Objective Communication between cancer patients and healthcare providers is recognized as an important aspect of these patients' health‐related quality of life (HRQOL). Nevertheless, no study has examined whether perceived communication between physicians and breast cancer patients is a determining factor in their HRQOL along the disease's trajectory. This longitudinal study aimed to ascertain whether such communication influenced the HRQOL of such women at three points in time. Methods The sample consisted of 120 French‐speaking women with stage I or II breast cancer aged 18 years or over (mean = 55 years) who underwent a lumpectomy with adjuvant treatment. The women filled out questionnaires at three different times: around the time of diagnosis, halfway through radiotherapy and at follow‐up. Either at the hospital or at home, they completed demographic and medical data questionnaires, the Medical Outcomes Study‐Social Support Survey, an HRQOL questionnaire (EORTC QLQ‐C30/BR23) and the Medical Communication Competence Scale. Results Generalized estimated equations analyses indicated that the women's perceptions of their own communication skills towards physicians had a greater impact on their HRQOL than the women's perception of physicians' communication skills. The women had better global health and better role, emotional, cognitive and sexual functioning as well as fewer side effects and symptoms during radiotherapy and at follow‐up when they perceived themselves as competent communicators at diagnosis and during radiotherapy. Conclusions The results underscore the importance for breast cancer patients of being proactive in information seeking and in the socio‐emotional aspect of their relationship with physicians to enhance their HRQOL. Copyright © 2013 John Wiley & Sons, Ltd.