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As Kayleigh McEnany regained consciousness, blinking awake and feeling groggy from anaesthesia, the phone rang.
'Hello?' she rasped.
The voice on the other end of the line surprised her.
It was Ivanka Trump. She was ringing to offer her best wishes after Kayleigh had undergone major surgery.
'It was within 24 hours of my procedure,' Kayleigh, 36, tells DailyMail.com in an exclusive interview, 'I had literally just woken up and was still in bed.'
A few days later, as she continued her recovery at home, her phone rang again.
This time, it was Donald Trump himself, the then-president. Kayleigh was shocked.
Kayleigh McEnany elected to have a double mastectomy in May 2018 after finding out she, like her mother, had the BRCA2 gene which increases the risk of developing breast cancer.
Donald Trump was a huge support to McEnany throughout the process.
'I was blown away,' she says, 'I was not expecting him to call.'
Back then, in May 2018, despite working for his party – as the national spokesperson for the Republican National Committee – Kayleigh barely knew the president.
But Trump clearly wanted it to be known that she was in his thoughts, telling her: 'You made such a bold decision. Melania and I are proud of you.'
The President's call was not just an act of unexpected kindness, but an acknowledgement of the decade of fear Kayleigh had just endured – concluding with the life-altering decision to have both her breasts surgically removed.
Today, Kayleigh is a familiar face – a former White House press secretary who now co-hosts Fox News's popular weekday show, Outnumbered.
But the story of her dramatic surgery began back in 2009, when Kayleigh was just 20 and her mother, Leanne McEnany, discovered during a routine test that she had the notorious BRCA2 gene mutation.
This increased Leanne's risk of developing breast cancer by up to 84 percent and ovarian cancer by up to 27 percent.
As a result, she decided to have all her breast tissue removed – plus a hysterectomy to eliminate as many risks as possible.
If this was devastating news for Leanne, it was deeply troubling for Kayleigh, who was told by doctors that there was a 50 percent chance she carried the gene, too. Several months later, she got herself tested and – on Christmas Eve – received the devastating confirmation.
'It was earth-shattering,' she recalls. 'My doctor told me, "You've tested positive".'
Kayleigh, who was staying with her parents for the holidays, burst into tears and ran downstairs to tell her family.
As she recovered in hospital with her mother, Leanne McEnany (pictured), she received calls of support from both Ivanka and Donald Trump.
McEnany had found out she had the gene in 2009, but waited almost a decade to have the surgery, until she met her husband, Sean Gilmartin.
She had decided to wait until she met someone because she 'thought that the surgery would be less traumatic if I had a partner in life'.
Her father took her in his arms and told her: 'Kayleigh, we all have a weakness in life, but now you know yours. So, attack it head-on.'
In that moment, she resolved to follow her mother's brave example.
First, though, came an unexpected step. In preparation for the double mastectomy, Kayleigh had breast implant surgery so that, when her breast tissue was removed at a later date, she wouldn't need to undergo immediate reconstructive surgery.
Kayleigh also had to grapple with what the operation meant for her future.
'I wasn't dating at the time,' she says. 'I didn't have a solid boyfriend, and I thought that the surgery would be less traumatic if I had a partner in life.'
So she delayed.
Every six months for the next ten years, she travelled to a specialist cancer center in Florida for check-ups by mammogram or MRI.
As time passed, Kayleigh graduated from Georgetown University, studied at Oxford and went on to Harvard Law School. But her decade of delaying was punctuated by a series of what she describes as terrifying false alarms.
'I remember being in law school and feeling a lump and I'd freak out,' she says. 'In the middle of prepping for exams, I'd drop everything and call my [doctor] for a mammogram. Luckily, it would all be ok.'
But always, the terror hung over her. In 2017, she met and married her husband, former baseball player Sean Gilmartin – who proved a godsend.
After the surgery she was promoted to White House press secretary, and spent time in the Oval Office with her daughter Blake.
Blake roamed the halls of the White House while McEnany worked.
And, a year later, Kayleigh finally felt ready – deciding to press ahead with the double mastectomy surgery.
'A big reason I had the confidence to make this decision was that I had found a supportive husband,' she says. 'He was my rock.'
Supported, too, by her strong Christian faith, Kayleigh found the strength to go through with the operation – and would be profoundly glad that she had done so.
If Kayleigh had feared she would be 'losing a piece of myself', her concerns vanished when the doctors removed her bandages. In fact, she says, she was amazed.
Kayleigh had opted for a nipple-sparing procedure and that, together with the implants she had put in a decade earlier, left the look of her original breasts almost entirely preserved.
'I turned to my mom and asked: "Did they even do the surgery?" I still looked like me,' she recalls. 'The approach I had taken left me feeling strong, confident, and nearly unchanged.
'I felt no pain during my night in the hospital, and the only discomfort I felt throughout my recovery was the strain from surgical drains that hung from small inserts on my sides and collected excess blood.'
In hindsight, she realized she need not have been afraid of 'losing' her breasts.
'There's a preconceived notion that [a mastectomy means] they are being chopped off,' she reflects. 'I hate when I hear that now. I bristle when I hear that because that's not the case. It doesn't have to be so emotional. It scares a lot of women when that's how a mastectomy is described.'
Kayleigh's wish to inform other women about the BRCA genes and the cancer-prevention routes now available drove her to address the Republican National Convention in August 2020, just over two years after her surgery.
At the 2020 RNC, Kayleigh told an audience of 17.3 million people what had happened to her, and about the support she had received from the Trump family in the immediate aftermath.
'I was blown away' by Trump's support, she said, 'Here was the leader of the free world caring about me.'
McEnany is now host of Outnumbered on Fox News and wants to encourage other women to discuss their options with their doctors.
She had been promoted to White House press secretary by then – after a stint working on Trump's re-election campaign – and had moved to Washington from her family home in Florida.
The morning of her RNC speech, she received another call from Trump – this time to wish her luck.
'Everyone is excited about your speech,' he told her. 'Deliver it emotionally and powerfully. This message is important.'
Reflecting on that moment now, Kayleigh says: 'President Trump will never know just how much his call meant.'
Kayleigh went on stage and told a nationwide audience of 17.3 million people what had happened to her, and about the support she'd received from the Trump family in the immediate aftermath.
'I was scared,' she told the crowd. 'The night before I fought back tears, as I prepared to lose a piece of myself.'
'[But] here was the leader of the free world caring about me,' she said.
Kayleigh tells the Mail that she has never looked back and now feels a profound sense of relief.
Letting out a deep breath, she says: 'I don't have to worry any more. I'm now free from worry. My chances of breast cancer were brought down from 84 percent to virtually 0 percent.'
And while she still has a heightened risk of ovarian cancer, she knows that she can elect to have a hysterectomy when the time is right.
Today, a mother of two young children, she wants to encourage other women to discuss their options with their doctors.
'We need to be more open with one another – and with our stories about how the threat of breast cancer affects us emotionally, psychologically and physically,' she says. 'It's important.'