A patient support table for breast MRI systems, the table including a base configured to slide into and out of the bore of an MRI system; a patient support member attached to the base and having a top surface shaped to support a patient in a prone position; two breast openings in the patient support member, the breast openings being sized and positioned to permit the patient's breasts to extend downward beneath the patient support member, at least a pair of breast immobilization paddles, one on each side of a breast opening, the immobilization paddles comprising a grid of breast contact elements that contact the breast while providing a plurality of openings through which a surgical tool may be inserted into the breast, and the paddles having a convex curvature along the Z direction (head to toe) so that the breast contacting surface of each paddle is further from the Y-axis center line of the breast opening midway along the Z extent of the paddle than at the Z extremities of the paddle.