A local breast coil is designed to be tightly coupled to the natural shape of the pendant breast to provide high SNR for diagnostic MR imaging applications, while still providing access for interventional procedures through openings in the coil. In accordance with one configuration, the coil has a symmetrical design, such that the coil can be rotated about the breast to position an opening in the coil proximate to a desired portion of the breast without incurring registration or other alignment or artifact errors due to inhomogeneous B1 excitation. Furthermore, the coil is designed to facilitate medial and lateral imaging of the breast. The coil is combined with a patient support system that facilitates rotation of the coil and interchangeability of the coil to match the configuration of the coil to the position of the breast being imaged.