A multi-mode breast x-ray imaging system comprising an x-ray source and an x-ray detector. The source and detector perform a single image scan which generates images during a single breast compression, using at least two different imaging modes including mammography and tomosynthesis imaging. The imaging modes may differ with regard to an imaging procedure selected from: receptor motion anti-scatter grid use exposure control and/or patient shielding, and the system may be arranged to apply an AEC method wherein a receptor count varies during the different imaging modes to compensate for radiographic scatter. The system may be adapted to use information from a single scout image to identify a density of a patients breast for use in the at least two imaging modes. The system may be adapted to dynamically modify an exposure technique for the image scan based on a signal reaching the detector.
