Why keep my nipples?

I was diagnosed with LCIS and have had multiple biopsies throughout the past 15 years with AHL and microcalcifications.  I have decided to undergo mastectomy with reconstruction, however my breast doctor says I will be keeping my nipples.  I understand that cancer can still get in through the nipple to the ducts plus there is Pagets desease.  What do you recommend.  Since I am doing this to prevent future cancer shouldn't I have nipples removed also?  Thank you

[CCF-RN,MSN-rf]

Dear Cathy Lee:  The reason doctors are concerned about keeping nipples is that they contain some breast tissue that, theoretically, could contain cancer cells.  Nipples are not a port of entry for cancer.  Paget's disease is a different primary cancer.  Recently, there has been some research into nipple sparing surgery, so this is not an outlandish statement.  However, the reason to spare nipples is for cosmetic reasons.  If you don't care, then you don't have to do this.  It is your choice.

[surgeon]

most people have felt that for the best prevention, removing nipples ought to be done, for the reasons you stated. Some recent reports have questioned the need; and it could be that because you have LCIS instead of DCIS, your doctors modified the recommendation. If it were me, I'd recommend removing the nipples (not necessarily the areolae, if cosmetics were the concern); even more so in a woman who had your concerns!!

[surgeon]

I guess I should add that I didn't read your original question quite carefully enough: it's not that cancer can get in via the nipple; but it can be in the nipple if it's already in the ducts.

[nurse12hr]

I had excellent nipple reconstruction.  I would have them removed for just the reasons you cited.

[Cathy Lee]

My breast surgeon doesn't want to remove the nipples.  I talked with my plastic surgeon and he said as part of the reconstruction process he will remove them for me.  Since I am doing the for preventative purposes I don't want anything that can possibly give me cancer.  Thanks for your replies.  I know now I'm doing the right thing.