Previous work [Burgess et al., Med. Phys. 28, 419–437 (2001)] has shown that anatomical noise in projection mammography results in a power spectrum well modeled over a range of frequencies by a power law, and the exponent of this power law plays a critical role in determining the size at which a growing lesion reaches the threshold for detection. In this study, the authors evaluated the power‐law model for breast computed tomography (bCT) images, which can be thought of as thin sections through a three‐dimensional (3D) volume. Under the assumption of a 3D power law describing the distribution of attenuation coefficients in the breast parenchyma, the authors derived the relationship between the power‐law exponents of bCT and projection images and found it to be . They evaluated this relationship on clinical images by comparing bCT images from a set of 43 patients to Burgess’ findings in mammography. They were able to make a direct comparison for 6 of these patients who had both a bCT exam and a digitized film‐screen mammogram. They also evaluated segmented bCT images to investigate the extent to which the bCT power‐law exponent can be explained by a binary model of attenuation coefficients based on the different attenuation of glandular and adipose tissue. The power‐law model was found to be a good fit for bCT data over frequencies from , where anatomical variability dominates the spectrum. The average exponent for bCT images was 1.86. This value is close to the theoretical prediction using Burgess’ published data for projection mammography and for the limited set of mammography data available from the authors’ patient sample. Exponents from the segmented bCT images (average value: 2.06) were systematically slightly higher than bCT images, with substantial correlation between the two .