With the development of new genomic tests for breast cancer the whole emphasis for classifying breast cancers has shifted from traditional descriptive, or ‘grade’ classifications to genomic tests that predict the tumour capacity for ‘cell proliferation’. Following surgery to remove the tumour, the breast cancer multi-disciplinary team (MDT) need to make decisions concerning the next most appropriate treatment options. Underpinning this decision is the ability to forecast the likelihood of the cancer recurring and / or forming metastases. The traditional ‘grade’ classifications are no longer sufficient on their own to fully inform this process. The latest genomic tests, combined with traditional pathology provide a far more accurate assessment.