Unilateral bloody/clear discharge, clear mammo & US..?

Hi all,

I am 36, no kids, have never breastfed, but am in early menopause, a symptom of a condition called primary ovarian failure.

I was referred to a breast center by my OBGyn given unilateral nipple discharge for the past 5 weeks and thickening around my nipple. The discharge is mostly yellow & sticky with a few strains of blood but sometimes is mostly if not all blood. While I do have a little spontaneous discharge (on my bra, on shirt while I sleep, etc) there’s much more when I squeeze. Ive been taking photos every few days to track changes

I have long suspected all to be related to my complicated and all-over-place hormones. I had a mammogram and US this morning that were clear. When I met with the breast surgeon later in the afternoon he seemed ready to give the all-clear until he saw my nipple, the discharge stains on my gown, the photos of the bloody discharge, and the scaly rash on my nipple. He seemed a little alarmed and asked me to come back for an MRI and to meet with a genetic counselor next week. He suggested that some surgeons might opt for an immediate duct excision surgery but he advised against pending the results of the MRI and given I’ve only had symptoms for a few months.

Might anyone have any similar experience? Am I mistaken to hold off on the duct excision surgery? Is there anything I should be doing that I’m not now? I still think this is all hormone related but the fact it’s unilateral, bloody, spontaneous, etc. has me down a google spiral.

Thanks!