A recently introduced Agfa film-screen combination used for mammography was compared with a widely used Kodak film-screen combination. This comparison involved evaluating the image quality and calculating a reference mean glandular dose for a breast phantom recommended by the ACPSEM. The image quality and dose were evaluated for a grid and non-grid technique as well as a range of kilovoltages. For the large area test objects in the phantom, the Agfa combination performed better. This reflected the high contrast capability of this film-screen combination. For the Kodak combination a better image score was achieved for the small area objects. These objects are indicative of the modulation transfer function and resolution characteristics of the film-screen combination. The reference mean glandular dose showed that at least 20% less dose was required for the Agfa combination. Although the Agfa combination offered improved contrast and dose saving, the Kodak combination was preferred because of the better representation of the small area objects which are an important element for early detection of breast cancer.