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This review gives an overview of current methods in digital breast tomosynthesis (DBT) and how they have developed from tomography applications elsewhere. Particular attention is given to patents which have impacted on currently available technology or offer a glimpse at future developments. A number of different approaches to clinical breast tomosynthesis systems are examined including different geometries, x-ray source assemblies, detector configurations, reconstruction algorithms and image display and analysis methods. Current studies in the clinical efficacy of DBT are also discussed.