Statistical learning and decision theory play a key role in many areas of science and engineering. Some examples include time series regression and prediction, optical character recognition, signal detection in communications or biomedical applications for diagnosis and prognosis. This paper deals with the topic of learning from biomedical image data in the classification problem. In a typical scenario we have a training set that is employed to fit a prediction model or learner and a testing set on which the learner is applied to in order to predict the outcome for new unseen patterns. Both processes are usually completely separated to avoid over-fitting and due to the fact that, in practice, the unseen new objects (testing set) have unknown outcomes. However, the outcome yields one of a discrete set of values, i.e. the binary diagnosis problem. Thus, assumptions on these outcome values could be established to obtain the most likely prediction model at the training stage, that could improve the overall classification accuracy on the testing set, or keep its performance at least at the level of the selected statistical classifier. In this sense, a novel case-based learning (c-learning) procedure is proposed which combines hypothesis testing from a discrete set of expected outcomes and a cross-validated classification stage.