A 2D mammogram image is synthesized using only a subset of tomosynthesis projection images. There may therefore be provided a method for use in a computer system comprising one or more processors, performing the steps of: obtaining a plurality of x-ray tomosynthesis projection images of a patient's breast; generating a three-dimensional reconstruction of the patient's breast using the x-ray projection images; synthesizing a two-dimensional mammogram using only a subset of the plurality of x-ray tomosynthesis projection images; and displaying the synthesized mammogram. There may be further provided an x-ray acquisition system, such as a tomosynthesis only acquisition station or a mammography only acquisition station, configured to synthesize a 2D mammogram, using only a subset of tomosynthesis projection images.