We develop a probabilistic network model over image spaces and demonstrate its broad utility in mammographic image analysis, particularly with respect to computer-aided diagnosis. The model employs a multi-scale pyramid decomposition to factor images across scale and a network of tree-structured hidden variables to capture long-range spatial dependencies. This factoring makes the computation of the density functions local and tractable. The result is a hierarchical mixture of conditional probabilities, similar to a hidden Markov model on a tree. The model parameters are found with maximum likelihood estimation using the expectation-maximization algorithm. The utility of the model is demonstrated for three applications: (1) detection of mammographic masses for computer-aided diagnosis; (2) qualitative assessment of model structure through mammographic synthesis; and (3) compression of mammographic regions of interest.