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"X-ray screening for breast cancer is an important public health initiative in the management of a leading cause of death for women. However, screening is expensive if mammograms are required to be manually assessed by radiologists. Moreover, manual screening is subject to perception and interpretation errors. Computer aided detection/diagnosis (CAD) systems can help radiologists as computer algorithms are good at performing image analysis consistently and repetitively. However, image features that enhance CAD classification accuracies are necessary for CAD systems to be deployed. Many CAD systems have been developed but the specificity and sensitivity is not high; in part because of challenges inherent in identifying effective features to be initially extracted from raw images. Existing feature extraction techniques can be grouped under three main approaches; statistical, spectral and structural. Statistical and spectral techniques provide global image features but often fail to distinguish between local pattern variations within an image. On the other hand, structural approach have given rise to the Bag-of-Visual-Words (BoVW) model, which captures local variations in an image, but typically do not consider spatial relationships between the visual "words". Moreover, statistical features and features based on BoVW models are computationally very expensive. Similarly, structural feature computation methods other than BoVW are also computationally expensive and strongly dependent upon algorithms that can segment an image to localize a region of interest likely to contain the tumour. Thus, classification algorithms using structural features require high resource computers. In order for a radiologist to classify the lesions on low resource computers such as Ipads, Tablets, and Mobile phones, in a remote location, it is necessary to develop computationally inexpensive classification algorithms. Therefore, the overarching aim of this research is to discover a feature extraction/image representation model which can be used to classify mammographic lesions with high accuracy, sensitivity and specificity along with low computational cost. For this purpose a novel feature extraction technique called 'Pixel N-grams' is proposed. The Pixel N-grams approach is inspired from the character N-gram concept in text categorization. Here, N number of consecutive pixel intensities are considered in a particular direction. The image is then represented with the help of histogram of occurrences of the Pixel N-grams in an image. Shape and texture of mammographic lesions play an important role in determining the malignancy of the lesion. It was hypothesized that the Pixel N-grams would be able to distinguish between various textures and shapes. Experiments carried out on benchmark texture databases and binary basic shapes database have demonstrated that the hypothesis was correct. Moreover, the Pixel N-grams were able to distinguish between various shapes irrespective of size and location of shape in an image. The efficacy of the Pixel N-gram technique was tested on mammographic database of primary digital mammograms sourced from a radiological facility in Australia (LakeImaging Pty Ltd) and secondary digital mammograms (benchmark miniMIAS database). A senior radiologist from LakeImaging provided real time de-identified high resolution mammogram images with annotated regions of interests (which were used as groundtruth), and valuable radiological diagnostic knowledge. Two types of classifications were observed on these two datasets. Normal/abnormal classification useful for automated screening and circumscribed/speculation/normal classification useful for automated diagnosis of breast cancer. The classification results on both the mammography datasets using Pixel N-grams were promising. Classification performance (Fscore, sensitivity and specificity) using Pixel N-gram technique was observed to be significantly better than the existing techniques such as intensity histogram, co-occurrence matrix based features and comparable with the BoVW features. Further, Pixel N-gram features are found to be computationally less complex than the co-occurrence matrix based features as well as BoVW features paving the way for mammogram classification on low resource computers. Although, the Pixel N-gram technique was designed for mammographic classification, it could be applied to other image classification applications such as diabetic retinopathy, histopathological image classification, lung tumour detection using CT images, brain tumour detection using MRI images, wound image classification and tooth decay classification using dentistry x-ray images. Further, texture and shape classification is also useful for classification of real world images outside the medical domain. Therefore, the pixel N-gram technique could be extended for applications such as classification of satellite imagery and other object detection tasks." -- Abstract.