The article discusses the role of histological grade in the prognostic classification of breast cancer, particularly in the molecular era. Histological grade, assessed using the Nottingham Grading System (NGS), is a robust and validated method for evaluating tumor biological characteristics and has been shown to be a significant prognostic factor in breast cancer. The NGS considers three morphological features: degree of tubule or gland formation, nuclear pleomorphism, and mitotic count. Multiple studies have demonstrated that NGS provides valuable prognostic information, particularly in early-stage breast cancer, where it can complement other established factors such as lymph node status and tumor size. The article also highlights the limitations of histological grading, including its subjective nature and the need for standardized methods to improve reproducibility. However, it emphasizes that histological grading remains a simple, inexpensive, and highly accurate method for assessing tumor biology and patient prognosis, especially in regions with limited access to advanced molecular technologies. The authors conclude that histological grading should be incorporated into staging systems and algorithms to define therapy for breast cancer patients, and that it should be used in conjunction with molecular tests rather than as a replacement.The article discusses the role of histological grade in the prognostic classification of breast cancer, particularly in the molecular era. Histological grade, assessed using the Nottingham Grading System (NGS), is a robust and validated method for evaluating tumor biological characteristics and has been shown to be a significant prognostic factor in breast cancer. The NGS considers three morphological features: degree of tubule or gland formation, nuclear pleomorphism, and mitotic count. Multiple studies have demonstrated that NGS provides valuable prognostic information, particularly in early-stage breast cancer, where it can complement other established factors such as lymph node status and tumor size. The article also highlights the limitations of histological grading, including its subjective nature and the need for standardized methods to improve reproducibility. However, it emphasizes that histological grading remains a simple, inexpensive, and highly accurate method for assessing tumor biology and patient prognosis, especially in regions with limited access to advanced molecular technologies. The authors conclude that histological grading should be incorporated into staging systems and algorithms to define therapy for breast cancer patients, and that it should be used in conjunction with molecular tests rather than as a replacement.