Considerable research has been conducted into the potential benefits of support groups for patients with metastatic breast cancer. An early report by Spiegel et al. suggested that participation in these groups not only had psychologic benefits but also resulted in prolongation of survival. A review of the published literature was undertaken. Five randomized trials of support groups in metastatic breast cancer have been published. Four of those five trials have reported survival results: Survival outcomes from the fifth study are pending. A variety of group interventions were investigated. All of the studies reported beneficial psychosocial effects of the intervention, although the effects, at times, were transient and were not always present for all study outcomes. Only the original publication by Spiegel's group identified a survival benefit. No survival benefit was seen for participation in support groups for the other three studies that reported survival effects. Mixed survival effects were reported for other psychologic interventions in other cancers. There was good evidence that support groups in metastatic breast cancer lead to improved psychologic outcomes. Evidence of beneficial survival effects was not convincing. Cancer 2005. © 2005 American Cancer Society.