Breast cancer management is an inevitable intertwining between multiple disciplines. Pathologists remain largely responsible for making the diagnosis that determines a patient’s management and prognosis. Simple morphology based classifications and tumour grading are now being complemented by exploration of disrupted cell pathways with the use of immunohistochemistry and molecular techniques that enable us to better predict cancer progression and response to treatment. This talk will explore how our understanding of breast cancer has evolved and how this has been central to the evolution and advances in breast cancer management.