Slipping on a blonde wig, Dan Camilleri, 8, played dress-up as she fitted the auburn toupee on her mother's balding head and carefully used light strokes to apply her make-up.

Her mother was undergoing chemotherapy after removing a malignant tumour from her breast, but all little Danny knew was that her "mummy was sick".

At home it was just Dan and her mother, so she quickly learnt to unravel the bandages covering her mother's scarred breast and put on new dressing, cook and wash the floors after school.

Now 23, Ms Camilleri does not wish to drag her future family through the same ordeal so she has chosen to undergo surgery to remove practically all her breast tissue to reduce her risk of breast cancer by more than 90 per cent.

"Breast cysts and breast cancer feature heavily on both sides of my family - my risk of developing cancer was 80 per cent," she says, in a soft-spoken voice.

The decision was not easy. Having just taken out a home loan with her long-time boyfriend, she needed to get another loan to pay for the surgery that cost nearly €5,500, but nothing could dampen her determination.

She got the green light from the bank a few days ago and her operation - a bilateral subcutaneous mastectomy - is scheduled for Saturday. Ms Camilleri is possibly the youngest woman to undergo such surgery in Malta.

Her green, feline-shaped eyes light up with excitement and there is no hint of fear in her voice: "In a way I wish the operation was tomorrow; I just want to get it over and done with." She decided to share her story with The Sunday Times because she wants women in a similar predicament to be aware of the choices available.

"I want anyone who's in my shoes to know they can do this, because I only learnt about it recently," she says.

It all started about a year ago when she began toying with the idea of reducing her breasts. Slim and tall, Ms Camilleri has a bra size of 32 F, which causes back problems, weighs her down and comes in the way of her dancing routine.

One day, as she tuned in to watch Dr 90210, a reality television series focusing on plastic surgery in Beverly Hills, she stumbled on bilateral subcutaneous mastectomy that was being used as a preventive procedure against breast cancer.

"This woman, in her 40s, kept getting lumps in her breast and she was living in fear of cancer every time she felt something. Her life was on hold until she underwent this procedure. I never knew such an operation was possible - it seemed quite drastic, but it was ingenious," she recalls.

She started browsing the internet and reading up on it, but she never dreamt such an operation was possible in Malta, so she put it at the back of her mind.

However, when she met the plastic surgeon at a private hospital to discuss breast reduction, she mentioned it as an afterthought and was stunned by the reply.

Suddenly everything became possible. She set up an appointment with the bank and once her loan was cleared, she called the hospital and booked her operation.

Unlike total mastectomies, subcutaneous mastectomies preserve the nipple and areola tissue allowing for a better cosmetic outcome. Her breasts will be reduced to a C cup, and implants will replace the breast tissue. "Growing up with big breasts and the self-consciousness it brings with it, you never dream of having implants," she says, laughing at the irony of life.

The procedure, which takes between six to eight hours, will leave her with two anchor-shaped scars, snaking down from her nipple to just under the breast.

However, the scars do not scare her and she puts it down to having been exposed to her mother's wounds at such a young age.

"Some of the photos of reconstructive surgery I've seen on breast cancer patients were horrific.

"If it means eliminating the chance of further interventions in life, then I'd rather go through planned surgery now. I'm very prepared for it, and the scars will fade," she says, pausing to take a sip of fresh orange juice.

Since booking her operation she has stopped smoking and is focusing on her health.

The photos the plastic surgeon showed her of a woman who clandestinely kept smoking despite his warnings to stop before her breast enlargement operation, were enough to make her quit.

Her boyfriend has been understanding throughout and is providing all the moral support, though he admits he is "50 times more scared than Dan".

Ms Camilleri clasps his hand and says: "It would be heartbreaking if my future family had to go through the same experience I did with my mother."

amassa@timesofmalta.com