1. Compare left and right breasts

–     Finding not seen in contralateral breast?

2. Compare with prior images

–     New microcalcifications? Magnify

–     New mass? Spot compression, rolled views, +/- DBT

–     New architectural distortion? DBT

3. Evaluate skin, nipples, axillae

–     Skin thickening (not explained by RT) or new nipple eversion? Consider inflammatory carcinoma

–     New unilateral grossly enlarged lymph node(s)? Consider metastatic breast cancer, lymphoma

Systematic Approach