〔Abstract〕 Objective To analyze the clinical necessity of extended resection for intraductal papilloma (IDP) after minimally invasive rotational excision. Methods A retrospective analysis was performed on the data of 86 IDP patients who underwent minimally invasive rotational excision at Shenzhen Longgang District Maternal and Child Health Hospital from May 2019 to June 2021. The surgical method was determined according to the patients' wishes, and the patients were divided into a control group (43 cases, underwent minimally invasive rotational excision) and an observation group (43 cases, underwent extended resection based on minimally invasive rotational excision). The postoperative complications, breast aesthetics, quality of life, recurrence and malignancy within 2 years were compared between the two groups. Results The incidence of postoperative complications and breast aesthetics in the observation group were 9.30% and 93.02%, respectively, there were no significant differences compared to 4.65% and 95.35% in the control group (P > 0.05). One year after surgery, the four scores in the general quality of life inventory-74 (GQOLI-74) of the two groups were higher than those before surgery. Except for psychological function, the other three scores in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). The recurrence rate within 2 years after surgery in the observation group was 6.98%, lower than 23.26% in the control group, and the difference was statistically significant (P < 0.05). The malignancy rate within 2 years after surgery in the observation group was 2.33%, lower than 11.63% in the control group, but the difference was not statistically significant (P > 0.05). Conclusion Compared with patients who did not undergo extended resection, patients with IDP after minimally invasive rotational excision showed a lower longterm recurrence rate and higher long-term quality of life. Moreover, the risk of complications did not increase, and breast aesthetics did not decline.