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The book has three main results parts. Chapter 3 illustrates the first independent validation study of a 70-gene signature developed from gene expression profiling for use in breast cancer prognosis and demonstration of its ability to add independent prognostic information to the clinical prognostic factors currently used. The successful validation of this study preceded the design and implementation of a world-wide randomized clinical trial evaluating the gene signature s clinical utility. This trial has commenced and is currently recruiting in Europe. Chapter 4 describes the finding that proliferation-related genes can predict clinical outcome consistently in breast cancer and many gene signatures developed for predicting breast cancer prognosis derive a significant proportion of their prognostic power from these genes. Finally, chapter 5 describes the use of proliferation-related genes to define two distinct prognostic molecular subgroups within estrogen receptor positive breast cancers.