County Durham Breast Cancer Claims: Unnecessary Mastectomy and Treatment Failings

Thousands of women who received breast cancer treatment through County Durham and Darlington NHS Foundation Trust could have their care examined following serious concerns about the standard of breast surgery and treatment provided by the Trust.

The scale of the review is considerable.

The Trust has extended its investigation into breast surgery services, potentially examining the treatment of thousands of women dating back to 2015. Full information for patients is available through the County Durham and Darlington NHS Foundation Trust Breast Surgery Services Review.

Of the cases already examined, hundreds of women have reportedly been identified as having suffered some degree of harm. Particularly concerning are findings involving unnecessary or excessive surgery, delayed diagnosis and treatment which may not have been in accordance with accepted clinical practice.

It has also been reported that 20 women underwent mastectomies which were subsequently considered unnecessary.

For the women concerned, this is far more than an administrative NHS review. An unnecessary mastectomy can cause permanent physical injury, scarring, psychological trauma and, in some circumstances, the need for further reconstructive surgery.

Patients whose treatment is now being questioned may understandably want to know what happened to them – and whether they are entitled to compensation through a medical negligence claim.

What has happened at County Durham and Darlington NHS Foundation Trust?

Concerns about the Trust’s breast services led to a review of breast cancer care initially concentrating upon treatment provided between January 2023 and February 2025.

The Trust has since decided to widen its investigation substantially.

Its proposed look-back programme will move backwards through earlier years, potentially reaching patients treated as far back as 2015.

The emerging findings are concerning because they do not relate to one single type of alleged error. Issues identified in cases reviewed so far have included:

• unnecessary or excessive breast surgery;
• mastectomy when less extensive surgery may have been appropriate;
• delayed diagnosis of breast cancer;
• concerns over whether treatment followed accepted practice;
• issues concerning reconstructive surgery;
• inadequate consideration of alternative treatment options; and
• wider concerns surrounding clinical decision-making and governance.

This does not mean that every woman treated by the Trust during the relevant period received negligent treatment. Nor does inclusion within the review automatically establish a legal entitlement to compensation.

Each patient’s treatment and outcome must be considered individually.

20 Women Reportedly Underwent Unnecessary Mastectomies

Perhaps the most disturbing finding to emerge from the review concerns women who underwent mastectomy unnecessarily.

A mastectomy is a major operation involving removal of breast tissue. There are circumstances in which it is an entirely appropriate and potentially life-saving treatment for breast cancer.

As the NHS explains in its guidance on breast cancer treatment, surgery may involve either removing the cancerous area of the breast through breast-conserving surgery or removing the whole breast by mastectomy. The appropriate treatment depends upon factors including the size and spread of the cancer.

The issue is therefore not whether mastectomy itself represents poor treatment. Plainly, in many cases it does not.

The important question is whether, given the individual woman’s diagnosis, pathology, tumour characteristics and other relevant circumstances, removal of the breast was clinically necessary and whether appropriate alternatives were properly considered and discussed.

NICE guidance on early and locally advanced breast cancer demonstrates the importance of individualised decision-making. Depending upon the type and extent of disease, breast-conserving surgery may sometimes be appropriate, while decisions about further surgery should take account of tumour margins, tumour characteristics, potential alternative treatments and the patient’s own circumstances, needs and preferences.

Where a patient has undergone irreversible surgery which a reasonably competent breast cancer team would not have recommended, there may be grounds for investigating a clinical negligence claim.

What Is an Unnecessary Mastectomy Compensation Claim?

A successful medical negligence claim normally requires evidence establishing two fundamental issues.

First, it must be shown that the treatment fell below the standard reasonably expected from the treating clinicians. This is commonly referred to as breach of duty.

Secondly, it must be established that the negligent treatment caused injury or loss which would probably have been avoided had appropriate treatment been provided. This is causation.

An adverse outcome alone does not establish negligence.

However, where an independent breast cancer expert concludes that a mastectomy should not have been performed and that an appropriate alternative would probably have preserved the breast, the consequences can potentially form an important part of a compensation claim.

Further information about the principles applying to these cases can be found in our guide to cancer misdiagnosis compensation claims.

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What Could Compensation Cover Following an Unnecessary Mastectomy?

Compensation is intended, so far as money can reasonably achieve it, to place an injured patient into the position she would have been in had the negligence not occurred.

Every case is different, but an unnecessary mastectomy claim could potentially include compensation for:

Physical injury and pain

This may include the operation itself, post-operative pain, permanent scarring, altered sensation and continuing symptoms.

Psychological injury

The psychological consequences of unnecessarily losing a breast can be substantial. Where appropriate, evidence may be obtained from an independent psychiatrist or psychologist.

Breast reconstruction

A claim may include the reasonable cost of future reconstructive treatment where this is clinically appropriate.

Further surgery and treatment

Some patients may require revision surgery, corrective procedures, treatment of complications or further reconstructive work.

Loss of earnings

Time away from employment and any longer-term reduction in earning capacity may potentially be recovered where caused by the negligent treatment.

Care and assistance

Help provided by partners, relatives or friends during recovery can sometimes form part of a damages claim.

Travel and other expenses

Reasonable additional expenditure caused by the injury may also be recoverable.

The appropriate heads of loss will depend upon what actually happened to the individual patient.

Breast Reconstruction Should Form Part of the Investigation

Another potentially important issue concerns women who were not offered appropriate reconstructive options.

Current NICE breast reconstruction guidance states that breast reconstruction should be offered after mastectomy for breast cancer.

Women should be offered information about immediate and delayed reconstruction options, with the benefits and risks discussed. NICE also recommends immediate reconstruction for women advised to undergo mastectomy, including those who may subsequently require radiotherapy, unless relevant comorbidities rule out reconstructive surgery.

Whether historical treatment was negligent will, however, depend upon the guidance and reasonable clinical practice applicable at the time the individual patient was treated. Current guidance cannot simply be applied retrospectively to every historical case.

Nevertheless, where a woman was never properly informed about reconstruction, or an appropriate reconstructive procedure was not offered, this may require careful investigation.

Delayed Breast Cancer Diagnosis May Result in a Different Type of Claim

The review has also identified cases involving delayed diagnosis.

These claims can be very different from unnecessary surgery cases.

The central question may become: what would probably have happened if the cancer had been diagnosed and treated at the correct time?

A delay may potentially result in:

• the cancer becoming larger;
• progression to lymph nodes or other tissue;
• the need for more extensive surgery;
• loss of the opportunity for breast-conserving surgery;
• additional chemotherapy or radiotherapy;
• increased treatment side-effects; or
• in particularly serious circumstances, an adverse effect upon prognosis or life expectancy.

Establishing this requires expert medical evidence. A delay in diagnosis does not automatically establish that the patient’s eventual outcome was caused by negligence.

We explain these issues in considerably more detail on our specialist page about delayed cancer diagnosis compensation claims, which specifically includes delayed breast cancer diagnosis.

Do I Have to Wait for the NHS Review Before Speaking to a Solicitor?

No.

A patient does not ordinarily have to wait until the Trust completes its internal review before obtaining independent legal advice.

This could be particularly important given the proposed timescale of the look-back exercise.

There is an important distinction between an NHS investigation and a clinical negligence claim.

The Trust’s review is intended to examine the treatment provided, identify patients who may have suffered harm and establish what went wrong.

A compensation claim is a separate legal process.

Patients concerned about their treatment can therefore seek independent advice rather than assuming that they must wait for the Trust to contact them.

Time Limits for Breast Cancer Negligence Claims

This point is particularly important for women whose treatment took place several years ago.

Clinical negligence claims in England and Wales are generally subject to a three-year limitation period.

Broadly, the three years may run from the date on which the negligence occurred or from the patient’s later date of knowledge of the material facts necessary to bring the claim.

The rules are more complicated in some circumstances. Different provisions apply to children and people who lack the relevant mental capacity, and the court has discretion in certain cases to permit a claim to proceed outside the normal limitation period.

Women should therefore not assume that participation in the Trust’s review automatically stops the legal limitation period from running.

Anyone concerned about treatment received several years ago should obtain individual legal advice about limitation as soon as reasonably possible.

What Should I Do If My Breast Cancer Treatment Is Being Reviewed?

If you have been contacted by County Durham and Darlington NHS Foundation Trust, or believe that your treatment may fall within the period now being examined, it is sensible to retain relevant documentation.

This may include:

• correspondence from the Trust;
• clinic letters;
• pathology reports;
• mammograms and other imaging reports;
• operation records;
• consent documentation;
• details of chemotherapy or radiotherapy;
• reconstructive surgery records; and
• subsequent correspondence concerning the review.

Patients should not worry if they do not possess a complete set of their medical records. These can ordinarily be obtained as part of the investigation of a potential claim.

The crucial question is not simply whether your treatment is included within the review.

It is whether the treatment you personally received fell below a reasonable standard of care and caused you avoidable injury or loss.

Can I Claim If I Had Unnecessary Breast Cancer Surgery?

Potentially, yes.

Examples which may justify investigation include circumstances where:

• a mastectomy was performed when breast-conserving surgery should reasonably have been offered;
• surgery was substantially more extensive than clinically necessary;
• appropriate treatment alternatives were not properly considered or discussed;
• breast cancer was diagnosed late and this resulted in more extensive treatment;
• reconstruction was not appropriately discussed or offered;
• an incorrect assessment of pathology or imaging resulted in unnecessary treatment; or
• failures in multidisciplinary decision-making caused avoidable harm.

Whether any of these amounts to negligence requires assessment of the individual medical evidence.

Specialist Breast Cancer Medical Negligence Solicitors

At R James Hutcheon Solicitors, we act for patients and families in medical negligence cases, including claims involving cancer diagnosis and treatment.

Breast cancer cases can involve difficult questions concerning pathology, radiology, breast surgery, oncology, reconstruction and causation. The fact that an NHS Trust has identified failings is important evidence, but it does not replace the need to investigate what happened to the individual patient.

Where appropriate, medical records can be obtained and reviewed and evidence sought from independent medical experts.

Our existing information on cancer misdiagnosis claims and delayed cancer diagnosis compensation explains how these claims are investigated.

If you received breast cancer treatment from County Durham and Darlington NHS Foundation Trust and have been told that your treatment is being reviewed – or you are concerned that you underwent unnecessary surgery or experienced a delayed diagnosis – contact R James Hutcheon Solicitors for an initial discussion about what happened.