We aimed to evaluate the influence of image reduction using a bi-cubic interpolation method on the accuracy of detection of clustered microcalcifications (MCLs) and masses on digital mammograms. Digital mammograms (n=194) of 97 subjects were selected retrospectively, comprising 47 patients with clustered MCLs or masses and 52 controls. Images were acquired in the craniocaudal view by phase-contrast mammography (PCM). Original PCM images comprised 25-μm pixels. The reduced images converted from the originals by bi-cubic interpolation were of 50-μm pixel size. Five observers independently interpreted all images, and rated their confidence concerning the presence of lesions on a continuous 0-100 scale. Receiver-operating characteristic (ROC) analysis was performed using the jackknife method and LABMRMC program. Differences in areas under the curve (AUC) values based on 95% confidence intervals were evaluated. The average AUC values for detection of masses were 0.8435 and 0.8646 for the original and reduced images, respectively. The difference between the average AUC values was not statistically significant (p=0.5855). Average AUC values for clustered MCLs detection were 0.9273 and 0.9574 for the original and reduced images, respectively. This difference was not statistically significant (p=0.1949). Detection of masses and clustered MCLs on digital mammograms was unaffected by bi-cubic interpolation image reduction.