Larger breasts

Question: How do you or how does your doctor go about moving the breast to listen at the apex? Ladies, what do you prefer?

I once attended a pre employment exam with my wife and the doctor lifted my wife's left breast up with his left hand, cupping underneath while he placed his stethoscope below his hand. He then laid her down and her breasts naturally fell to the side which assisted him in the placement of the bell. Hope this helps

Usually you just use your hand with the bell and kind of root your way under the breast, I do not use my other hand hand to lift the breast. If it was a play setting, yes I would use two hands to lift the breast up.

The Apex- which is around the 5th intercostal space. This is actually underneath the breast, not over it. So in order to listen to the heart, you need to place your stethoscope underneath the breast tissue- pretty much right where the underwire of the bra would be. You really shouldn't be listening through the breast tissue at all. If the woman has large breasts, you'll need to lift (or ask the patient to lift) the breast slightly in order to put your stethoscope underneath.

I remember reading about a junior doctor who was taught from a senior consultant about using the back of the hand holding the diaphragm to move the breast out of the way during auscultation. It’s a very simple and effective technique and places the patient at ease as you are not actually handing or holding her breast.

I have used this technique on numerous occasions and I do feel that it does place the woman at ease.

He usually just places it wherever because my bras have wires, or I'm lied down so it's not a problem.

My lab partner in college had huge breasts she said her doc who was a female had her raise her left breast to listen to her apex or she would have her lean toward or lay on her back then her breast would displace she said it was no big deal she also said her doc would have her do deep knee bends to get her heart rate up she said that got interesting doing knee bends topless.

I've never been asked to lift mine but in the past doctors have lifted it and placed the chest piece under it, I've also had the doctor just push it under there in their hand.

I haven't had a doctor listen to my heart under my breast since I was a teen 😢

And how long has it been since you were a teenager,JJ? I'd say it's time somebody got up under your left breast with a good stethoscope for a nice long listen at your mitral valve.

To answer your question Steth, let's just say it's been TOO LONG 😉

My girlfriend has larger breasts. When I listen, I just move them up or to the side as needed. Granted, I'm a bit more familiar with her than I would expect a doctor to be.

The last time i had this done she just used the back of her hand to push my breast up some although it was still in the bra and she put the bell under the edge of my bra.

When the patient has large and ptotic breasts, i gently lift up a little bit the left One to listen to the apex

Usually just lifts it up with the back of their hand while placing the stethoscope. My breasts are large and this sometimes seems like an awkward manoeuvre.

I had one doctor who raised it with the back of his left hand while placing with the other. That seemed to make a lot more sense as it gave him the soace he needed but didn't seen obtrusive.

Once I was asked to raise the breast myself. I really didn't like that. Not sure why. Maybe it's because I really wasn't sure what I should be doing with it or how much was too much. Totally overthinking it I know, but think it would just have been easier for the doctor to do it. They know what they need.

. . . .Once I was asked to raise the breast myself. I really didn't like that. Not sure why. Maybe it's because I really wasn't sure what I should be doing with it or how much was too much. Totally overthinking it I know, but think it would just have been easier for the doctor to do it. They know what they need.

In nursing school, we were taught to have the patient lift her breast.

Especially when the examiner is male, there is never any question of impropriety and it's easy for the patient to do.

Yes listening to the apex of a woman with large breast can be a bit awkward with regards to moving the breast to place the stethoscope in the correct position. In reality you have 3 options , ask the patient to lift her own breast.

As sparks-and-steths has said it can be a bit confusing:

Once I was asked to raise the breast myself. I really didn't like that. Not sure why. Maybe it's because I really wasn't sure what I should be doing with it or how much was too much. Totally overthinking it I know, but think it would just have been easier for the doctor to do it. They know what they need.

As Susie said it prevents any hint of impropriety as you are not actually handling their breast :

In nursing school, we were taught to have the patient lift her breast.

Especially when the examiner is male, there is never any question of impropriety and it's easy for the patient to do.

The 2nd option is to physically hold the breast and lift it . Since I'm male nurse I prefer not to perform this option as in a clinical environment I would not want any hint of impropriety at all as I'm usually alone with the patient.

The 3rd method I the one I employ, is to use the back of the hand holding the diaphragm to move the breast out of the way during auscultation. It’s a very simple and effective technique and places the patient at ease as you are not actually handing or holding her breast. I have used this technique on numerous occasions and I do feel that it does place the woman at ease and never had any complaints.

I always had to take off bra for auscultation and had doctors holding and moving breasts, it was embarassing, but followed by breasts exam anyway.

Inge