What is the most appropriate response for a 50-year-old postmenopausal patient experiencing bilateral milky nipple discharge?

The most appropriate response for a 50-year-old postmenopausal patient experiencing bilateral milky nipple discharge is to reassure her that bilateral nipple discharge is often benign and can be a normal occurrence in some cases, particularly when it's not associated with other symptoms. This response emphasizes the less alarming nature of bilateral discharge compared to unilateral discharge, which might warrant more concern for underlying pathology.

In a postmenopausal context, milky discharge can stem from various benign causes, including hormonal changes, stimulation, or even galactorrhea due to elevated prolactin levels. It is prudent for patients to monitor the discharge, and if it persists or is accompanied by other symptoms, such as a lump, changes in breast appearance, or discomfort, they should seek further evaluation. This approach aligns with standard clinical practice where reassurance and monitoring are key, rather than immediate invasive interventions or anxiety over malignancy, which may not be warranted in this situation.