Background: Mammographic digital imaging is based on X-ray sensors with solid image quality characteristics. These primarily include (a) a response curve that yields high contrast and image latitude, (b) a frequency response given by the Modulation Transfer Function (MTF), which enables small detail imaging and (c) the Normalize Noise Power Spectrum (NNPS) that shows the extent of the noise effect on image clarity. Methods: In this work, a methodological approach is introduced and described for creating digital phantom images based on the measured image quality properties of the sensor. For this purpose, a mathematical phantom, simulating breast tissue and lesions of blood, adipose, muscle, Ca and Ca(50%)-P(50%) was created by considering the corresponding X-ray attenuation coefficients. The simulated irradiation conditions of the phantom used four mammographic spectra assuming exponential attenuation. Published data regarding noise and blur of a commercial RadEye HR CMOS imaging sensor were used as input data for the resulting images. Results: It was found that the Ca and Ca(50%)-P(50%) lesions were visible in all exposure conditions. In addition, the W/Rh spectrum at 28 kVp provided more detailed images than the corresponding Mo/Mo spectrum. Conclusions: The presented methodology can act complementarily to image quality measurements, leading to initial optimization of the X-ray exposure parameters per clinical condition.