Hi,thanks for posting your concern in the HCM. A single measurement of serum prolactin level above the upper limit should be diagnosed as a case of hyperprolactinemia. A prolactin level more than 500 mcg/l is diagnostic of macroprolactinoma. Even prolactin level more than 250 mcg/l indicates the presence of a prolactinoma. Increase in serum prolactin level may occur in several physiological conditions including pregnancy, lactation, stress, sleep etc. Exclusion of offending medication use, pituitary and parasellar tumors, renal failure, hypothyroidism is needed in case of hyperprolactinemia.So, for that relevant investigations including imaging will be necessary. Hyperprolactinemia does cause breast pain especially a rising prolactin level. An urgent endocrinologist consultation is necessary for further evaluation and treatment. You may be recommended to stop any offending medication (if any) and /or prescribed dopamine agonist therapy. However, further treatment or requirement of surgery will depend on the underlying cause of hyperprolactinemia. For any further query, please write back to us. Regards. Dr. Kaushik