the years in operations at Spire Little Aston Hospital, Sutton Coldfield, Birmingham.

She had one such operation in July 2008 which prosecutors have alleged was unnecessary.

On a later occasion in October 2008, her right breast was cut into 27 times to take biopsies, which the Crown has again alleged was an entirely unjustified procedure.

It was immediately after that operation she claimed Paterson recommended "a double mastectomy".

She said Paterson told her the left breast was "becoming unstable" because of the many procedures and it would be "wise" to have a mastectomy.

As she dabbed tears from her eyes, addressing the jurors, she described her feelings at the time.

Ms Perks, of Burntwood, Staffordshire, said: "I was upset. The way it was discussed I was frightened because I didn't want to get full-blown breast cancer."

"It wasn't something that I particularly wanted.

"But I felt very frightened."

In the event, she had a single mastectomy after insurers declined to cover reconstructive surgery on the right breast because its removal was classed as preventative.

Complications resulting from that operation on November 15 2008 meant she needed a further final operation by a different surgical team in 2012.

Under cross-examination, Ms Perks told jurors she was tested by a genetics lab after her mastectomy.

She said: "As it turned out, I am no higher risk than anybody else walking the streets."

When Paterson's barrister Nicholas Johnson QC asked if she was suggesting she had been "conned", she replied: "Yes, I have been conned - that I was high risk. And that my family were a high risk.

"Yes, I was conned by Mr Paterson that I was high risk."

Paterson, 59, of Castle Mill Lane, Ashley, Altrincham, Greater Manchester, is expected to claim none of the operations were unnecessary or unjustified when his defence begins sometime next week.

He denies 20 counts of wounding with intent, relating to procedures carried out between 1997 and 2011.

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