ALTHOUGH ANEMIA is common in patients with disseminated carcinoma, it is more often due to decreased erythropoiesis and/or external blood loss than hemolysis.<sup>1</sup>Cases with hemolysis are of particular interest because the mechanisms of increased red cell destruction are poorly understood. This report presents an unusual case of metastatic breast carcinoma with hemolytic anemia. There were bizarre poikilocytes on the patient's peripheral blood smear similar to those seen in microangiopathic hemolytic anemia (MHA) as recently described by Brain et al.<sup>2</sup>Biochemical studies, as well as pathological findings, are included in the following case study. <h3>Report of a Case</h3> A 71-year-old Caucasian widow was admitted to Harbor General Hospital on Aug 2, 1963. because of jaundice, fleeting numbness of the left side of her body and her entire face and tongue, and complaints of difficulty in coordinating her thoughts and speech. She had noted increasing weakness and a moderate