NHS Trust Expands Review of Cancer Cases Amid Unnecessary Mastectomy Allegations

An NHS trust has agreed to review up to 4,500 more cancer cases after admitting that women underwent unnecessary mastectomies. The County Durham and Darlington NHS Foundation Trust (CDDFT) will expand its investigation into its breast unit, which has been described as dysfunctional.

Victims have reported being subjected to agonizing pain due to surgeries they did not need, with at least 20 women confirmed to have had mastectomies unnecessarily. The trust's 'lookback review,' which began in April of the previous year and initially covered patients treated between January 2023 and February 2025, will now extend its examination of breast cancer cases back to 2015. This expanded review is expected to take five years to complete.

So far, the review has examined 538 cases, identifying 321 patients who experienced harm, including one fatality. The decision to broaden the scope of the review was made during an extraordinary meeting of the trust's board. Board chair Alison Marshall issued a sincere apology to all affected women and their families, acknowledging the profound impact of the failings in breast services.

Concerns within the trust's breast services were initially raised in 2015 following a service reconfiguration and the discontinuation of breast surgical trainee posts. Over subsequent years, patients and various health bodies, including the Northern Cancer Alliance, Care Quality Commission, and NHS England, reported multiple issues. These concerns included treatments not aligning with best practices, excessive surgeries, and delayed diagnoses.

Approximately 640 patients have contacted a dedicated helpline to request a review of their cases. The initial phase of the review, costing £523,000 in its first year, involved nine reviewers examining around 80 cases monthly. The expanded review aims to provide a proportionate and evidence-led clinical approach in response to emerging findings, with decisions supported by clear clinical rationale and formal governance.

The National Crime Agency and Durham Police are investigating allegations from former patients to determine if any criminal offenses have occurred. Consultant surgeon Amir Bhatti, who served as CDDFT's clinical lead for breast services from 2013 to 2024, has been suspended from clinical practice pending an internal investigation, although he remains employed by the trust on full pay. The trust paid nearly £6 million over six years for breast cancer diagnostic clinics and surgery companies privately run by Mr. Bhatti, a situation acknowledged as a conflict of interest.

A 2025 review by governance specialist Mary Aubrey highlighted concerns about financial incentives for Mr. Bhatti's firms to treat more NHS patients on a per-case basis, potentially compromising clinical standards. Consultants reportedly performed more operations and consultations per session when acting privately compared to their NHS duties. Further concerns were raised in a report by the Royal College of Surgeons regarding inadequate discussion of breast cancer cases in multidisciplinary team meetings, leading to surgeons having significant autonomy. The trust also exhibited a high rate of repeated procedures and a low uptake of immediate breast reconstruction post-mastectomy.

Mr. Bhatti has denied performing unnecessary mastectomies, attributing the situation to the NHS's payment of £6 million to his private clinics over six years. He declined to apologize to patients who described being 'mutilated' under his care, stating that unnecessary breast removal is not something anyone would do. He has stated that he cannot comment further due to ongoing investigations.

Chief executive Steve Russell acknowledged the distress, uncertainty, and harm experienced by women and their families. He stated that while apologies cannot undo the past, the trust is committed to supporting affected individuals. Options such as breast reconstruction surgery may be offered to women who underwent unnecessary mastectomies. Russell also noted that the trust is currently exceeding national standards for breast cancer treatment, including breast conservation surgeries and immediate reconstruction offerings. He expressed confidence that changes implemented within the service have improved outcomes and that patients today can expect appropriate treatment and good clinical results. The dedicated helpline remains open for any concerned patients to contact, regardless of when they received treatment.