Breast cancer patients in north-east England have been left reeling after revelations of unnecessary mastectomies, delayed diagnoses, and a glaring lack of compassionate care at the County Durham and Darlington Foundation Trust (CDDFT). According to reporting by the BBC, more than 200 cases are now under investigation at CDDFT, with 43 involving significant harm and at least one death being closely examined. The scope of the review is vast: medical records for nearly 1,600 patients treated since 2023 are being scrutinized for evidence of substandard care in the trust’s breast cancer service.
Women who underwent treatment at CDDFT have spoken out, describing their experiences as traumatic and, in some cases, feeling "butchered" by hasty surgeries. A leading expert has gone so far as to call the situation "a textbook example of how not to carry out breast cancer management." These damning assessments come alongside the publication of an independent review by governance specialist Mary Aubrey, which lays bare a catalogue of failures dating back over a decade.
The Aubrey review, released this week, highlights a series of critical shortcomings. Outdated clinical practices failed to meet national best practice guidelines, resulting in delayed diagnoses and, at times, missed cancers. The review also found a high rate of "re-excision"—meaning repeated procedures for the same patient—and a strikingly low uptake of immediate breast reconstruction following mastectomy. Operations were sometimes performed at a speed that raised red flags, and the outsourcing of many patient appointments to private clinics created what the review described as a "conflict of interests" that posed risks to clinical standards.
Persistent concerns about the trust’s breast cancer service have been raised since 2012, when CDDFT lost its status as a training centre for breast surgery. Yet, according to the review, the trust "failed to act on repeated warnings and evidence... which allowed unsafe and outdated practices to persist." The trust, for its part, has issued a public apology to "women and their families who have been harmed because of our substandard care," admitting that "over many years, warning signs were repeatedly missed or not acted upon."
The personal stories behind these statistics are harrowing. Kate Driver, a 31-year-old from Chester-le-Street, discovered a lump in her right breast just before Christmas 2023. She was referred by her GP to CDDFT for a specialist appointment, which took place at a private clinic run by Spire Hospital in Washington. There, she was seen by Mr. Amir Bhatti, the trust's clinical lead for breast surgery. Bhatti performed a fine needle aspiration (FNA) test, a method not considered best practice for breast biopsies due to its risk of producing inadequate samples. Kate’s results, which should have come within 48 hours, were inconclusive, and she waited weeks before finally learning she had cancer.
"Waiting so long and having to chase everything up made it a hundred times worse than it needed to be," Kate told the BBC. "I couldn't eat, I couldn't sleep. It just made it felt like no-one really cared, no-one was taking it seriously." The ordeal didn’t end there. Kate was told she would need a mastectomy and was advised against immediate breast reconstruction. Seeking a second opinion at another trust in Newcastle, she learned there was no medical reason to delay reconstruction and chose to transfer her care. CDDFT later apologized to Kate, admitting her care "fell below acceptable standards."
Kate’s experience is far from unique. Research from 2024 shows that nearly half of women diagnosed with breast cancer at CDDFT underwent mastectomies, compared to a UK average of about 27% in 2022. Even more troubling, only 7.5% of mastectomies at CDDFT were followed by immediate breast reconstruction—well below the nationally recommended minimum of 25%.
Dawn Gillott, another patient under investigation, echoed these concerns. "I felt like I didn't have a choice. It was 'you're having this and that's all there is to it'," she said. Dawn was left with a massive scar and persistent pain, wondering if her mastectomy was truly necessary. "Maybe it wasn't. Maybe I could have had a lumpectomy," she reflected.
The independent reviews also shed light on the financial arrangements underpinning the trust’s breast cancer service. Between 2019 and April 2025, CDDFT paid nearly £6 million to private clinics run by Mr. Bhatti, who was also a director of one of the companies behind these clinics, Durham Surgical Services. These clinics operated largely out-of-hours, with patients seen in the evenings and on weekends. The Royal College of Surgeons (RCS) found that the clinics were paid on a per-patient or per-appointment basis—a structure that some staff described as "overly generous" and which created incentives for high patient turnover. The RCS report noted that it was not unusual for clinics to run until 11:30 p.m.
"Obviously there was an incentive to see as many people as possible because of the per capita payment," remarked Professor Ian Fentiman, emeritus professor of surgical oncology at King's College London. The RCS review also raised concerns about the speed of some surgeries, documenting cases where a mastectomy and lymph node procedure were completed in just 28 minutes, and an excision of benign tissue in 10 minutes—procedures the review team considered unnecessarily rushed.
Beyond the numbers, patients described a lack of compassion in their care. Catriona McEvoy from Stanley, County Durham, said she felt women were treated "like a conveyor belt." She recalled a doctor cutting her breast to drain an infection without so much as a word, pain relief, or her consent: "There was no dignity in any of it." The trust has since placed this doctor under supervision.
The RCS review was blunt in its assessment, calling the service "an appalling indictment" of "third-rate" breast care. "In every way, things were being done wrongly," said Prof. Fentiman. These findings followed earlier internal reports—including a 2019 NHS Getting It Right First Time (GIRFT) report and a 2024 Northern Cancer Alliance review—that highlighted similar concerns, but these were not made public until a Freedom of Information request by the BBC.
Steve Russell, who became chief executive of CDDFT in September 2025, has publicly expressed regret and a commitment to change. "The important thing to do... is to say how deeply sorry I am, that women who have been cared for in our breast services have been let down by us," he said. "It is true to say that there were a number of missed opportunities. It was not good enough and it is not good enough that we were too slow to act on the information that was there. I'm determined to make changes so that it doesn't happen again."
Mr. Bhatti, who is no longer clinical lead or performing surgeries while investigations continue, has disputed some findings of the RCS report, stating it contained "some factual inaccuracies" and "erroneous conclusions." He maintains, "serving the best interests of all our patients is of paramount importance" and that when mistakes are made, "we learn from this and make the necessary changes and improvements." His spokesperson added that he has been raising concerns about equipment adequacy since May 2021.
As NHS England pledges to support the trust’s new leadership in making overdue improvements, the stories of those affected serve as a stark reminder of the human cost of systemic failures in healthcare. For many women in County Durham and Darlington, the scars—both physical and emotional—are a lasting testament to a system that, for far too long, failed to listen.
