Objective To analyze the relationship between disease-related communication and fear of cancer recurrence in breast cancer patients and their spouses using a dyadic analysis approach. Methods Totally 332 couples treated in three class-3 grade-A hospitals in Anhui province for breast cancer were selected and surveyed using the Fear of Progression questionnaire-Short form and the Cancer-Related Communication Problems Scale. Results The score of disease-related communication of breast cancer patients (20.92±5.48) was significantly higher than that of their spouses (18.48±5.23) (P<0.05). However, the score of cancer recurrence fear in breast cancer patients (32.57±6.19) was significantly lower than that in their spouses (36.60±6.05) (P<0.05). The disease-related communication of breast cancer patients and their partners could positively predict their own fear of cancer recurrence, as well as the other′s (all P<0.05). Conclusion Breast cancer patient and partner disease-related communication seems to impact not only on their own fear of cancer recurrence, but also on that of the other′s. Communication strategies should be developed for breast cancer couples as a whole to alleviate their fear of cancer recurrence.