Breast cancer patients at an NHS Trust in north-east England endured unnecessary mastectomies, delayed diagnoses, and a lack of compassionate care, according to information obtained by the BBC. The County Durham and Darlington Foundation Trust (CDDFT) is currently investigating over 200 cases, with 43 reported to involve significant harm, and one case resulting in death.
Patients have described feeling "butchered" by their surgeries. A leading expert criticized the situation as "a textbook example of how not to carry out breast cancer management." It has also been uncovered that nearly £6 million was diverted to private clinics operated by the trust’s main breast cancer surgeon.
An independent review of CDDFT, conducted by governance specialist Mary Aubrey, has been published this week. It points out several inadequacies, including:
- Outdated clinical practices failing to meet best practice guidelines, causing delayed diagnoses and missed cancers.
- A high rate of repeat procedures ("re-excision") and a low uptake of immediate breast reconstruction post-mastectomy.
- Operations potentially performed "too quickly."
- Outsourcing many patient appointments in a way that created conflicts of interest and posed risks to clinical standards.
The Aubrey review states that "persistent concerns" were raised since 2012, after the trust lost its training status for breast surgery services. It further criticizes the trust for ignoring repeated warnings and evidence, which allowed unsafe and outdated practices to continue. CDDFT has apologized to "women and their families who have been harmed because of our substandard care," admitting that "warning signs were repeatedly missed or not acted upon."
Kate Driver, a 31-year-old from Chester-le-Street, is one of the affected women. She discovered a lump in her right breast in late 2023 and was referred to the trust for a specialist appointment. Although it was an NHS appointment, it took place at a private clinic at Spire Hospital in Washington, where Mr. Amir Bhatti, the trust's clinical lead for breast surgery, administered a fine needle aspiration (FNA) test. What Kate did not know was that FNA is not recommended for breast biopsies due to risks of inadequate samples and delayed diagnoses.
Her test, which was supposed to be completed within 48 hours, yielded inconclusive results, forcing her to wait weeks for a diagnosis, which turned out to be breast cancer. "Waiting and having to chase everything up made it a hundred times worse than it needed to be," Kate shared, adding that she was left feeling that no one cared or took her situation seriously.
Further complications arose when Kate was informed she needed a mastectomy but was advised against simultaneous breast reconstruction because of her cancer type. "They were going to completely remove my right breast and leave me with nothing, just a big scar," Kate said. She sought a second opinion at another trust in Newcastle and discovered that immediate breast reconstruction was a viable option.