Various methods and systems are provided for breast positioning assistance during mammography and image guided interventional procedures. In one example, a vision system is utilized to evaluate one or more of a patient position, a breast position, and breast anatomy to determine if the patient and breast are adjusted to desired positions preferred for a desired view and imaging procedure. Further, based on the evaluation, prior to acquiring x-ray images, real-time feedback may be provided to guide the user to position the breast and/or the patient.