Breast cancer as a medical condition and mammograms as images exhibit many dimensions of variability across the population. Similarly, the way diagnostic systems are used and maintained by clinicians varies between imaging centres and breast screening programmes, and so does the appearance of the mammograms generated. A distributed database that reflects the spread of pathologies across the population is an invaluable tool for the epidemiologist and the understanding of the variation in image acquisition protocols is essential to a radiologist in a screening programme. Exploiting emerging grid technology, the aim of the MammoGrid [1] project is to develop a Europe-wide database of mammograms that will be used to investigate a set of important healthcare applications and to explore the potential of the grid to support effective co-working between healthcare professionals.