Digital breast tomosynthesis is a new three-dimensional (3D) breast-imaging modality that produces images of cross-sectional planes parallel to the detector plane from a limited number of X-ray projections over a limited angular range. Several technical and clinical parameters have not yet been completely optimised. Some of the open questions could be addressed experimentally; other parameter settings cannot be easily realised in practice and the associated optimisation process requires therefore a theoretical approach. Rather than simulating the complete 3D imaging chain, it is hypothesised that the simulation of small lesions into clinical (or test object) images can be of help in the optimisation process. In the present study, small 3D objects have been simulated into real projection images. Subsequently, these hybrid projection images are reconstructed using the routine clinical reconstruction tools. In this study, the validation of this simulation framework is reported through the comparison between simulated and real objects in reconstructed planes. The results confirm that there is no statistically significant difference between the simulated and the real objects. This suggests that other small mathematical or physiological objects could be simulated with the same approach.