A novel screening assay was used to test 13 previously described antibreast cancer antibodies for those which recognize antigens elevated in serum of breast cancer patients. Binding of three of these antibodies to breast or lung carcinoma cells was inhibited to a significantly greater extent by tumor patient serum than by normal serum, suggesting that the antigens might be useful serum markers. Two of these antibodies, W1 and W9, were shown to recognize nonoverlapping epitopes on a high molecular weight molecule(s) purified from serum from breast cancer patients. A sensitive double determinant immunoassay was developed to measure W1 antigen levels in sera from a total of 389 cancer patients and controls. Forty seven % (37 of 79) of individuals having breast cancer showed elevated serum levels of the W1 antigen, whereas only 4% (1 of 25) of normal controls and 2% (1 of 47) of patients hospitalized for nonmalignant disorders showed elevated levels. These differences were statistically significant (P < 0.001). The percentage of breast cancer patients showing elevated serum levels was greater for individuals with metastatic disease. Statistically significant numbers of lung, ovarian, and prostate, but not colon, cancer patients also had elevated serum levels of the W1 antigen. These data suggest that measurement of the W1 antigen in serum might provide clinically useful information on the course of metastatic breast and other cancers.