Unnecessary Mastectomies in County Durham: What the NHS Review Found

Twenty women had their breasts removed unnecessarily while being treated for cancer at County Durham and Darlington NHS Foundation Trust. The Guardian

Of 514 cases reviewed by the trust so far, 315 patients were found to have suffered harm, including 77 who were significantly harmed. The Guardian One patient treated at the breast unit is known to have died.

The trust said the 20 women were among hundreds of patients who came to harm during treatment at its breast unit. Chief executive Steve Russell leads the organisation conducting the look-back. The review covers breast cancer cases between January 2023 and February 2025. It also covers 640 former patients who contacted a special helpline.

The trust board will meet in public on September 24 to consider the future scope and timeframe of the review. A decision is imminent on whether to extend that review to cases dating back to 2015. BBC Extension could mean re-opening up to 10,000 medical records.

Denise Howarth, 51, of Consett, County Durham, was diagnosed with stage one cancer in her left breast in February 2023 and later told her mastectomy had not been needed. A lumpectomy removes only the tumour and nearby tissue, while a mastectomy removes the whole breast. She first underwent a lumpectomy, then a mastectomy, as well as eight rounds of chemotherapy and radiotherapy. In September 2025 the trust told her she could have been offered a second lumpectomy rather than full breast removal, an option never discussed with her.

Jo, a former NHS worker using a pseudonym, underwent a mastectomy in 2021 and contacted the trust's helpline about it. She was told in a phone call earlier this year that her mastectomy could have been avoided. Her care, like Howarth's, was overseen by Mr Amir Bhatti, who was the trust's clinical lead for breast services from 2013 to 2024.

Bhatti has been suspended from carrying out clinical practice but remains employed by County Durham and Darlington Foundation Trust on full pay. BBC Over six years the trust paid nearly £6m to breast cancer diagnostic clinics and surgery companies run privately by Bhatti.

Russell has apologised unreservedly for harm caused by the trust's breast unit. The trust has also identified cases where cancer diagnoses were missed or delayed. Some patients whose cancer diagnoses were missed or delayed subsequently saw their cancer spread.

In its official update titled "A further update on breast service improvements, patient reviews and ongoing support," the trust said it is "deeply sorry for the distress and harm that has been caused" and said the harm has had a "profound impact on women and their loved ones." CDDFT The update was published on the trust's own website on 24 February 2026.

The National Crime Agency is working with Durham police to investigate allegations by former patients and determine if any criminal offences took place. That parallel process sits alongside the clinical review. The threshold is distinct. Clinical harm does not equal criminal liability.

The broader context here is scope. A review confined to January 2023 to February 2025 already found harm in more than six in ten cases examined. A move back to 2015 would multiply the caseload. It would test the trust's capacity to maintain consistent standards for harm grading, duty of candour — the duty to be open with patients about mistakes — and follow-up care.

The broader context for surgery decisions is accountability. Unnecessary mastectomy is a grave outcome. It involves consent, input from a multidisciplinary team of surgeons and other specialists, pathology and radiology concordance, meaning lab and scan results point the same way, and documentation of alternatives such as repeat breast-conserving surgery. The detail that a second lumpectomy was available but not discussed will draw close attention. So will missed or delayed diagnoses that allowed spread.

In my view, the third question is structural. The verified facts establish large payments from a public trust to private entities controlled by its own clinical lead, alongside a pattern of harm under that lead's oversight. They do not establish a causal link. Investigators and regulators will need to separate commissioning decisions, conflict-of-interest controls and clinical audit trails. The September 24 public board meeting is the next procedural marker. It will set whether the look-back widens and how support for affected women and families is organised.