A major breast cancer review in County Durham is being expanded to examine up to 4,500 additional cases after hundreds of patients were found to have suffered harm from failings in breast cancer services.
The County Durham and Darlington NHS Foundation Trust agreed to extend its review after investigations identified problems including delayed diagnoses, treatment that did not follow best practice and unnecessary surgery. The review will now examine cases dating back to 2015.
Breast Cancer Review Finds Harm in Hundreds of Cases
The trust’s existing breast cancer review began in April 2025 and initially covered patients treated between January 2023 and February 2025. Chief nurse Gill Hunt told an extraordinary board meeting in Durham that 538 cases had been examined so far.
Of those cases, 321 patients had experienced some form of harm, including one death. Around 640 patients had also contacted a dedicated helpline seeking a review of their treatment.
The breast cancer review has so far involved nine reviewers assessing about 80 cases each month. The work cost approximately £523,000 during its first year, according to a report presented to the board.
Hunt said concerns about the service were first raised in 2015 following a service reconfiguration and the loss of breast surgical trainee posts. In the years that followed, patients and organisations including the Northern Cancer Alliance, the Care Quality Commission and NHS England raised further concerns.
The issues identified included treatment that was not aligned with best practice, excessive surgery and delays in diagnosing cancer.
NHS Trust Apologises for Breast Cancer Failings
Before agreeing to expand the breast cancer review, trust board members offered apologies to patients and their families for the harm caused.
Board chair Alison Marshall said: “I would like to offer a sincere apology to all the women and their families who have been affected by the failings in our breast services. I can’t imagine the impact that has had.”
Marshall said the trust could not reverse what had happened but promised it would be “open, honest and transparent” about the failings.
The expanded review will be extended one year at a time, going back to 2015. The process could cover as many as 4,500 further cases and is expected to take about five years to complete.
Hunt said the expanded investigation would provide a “proportionate and evidence-led clinical approach” based on the findings emerging from the review. She added that decisions would be backed by clinical reasoning and formal governance processes.
She also highlighted lessons about how NHS leaders should respond when patients or other organisations raise concerns about care.
Unnecessary Mastectomy Patients Offered Support
Chief executive Steve Russell said the trust was “incredibly conscious” that women and their families had experienced “distress, uncertainty and harm”. He said the organisation would support affected women as much as possible, while acknowledging that an apology could not undo what had happened.
Some women who underwent unnecessary mastectomies could be offered breast reconstruction surgery, Russell said, noting that they should previously have been offered that option.
Russell also said the trust is now exceeding national standards in several areas of breast cancer treatment, including the number of women receiving breast-conserving surgery and those being offered immediate reconstruction.
“None of that changes what has happened to women in the past but hopefully gives confidence the changes made in the service have had an impact on the outcomes,” he said.
He added that patients receiving care today could be “confident” they would be “treated appropriately” and achieve “good clinical outcomes”.
Patients Call for Wider Breast Cancer Investigation
Denise Howarth, a 51-year-old from Consett in County Durham, attended the board meeting after experiencing an unnecessary mastectomy. She said she was pleased that the breast cancer review would be extended because more cases could still emerge.
However, Howarth said patients whose historical cases are examined should be contacted with “dignity” and “compassion”. She warned that being told their treatment was being reviewed because of possible failings could cause further shock and pain.
Howarth also called for a public inquiry and said the trust should examine cases dating back further than 2015 because her own treatment took place in 2012.
The trust’s helpline will remain available by phone and email. Russell said patients with concerns are encouraged to contact the service regardless of when they received treatment.