A 31-year-old woman comes to the office because of a 6-month history of nipple discharge. She has noticed that her breasts are tender and both nipples produce milky discharge on applying mild pressure. She has not noted any bloody or clear nipple discharge, breast lumps, or skin changes. She also states she has not had a menstrual period for 6 months, and her periods had been irregular for 8 months before they stopped altogether. Prior to her menstrual irregularities, her menses occurred at a normal frequency and duration. She is sexually active with a single partner and is trying to conceive.
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