Three patients with advanced breast cancer are described who developed lymphangitic pulmonary metastases with normal chest x-rays and abnormal perfusion lung scans. The abnormal lung scans can probably be attributed to embolization of the pulmonary vasculature, first described in association with lymphangitic pulmonary metastases in 1903. The importance of recognizing this condition in patients with breast cancer is shown by their frequently good responses to combination chemotherapy.