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Objective: To assess fear of progression (FoP)'s relationship with symptom burden and disease and social/family factors, as well as, determine the status of FoP in women with stage‐IV breast cancer in Shandong, China. Methods: Two hundred and sixteen women were recruited from the department of breast cancer internal medicine, Shandong Cancer Hospital and Institute. Data for this observational study were collected between October 2020 and January 2021 using the MD Anderson Symptom Inventory, the Fear of Progression Questionnaire‐Short Form (FoP‐Q‐SF) and a participant information scale. SPSS 23.0 was used for statistical analysis. Results: After excluding invalid responses, the data of 200 participants were analysed. The average total FoP‐Q‐SF score was 29.39 ± 9.39 (95% confidence interval, 21.81–27.64). The FoP level among the participants was relatively low. For disease and social/family factors, FoP statistically significantly differed by satisfaction with family emotional support and the Eastern Cooperative Oncology Group (ECOG) score. The ECOG score was positively correlated with FoP. Furthermore, symptom burden was positively correlated with FoP. Conclusions: Among patients with stage‐IV breast cancer, satisfaction with family emotional support, ECOG score and symptom burden play key roles in FoP. Interventions, including providing appropriate emotional support from family, improving physical fitness and relieving symptom burden, must be considered in future studies, which may improve patients' overall physical and mental status and provide a supportive therapeutic environment. [ABSTRACT FROM AUTHOR]