Brave Sarah Ferguson underwent breast cancer surgery that lasted a grueling EIGHT HOURS

The Duchess of York underwent major eight-hour surgery while surgeons battled breast cancer, it can be revealed today.

Last week it emerged that Sarah Ferguson, 63, had been diagnosed with the disease and had a successful mastectomy at King Edward VII’s Hospital in London.

But The Mail on Sunday can today reveal the full extent of her exhausting ordeal, which included four days in intensive care at the private hospital where the Duchess was monitored 24 hours a day.

Last night a friend of the Duchess, who is now back at home, said: ‘The operation took a very long time – it took eight hours – and it was more involved than people think. Today she wants to say that she is very grateful to those who saved her and that she feels very lucky to be alive.

“The Duchess would like to give a special thank you to the two incredible surgeons Christina Choy and Stuart James who performed the operation and the entire medical team who worked tirelessly to assist her.”

Last week, she told friends she has a “long road” to recovery but is determined to “beat it.”

Back home in Royal Lodge, Windsor, where she lives with ex-husband Prince Andrew, she has the full support of her family.

Her youngest daughter, Princess Eugenie, has “almost moved in” to care for her mother, while sister Princess Beatrice is a frequent visitor and “constantly on the phone.”

Andrew was on hand to help, and friends and family gathered to provide hot meals and run errands.

A source at Buckingham Palace confirmed that the king had also written to his former sister-in-law, sending his heartfelt wishes for a speedy recovery.

A Palace insider said plans for the Yorks to move out of Royal Lodge and into Frogmore Cottage, Harry and Meghan’s former home, have been “quietly shelved” for now.

The Duchess’s cancer nightmare began less than two months ago when a routine pre-coronation test first discovered something was seriously wrong.

In early May, Sarah attended an appointment in London for a mammogram. Instead of getting everything safe, as expected, the technician explained that a “shadow” could be seen in the chest.

A source close to the Duchess said: ‘Most people usually associate breast cancer with a lump, but that’s not always the case.

‘A nodule can be detected by the patient, but this was a ‘shadow’, which can go unnoticed because it is a larger spread of cancer cells that can be picked up by screening. In Sarah’s case, a biopsy was taken of the shaded tissue and the results came back a few days later to confirm the diagnosis: breast cancer.’

Given the size of the area, a lumpectomy was ruled out and Sarah was strongly advised to proceed with a single mastectomy, which would eradicate the shadow of cancer cells across the breast. Sarah was said to be devastated but determined to go through with a mastectomy as soon as possible, telling friends she had “no choice” but to go through with the operation.

Christina Choy was the surgeon who performed the mastectomy.

When it was done, consultant plastic surgeon Stuart James, once hailed by Tatler magazine as one of the top breast doctors in the country, took over and performed breast reconstruction using the “DIEP flap” technique. Coincidentally, Mr. James is known to Prince William.

In 2013, the heir to the throne visited an operating room at the Royal Marsden Hospital in Chelsea, where Mr James explained the procedure of breast reconstruction. The special procedure is so complex that only highly skilled surgeons should attempt it.

It involves making an incision in the abdomen and taking fat from the stomach to form a new breast.

Experts say this can take more than six hours because it involves a microvascular surgery in which delicate 2mm blood vessels are cut and then joined together.

But the long time under general anesthesia took its toll on Sarah Ferguson, whose vitals were then monitored in intensive care for four days.

Just days after she was released from the hospital, she is said to be in “good spirits.” A friend said the Duchess joked that the type of reconstruction – removing excess fat from the abdomen to form a new breast – meant she would effectively benefit from a tummy tuck. She added: “Sarah even joked before the surgery that she was looking forward to getting slimmer with the fat removed from her abdomen for breast reconstruction and that she would get a healthy kick, eat right and exercise.

“She said, ‘Soon we can go out together in white skinny jeans.’ Her strength through it all has been an inspiration.”

The Duchess of York, whose stepfather Hector Barrantes died of lymphatic cancer in 1990 aged 51, has long been a champion of the charities dedicated to fighting the disease.

In November of that year, she opened a specialist cancer unit at Middlesex Hospital in London for the Teenage Cancer Trust. Since then, Sarah has become a patron of the charity and has attended nearly all of the charity’s new openings. Over the years, her daughters Beatrice and Eugenie have joined their mother in supporting the cause.

Sarah said both princesses spent their 18th birthdays visiting teen cancer wards.

Sarah Ferguson revealed her own battle with cancer before her surgery, saying in her podcast, “I volunteered to work for the Teenage Cancer Trust…because my stepfather died of cancer.

‘He was a fantastic man. I adored him.’

A source said that after a period of recovery, the Duchess intends to “spread the word” and work to raise awareness of the importance of early cancer detection.

She told her podcast, “I tell people out there to get checked. Go get screened. Go and do it. I’m not just talking about breast cancer, but about all forms of cancer.’