MicroRNAs (miRNAs) are non-coding single-stranded RNAs in eukaryotes and are involved in the regulation of the post-transcriptional expression of specific genes. Studies have demonstrated that miRNAs play important roles in regulating diverse physiological events such as cell proliferation, differentiation and embryo development. In recent decades, considerable attention has been given to the relationship between miRNA and the pathology of cancers, particularly breast cancer. A large number of miRNAs have been shown to be involved in the pathophysiology of breast cancer. Studies have revealed that some miRNAs might regulate the oncogenesis and growth of breast cancer by acting on breast tumor-initiating cells or other downstream targets. Studies have also demonstrated that some miRNAs act as suppressors of metastasis or promoters of breast cancer. Additionally, certain miRNAs are involved in cancer tissue angiogenesis (one of the most important mechanisms of tumor growth and metastasis). Clinical evidence indicates that some miRNAs can be used as diagnostic and prognostic biomarkers for breast cancer due to their significantly increased or decreased expression in cancer tissue. Moreover, certain miRNAs may have therapeutic potential for targeting ER-α/HER, breast tumor-initiating cells and metastasis as well as multidrug resistance. In this review, we discuss the relationship between miRNAs and the pathogenesis of breast cancer as well as the progress of current research on the miRNA-specific diagnosis, prognosis and treatment of breast cancer.