This volume of Springer’s Lecture Notes in Computer Science series records th the proceedings of the 8 International Workshop on Digital Mammography (IWDM), which was held in Manchester, UK, June 18–21, 2006. The meetings bring together a diverse set of researchers (physicists, mathematicians, computer scientists, engineers), clinicians (radiologists, surgeons) and representatives of industry, who are jointly committed to developing technology, not just for its own sake, but to support clinicians in the early detection and subsequent patient management of breast cancer. The conference series was initiated at a 1993 meeting of the SPIE in San Jose, with subsequent meetings hosted every two years by researchers around the world. Previous meetings were held in York, Chicago, Nijmegen, Toronto, Bremen, and North Carolina. It is interesting to reffect on the changes that have occurred during the past 13 years. Then, the dominant technology was film-screen mammography; now it is full-field digital mammography. Then, there were few screening programmes world-wide; now there are many. Then, there was the hope that computer-aided detection (CAD) of early signs of cancer might be possible; now CAD is not only a reality but (more importantly) a commercially led clinical reality. Then, algorithms we real most entirely heuristic with little clinical support; now there is arequirement for substantial clinical support for any algorithm that is developed and published. However, upon reffection, could we have predicted with absolute certainty what would be the key questions to be addressed over the subsequent (say) six years? No! That is the nature, joy, and frustration of research. There are more blind alleys to explore than there are rich veins that bring gold (in all senses of that analogy!).