Both normal and malignant breast tissue contain the specific receptor for 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3). A recent study has shown its presence in 80% of surgically removed breast tumors, although only at low levels. We have measured the 1,25-(OH)2D3 receptor in breast tumors from 68 patients and have found it at similar frequency (75%) but at much higher concentrations (range, less than 1 to 30 fmol/mg protein). This receptor has the same characteristics as that measured in classic 1,25-(OH)2D3 target tissues and was distinguished by sucrose gradient centrifugation from plasma contaminants. Complete case histories and follow-up were available on 56 of these patients, and 1,25-(OH)2D3 receptor status (less than 8 or greater than or equal to 8 fmol/mg protein) was not related to the level of estrogen receptors, menopausal status, T-stage or histology of tumors, or presence of 99mTc phosphate hot spots on bone scans. The lack of relationship between the level of 1,25-(OH)2D3 receptors and other prognostic indicators suggests its potential as a new independent variable for assessing breast cancer patients. However, at this stage, 1,25-(OH)2D3 receptor status did not result in any significant difference in probability of survival or metastasis-free survival. Assessment of the importance of this variable for treatment or outcome must await an increased number of patients and a longer time since surgery.