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This book contains the scientific papers presented at the Fourth International Workshop on Digital Mammography, which was held in Nijmegen, The Netherlands, in June 1998. These papers give an overview of ongoing research in digital mammography, aimed at improved detection and diagnosis of breast cancer. Topics that are covered are computer-aided diagnosis, image processing, detector development, system design, observer performance and clinical evaluation. Potential benefits of this new technology are large. With digital mammography image quality can be increased and advanced processing techniques can be implemented, making it easier for radiologists to diagnose breast cancer, and allowing detection of the disease at an earlier stage. The book includes around 100 contributions, many of which give detailed technical descriptions of new methods and systems. The purpose of this book is to help and stimulate further research to develop this important area.