A hybrid SPECT-CT system for dedicated 3D breast imaging (mammotomography) is currently under development. Each imaging system will be placed on top of a single rotation stage and moved in unison azimuthally, with the SPECT system additionally capable of polar and radial motions. In this initial prototype, the CT system will initially be positioned at a fixed polar tilt. Using a phantom with three tungsten wires, the MTF of the CT system was measured in 3D for different CT system tilts. A phantom with uniformly arranged 0.5cm diameter acrylic spheres was suspended in air in the CT field of view, and also placed at multiple locations and orientations inside an oil-filled breast phantom to evaluate the effect of CT system tilt on lesion visibility and distortion. Projection images were collected using various simple circular orbits with fixed polar tilts ranging between ±15°, and complex 3D saddle trajectories including combined polar and azimuthal motions at maximum polar tilt angles. Reconstructions were performed using an iterative reconstruction algorithm on 4x4 binned projection images with 0.508mm3 voxels. There was minor variation in the MTF in the imaged volume for the CT system at all trajectories, potentially due to the use of an iterative reconstruction algorithm. Results from the spherical cross phantoms indicated that there was more reconstruction inaccuracy and geometric distortion in the reconstructed slices with simple circular orbits with fixed tilt in contrast to complex 3D trajectories. Line profiles further showed a cupping artifact in planes farther away from the flat plane of the x-ray cone beam placed at different tilts. However, this cupping artifact was not seen for images acquired with complex 3D trajectories. This indicated that cupping artifacts can also be caused by undersampled cone beam data. These findings generally indicate that despite insufficient sampling with the cone beam imaging geometry, it is possible to place the CT system at a stationary polar tilt with the CT tube positioned upward such that a patient can be comfortably placed above the system and allow complete sampling near the top of the pendant, uncompressed breast and chest wall. However, a complex 3D trajectory allows for more complete sampling of the entire image volume.