We conclude that Prosigna®, when combined with clinicopathological biomarkers (tumor size, Ki67, NHG), adds important clinical utility and improved risk stratification, reduces the use of chemotherapy, but also identifies high-risk ER positive/HER2 negative, N0, postmenopausal patients who would not receive treatment based on only routine clinicopathology. Here, MKI67 is linked to neoplasm.