A method of detecting breast masses and calcifications in digitized images, includes providing a plurality of 2-dimensional (2D) digital X-ray projectional breast images acquired from different viewing angles, extracting candidate lesions and 2D features from said 2D projectional images, computing spicularity characteristics of said candidate lesions, including location, periodicity, and amplitude, applying learning algorithms to said candidate lesions to predict a probability of malignancy of said lesion, receiving from said learning algorithm a probability map of detections for each breast image, said detections comprising associating pixels with a probability of being associated with a malignancy, creating a synthetic 2D slice for each X-ray image wherein malignant regions are indicated by ellipses on a non-malignant background, and constructing a synthetic 3-dimensional (3D) image volume from said 2D synthetic slices.