An x-ray breast imaging system comprising: a compression paddle (16, 160), wherein the compression paddle is adapted to be disposed in: a compressing position wherein a compressed breast is disposed between the compression paddle and a breast platform; a non-compressing position wherein the compressed breast is not disposed between the compression paddle and the breast platform, wherein the compression paddle comprises: a front wall (16a, 102, 112, 122, 144, 170) configured to be adjacent and face a chest wall of a patient during imaging; a bottom wall (106d, 104, 114, 124) configured to extend away from the patient's chest wall and to be adjacent a length of a top of the compressed breast, wherein the bottom wall comprises a central portion and two outer edge portions, wherein the central portion is a non-coplanar with the two outer edge portions, and wherein the compression paddle is movable; and a first axis substantially orthogonal to the front wall, wherein the two outer edge portions define a reference plane, and wherein the central portion is disposed above the reference plane so as to define a concave surface extending from a first outer edge portion to the central portion to a second outer edge portion, and wherein a distance between the central portion and the reference plane is substantially identical in both the compressing position and the non-compressing position, characterized in that the compression paddle further comprises a rear wall disposed opposite the front wall, wherein the central portion of the bottom wall comprises a pitched surface, wherein a first distance between the central portion and the reference plane proximate the front wall is greater than a second distance between central portion and the reference plane proximate the rear wall. a compressing position wherein a compressed breast is disposed between the compression paddle and a breast platform; a non-compressing position wherein the compressed breast is not disposed between the compression paddle and the breast platform, wherein the compression paddle comprises: a front wall (16a, 102, 112, 122, 144, 170) configured to be adjacent and face a chest wall of a patient during imaging; a bottom wall (106d, 104, 114, 124) configured to extend away from the patient's chest wall and to be adjacent a length of a top of the compressed breast, wherein the bottom wall comprises a central portion and two outer edge portions, wherein the central portion is a non-coplanar with the two outer edge portions, and wherein the compression paddle is movable; and a first axis substantially orthogonal to the front wall, wherein the two outer edge portions define a reference plane, and wherein the central portion is disposed above the reference plane so as to define a concave surface extending from a first outer edge portion to the central portion to a second outer edge portion, and wherein a distance between the central portion and the reference plane is substantially identical in both the compressing position and the non-compressing position, characterized in that the compression paddle further comprises a rear wall disposed opposite the front wall, wherein the central portion of the bottom wall comprises a pitched surface, wherein a first distance between the central portion and the reference plane proximate the front wall is greater than a second distance between central portion and the reference plane proximate the rear wall. a front wall (16a, 102, 112, 122, 144, 170) configured to be adjacent and face a chest wall of a patient during imaging; a bottom wall (106d, 104, 114, 124) configured to extend away from the patient's chest wall and to be adjacent a length of a top of the compressed breast, wherein the bottom wall comprises a central portion and two outer edge portions, wherein the central portion is a non-coplanar with the two outer edge portions, and wherein the compression paddle is movable; and a first axis substantially orthogonal to the front wall, wherein the two outer edge portions define a reference plane, and wherein the central portion is disposed above the reference plane so as to define a concave surface extending from a first outer edge portion to the central portion to a second outer edge portion, and wherein a distance between the central portion and the reference plane is substantially identical in both the compressing position and the non-compressing position, characterized in that the compression paddle further comprises a rear wall disposed opposite the front wall, wherein the central portion of the bottom wall comprises a pitched surface, wherein a first distance between the central portion and the reference plane proximate the front wall is greater than a second distance between central portion and the reference plane proximate the rear wall.