Several breast microwave sensing (BMS) systems have shown encouraging results as a potential breast cancer detection tool. The existing systems in the literature have diverse designs, equipment, measurement protocols, and analysis methods. However, there is relatively little investigation on the impact and performance of varying system designs. This work compares the impact of system design parameters on three existing BMS systems. The first system, a bed-based system, was designed for use in a permanent clinic. The second system, a bench-top system, was created for laboratory research. The third system, a portable system, was designed for use in low-income and remote communities. The bed-based system had the highest resolving capabilities, achieving a spatial resolution of 12.4 ± 0.5 mm. Additionally, the bed system had the highest signal-to-noise ratio of 26 ± 1 dB. The portable system had the least intensity dependence on polar positions within the imaging chamber. The bed system had the highest contrast between tumor- and adipose-mimicking materials. However, the contrast of tumor- and fibroglandular-mimicking materials was similar for each system. By comparing and evaluating the performance of multiple BMS systems, we improve our understanding of system design, allowing for potential studies into an ideal BMS system.