Twenty-seven evaluable patients with refractory, metastatic breast carcinoma were treated with Adriamycin (doxorubicin) 30 mg/m2 and vinblastine 6 mg/m2 intravenously on days 1 and 28 every 8 weeks, and mitomycin C 10 mg/m2 intravenously on day 1 every 8 weeks (AVM). There were three complete and six partial responses for a total response rate of 33%. In addition, 2 patients had minimal responses, and 10 patients achieved disease stabilization. Median time to disease progression for responders was 116 days (range, 49-812+ days). Drug toxicity was tolerable: 12 patients (44%) experienced significant bone marrow suppression. There were no drug-related deaths. Although AVM appears to be an active drug combination in heavily pretreated patients with metastatic breast carcinoma, the contribution of vinblastine and mitomycin C to single agent Adriamycin in previously treated patients is not clear from this study.