A distributed architecture allows for decoupling of mammographic image acquisition and review, thereby enabling more efficient use of resources and enhanced processing. In one embodiment, the system (100) includes a number of image acquisition stations (102) and a number of image review stations (110) all associated with a central server (104). The server (104) is operative to access an image repository (106), a patient information data base (108) and a number of DICOM tools (112). The invention allows for more efficient and/or more convenient use of the image acquisition equipment and image processing stations. Moreover, the distributed architecture including the central image repository provides certain processing and analysis advantages. The invention also provides certain processing and workflow enhancements that allow for a more full realization of potential digital mammography advantages.