Purpose: Physical phantoms are central to the evaluation of 2D and 3D breast-imaging systems. Currently, available physical phantoms have limitations including unrealistic uniform background structure, large expense, or excessive fabrication time. The purpose of this work is to outline a method for rapidly creating realistic, inexpensive physical anthropomorphic phantoms for use in fullfield digital mammography (FFDM) and digital breast tomosynthesis (DBT). Methods: The phantom was first modeled using analytical expressions and then discretized into voxels of a specified size. The interior of the breast was divided into glandular and adipose tissue classes using Voronoi segmentation, and additional structures like blood vessels, chest muscle, and ligaments were added. The physical phantom was then fabricated from the virtual model in a slice by slice fashion through inkjet printing, using parchment paper and a radiopaque ink containing 33% (I 33% ) or 25% (I 25% ) iohexol by volume. Three types of parchment paper (P1, P2, and P3) were examined. The phantom materials were characterized in terms of their effective linear attenuation coefficients (l eff ) using full-field digital mammography (FFDM) and their energy-dependent linear attenuation coefficients (l(E)) using a spectroscopic energy discriminating detector system. The printing method was further validated on the basis of accuracy, print consistency, and the reproducibility of ink batches. Results: The l eff of two types of parchment paper were close to that of adipose tissue, with l eff = 0.61 AE 0.05 cm À1 for P1, 0.61 AE 0.04 cm À1 for P2, and 0.57 AE 0.03 cm À1 for adipose tissue. The addition of the iodinated ink increased the effective attenuation to that of glandular tissue, with l eff = 0.89 AE 0.06 cm À1 for P1 + I 25% and 0.94 AE 0.06 cm À1 for P1 + I 33% compared to 0.90 AE 0.03 cm À1 for glandular tissue. Spectroscopic measurements showed a good match between the parchment paper and reference values for adipose and glandular tissues across photon energies. Good accuracy was found between the model and the printed phantom by comparing a FFDM of the virtual model simulated through Monte Carlo with a real FFDM of the fully printed phantom. High consistency was found over multiple prints, with 3% variability in mean ink signal across various samples. Reproducibility of ink consistency was very high with <1% variation signal from multiple batches of ink. Imaging of the phantom using FFDM and DBT systems showed promising utility for 2D and 3D imaging. Conclusions: A novel, realistic breast phantom can be created using an analytically defined breast model and readily available materials. The work provides a method to fabricate any virtual phantom in a manner that is accurate, inexpensive, easily accessible, and can be made with different materials or breast models.

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