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In this paper, we consider uncertainty handling and propagation by means of random fuzzy variables (RFVs) through a computer-aided-diagnosis (CADx) system for the early diagnosis of breast cancer. In particular, the denoising and the contrast enhancement of microcalcifications is specifically addressed, providing a novel methodology for separating the foreground and the background in the image to selectively process them. The whole system is then assessed by metrological aspects. In this context, we assume that the uncertainty associated to each pixel of the image has both a random and a non-negligible systematic contribution. Consequently, a preliminary noise variance estimation is performed on the original image, and then, using suitable operators working on RFVs, the uncertainty propagation is evaluated through the whole system. Finally, we compare our results with those obtained by a Monte Carlo method.