Soru

A $38$-year-old woman presents to the breast clinic complaining of bilateral, milky nipple discharge for the past $4$ months. She also reports cessation of her menses $6$ months ago, generalized fatigue, and occasional morning headaches. She has no prior medical history and takes no medications. Physical examination reveals normal-appearing breasts with no palpable masses, skin dimpling, or axillary lymphadenopathy. Gentle pressure elicits a non-bloody, milky discharge from both nipples. A urine pregnancy test is negative. Laboratory evaluation reveals the following:

Prolactin: $185 \text{ ng/mL}$ (Reference: $4 - 23 \text{ ng/mL}$)
Thyroid-stimulating hormone (TSH): $0.2 \text{ \mu U/mL}$ (Reference: $0.4 - 4.0 \text{ \mu U/mL}$)
Free thyroxine (T4): $0.5 \text{ ng/dL}$ (Reference: $0.9 - 2.4 \text{ ng/dL}$)

Which of the following is the most appropriate next step in the management of this patient?