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Although previous evidence has shown increased likelihood for survival in cancer patients who have social support, little is known about changes in social support during illness and their impact on survival. This study examines the relationship between social support and survival among women diagnosed with breast carcinoma, specifically assessing the effect of network size and changes in social contact post-diagnosis.A population-based sample of 584 women was followed for up to 12.5 years (median follow-up = 10.3 years). The mean age at diagnosis was 44 years, 81% were married, and 29% were racial/ethnic minorities. Cox regression analysis was used to estimate survival as a function of social support (changes in social contact and the size of social support), disease severity, treatment, health status, and socio-demographic factors.Fifty-four percent of the women had local and 44% had regional stage disease. About 53% underwent mastectomy, 68% received chemotherapy, and 55% had radiation. Regression results showed that disease stage, estrogen receptor status, and mastectomy were associated with greater risk of dying. Although network size was not related to survival, increased contact with friends/family post-diagnosis was associated with lower risk of death, with a hazard ratio of 0.31 (95% CI, 0.17–0.57).Findings from this study have identified an important aspect of a woman's social network that impacts survival. An increase in the amount of social contact, representing greater social support, may increase the likelihood of the women's survival by enhancing their coping skills, providing emotional support, and expanding opportunities for information-sharing. Copyright © 2010 John Wiley & Sons, Ltd.