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Article History

Received: 7 December 2024

Accepted: 27 January 2025

First Online: 22 April 2025

Declarations

: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Also ethics committee of Medical Sciences, Iran approved this study by b(Code NO:…..)

: The institutional and/or national research committee approved all the procedures and they followed the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Also, the research was approved by the Ethics Committee of IRAN University, Iran (code no: IR.IUMS.FMDREC.1402.278).

: All the studied patients gave informed consent.

: All authors consent freely-given to participate in the research project

: Each author provided consent for the disclosure of identifiable information, encompassing photographs, videos, case histories, or details within the text (“Material”), to be published in the specified Journal and Article. Consequently, the published material in the Journal is accessible to all readers.

: • Personal financial interests: The authors declare no personal financial interest.• Patents: The authors declare no Patents• Personal or professional relations with individuals and organizations (e.g., children and parents, husband and wife, and family relationships): No• Unpaid membership in a government or nongovernmental organization: No• Are you one of the editorial board members or a reviewer of this journal? The authors declare they are not editorial board members or reviewers of this journal.

: Ethical guidelines prevent the release of specific metadata related to clinical data involving human subjects. Consequently, we are unable to provide access to a summary of the patients' data.

: The study has several limitations that should be acknowledged. First, its retrospective and single-center design may introduce selection bias and restrict the ability to establish causal relationships. Additionally, the exclusion of patients with a history of malignancy or significant breast diseases may limit the generalizability of the findings, as the study population may not fully reflect the diversity seen in clinical practice. The follow-up duration was relatively short (six months) for some patients, potentially missing late recurrences, although longer follow-up periods for others allowed for the assessment of long-term outcomes. Furthermore, the diagnosis of malignancy upgrades in intraductal papillomas (IDPs) may be influenced by sampling methods; VAE, which allows for larger tissue samples, may provide a more comprehensive assessment, while CNB, with smaller samples, may have a lower detection rate. Despite the inclusion of a substantial number of participants (320), which enhances the reliability of the findings, these limitations remain significant.To address these limitations, future studies should adopt a prospective cohort design. This approach would enable real-time data collection and comprehensive follow-up, allowing for a more precise evaluation of risk factors, treatment outcomes, and disease progression. Incorporating additional risk factors into the analysis would further broaden the scope and strengthen the evidence base, ultimately improving the clinical management of IDPs.