PURPOSE: To study the effect of three mammography target-filter combinations on contrast and dose. MATERIALS AND METHODS: With screen-film sensitometry, the contrast of a calcification target embedded in simulated breast tissue was measured for three target-filter combinations--molybdenum-molybdenum (Mo-Mo), molybdenum rhodium (Mo-Rh), and rhodium-rhodium (Rh-Rh)--as a function of x-ray tube potential, breast thickness, and breast composition. The corresponding average glandular tissue doses were also determined. RESULTS: Contrast and dose decreased with increasing kilovolt peak with all three target-filter combinations. Contrast was highest for Mo-Mo and lowest for Rh-Rh for images exposed with a low kilovoltage (< 29 kVp). For thick or radiographically dense phantoms, the contrast produced with Mo-Mo was less than or equal to that produced by the other two x-ray spectra when a higher kilovoltage (> or = 29 kVp) was selected. Average glandular dose was greatest for Mo-Mo and lowest for Rh-Rh for all phantom thicknesses, breast compositions, and tube potentials studied. CONCLUSIONS: For the thick or dense breast, the alternative target-filter selections can achieve contrast comparable to or better than that obtainable with Mo-Mo while using a smaller dose.