Establishing spatial correspondence between features visible in X-ray mammograms obtained at different times has great potential to aid assessment and quantitation of change in the breast indicative of malignancy. The literature contains numerous nonrigid registration algorithms developed for this purpose, but existing approaches are flawed by the assumption of inappropriate 2-D transformation models and quantitative estimation of registration accuracy is limited. In this paper, we describe a novel validation method which simulates plausible mammographic compressions of the breast using a magnetic resonance imaging (MRI) derived finite element model. By projecting the resulting known 3-D displacements into 2-D and generating pseudo-mammograms from these same compressed magnetic resonance (MR) volumes, we can generate convincing images with known 2-D displacements with which to validate a registration algorithm. We illustrate this approach by computing the accuracy for two conventional nonrigid 2-D registration algorithms applied to mammographic test images generated from three patient MR datasets. We show that the accuracy of these algorithms is close to the best achievable using a 2-D one-to-one correspondence model but that new algorithms incorporating more representative transformation models are required to achieve sufficiently accurate registrations for this application.