Early diagnosis of breast cancer is highly dependent on quality breast imaging and precise image interpretation. The BREAST programme is an innovative strategy for reader performance self-evaluation in breast cancer detection. Using an online system, detailed feedback on reader/image interpretation is given instantly. Our strategy is currently focused on mammograms but has the potential to be available for a wide range of medical imaging modalities. BREAST also serves a solution to researchers requiring large observer numbers by facilitating the involvement of experts wherever they are located. In summary, BREAST improves the efficacy of mammographic cancer detection through a system of reader performance monitoring and enables research studies with a large amount of robust data.