Claire Cook's sons Samuel, 10, and Joshua, 9, hugged their mum more than usual this week.
"They know they won't be able to hug me very hard for a while," the 36-year-old says.
The day before Mrs Cook went into hospital on Tuesday for her double mastectomy and breast reconstruction, the family celebrated Samuel's birthday.
"He was riding the high of his birthday and just when I put him to bed, he got upset and said I'm going to miss you," Mrs Cook said.
It was to be the first time her sons had spent more than a night away from her, but she hopes this short-lived upset means she will be around longer.
Mrs Cook's mother Gail Neil died 18 months ago after a seven-year battle with breast cancer. Her grandmother was diagnosed with the disease at 34 and died of radiation poisoning.
Every year Mrs Cook had checks at Royal Perth Hospital's high-risk breast clinic and endured the anxiety of wondering if, this time, she had it.
Then in April, Mrs Cook and husband Jonathan endured a torturous overnight wait after a routine ultrasound showed a "shadowy mass". The results thankfully showed no cancer but the scare prompted her life-changing decision.
The day before her operation, Mrs Cook says she feels anxious and, strangely some might think, excited.
"It's strange because I know this is a massive operation, a massive recovery," she said. "There's a little bit of excitement, for want of a better word.
"I realise I'm luckier than so many other people, including my mum, because they have this surgery and then go straight to chemotherapy."
About 7am the next day, Mrs Cook is teary as she is wheeled into surgery and her decision is to be realised.
Surgeons Christobel Saunders and Mark Lee and anaesthetist Jenni Morgan and their team are ready for the 3½-hour operation.
After Professor Saunders removes one breast and its risk of cancer, Mr Lee begins a reconstruction as she moves to the other side.
Mr Lee developed the scarless latissimus dorsi technique two years ago and has used it about 50 times.
He uses the incision to remove the breast to reach the back muscle, dissects a 20cm piece and pulls it to the front to cover an implant.
It looks awkward and difficult as Mr Lee frees the muscle, but the method cuts 90 minutes of surgery time.
In traditional reconstructions using this muscle, the patient is turned over after her breasts are removed and two long incisions made to dissect the muscle.
"It's a pretty big step to take but some of these girls have a 90 per cent lifetime risk of getting it," Mr Lee says. "It's a sword hanging over their heads.
"Essentially they go to sleep with two breasts and wake up with two nice breasts. It can make the decision easier."
He stitches the skin back in a way to create a "nipple" tattooed with pink ink later.
An anxious Mr Cook is relieved to hear the operation is finished and after two hours in recovery, his wife is wheeled to her room where he had waited for an emotional reunion.
"I feel like I've got a brick on my chest, but it's worth it," she says drowsily.
Looking at a photo of her late mother, she says: "I'd sum it up like this, my mum is my inspiration and my boys are my motivation."
A day later, Mrs Cook needed a blood transfusion because her cell count and blood pressure were low.
Her recovery will be long and painful, even after a week in hospital, and she will not be able to lift anything heavier than a loaf of bread for six weeks.
But on Friday Mrs Cook told how her anxiety of having a high risk of breast cancer lifted as soon as she woke after the surgery. "I thought that's it. We're done. I'm not going to die of breast cancer."