Experience with 7 patients who had extrahepatic biliary obstruction caused by metastatic breast cancer is described. The interval from the original diagnosis of breast cancer to the development of jaundice averaged 40 mo., with a range of 9 mo. to 8 yr. All patients were treated with surgical decompression, radiation, transhepatic catheter drainage, chemotherapy, or a combination of these modalities. Resolution of jaundice was achieved in 6 patients. Prolonged survival was realized in 3, 1 patient lived for more than 6 yr after surgical bypass, and 2 are alive and well at present (greater than 11 mo. after relief of biliary obstruction). Extrahepatic biliary obstruction by metastatic breast carcinoma should be distinguished from jaundice due to hepatic parenchymal destruction by this tumor; while the latter implies end-stage cancer, the former has the potential for significant palliation and prolonged survival.