How Are Brain Tumours Graded?

There are different types of brain tumour, which are classed as malignant (cancerous) or benign (non-cancerous). They are further labelled according to the position in the brain, and graded from 1-4. Grade 1 and 2 are the least serious non-cancerous tumours, and grades 3-4 are cancerous. Here is some more information about how they are graded. 

Why are tumours graded?

Brain tumours are graded to provide you with an accurate diagnosis of your condition, and also to guide clinicians on a treatment pathway, and understand how the tumour might develop. The grading will usually be decided after a biopsy has been carried out, where a neuropathologist analyses the cell patterns from a sample of the tumour.

The more abnormal the brain tumour cells appear under a microscope, the higher the grade of tumour. Grade 1 tumours can have almost normal looking cells, while a grade 4 tumour will have the most abnormal looking cells. 

Sometimes, a tumour can be ‘mixed grade’ which means that the cells contained both low grade and high grade patterns. Even if the majority of the cells were low grade, the presence of high grade cells means that the tumour will be classed as high grade. 

Low grade tumours

A tumour that is grade 1 or 2 is classed as a low grade tumour. They are slow growing, and unlikely to spread or return if they are removed. Although they are benign, this doesn’t they are harmless or won’t require treatment. Depending on the position of the tumour in the brain, it can cause serious symptoms that may even be life threatening. 

Some benign tumours can cause a build up of pressure on the brain, by blocking the flow of cerebrospinal fluid which is essential for the brain to function normally. The tumour can also press on other areas of the brain, which may eventually cause damage. 

Furthermore, sometimes a low grade tumour can progress into a malignant grade 3 tumour, which could then develop into a grade 4 tumour. A grade 1 or 2 tumour may require surgery to remove it. 

High grade tumours

High grade tumours are graded as 3 or 4. They are fast growing and malignant (cancerous), and likely to spread to other areas of the brain or spinal cord. A combined treatment of surgery and radiotherapy or chemotherapy is usually required. 

Receiving your diagnosis

When your doctor or healthcare professional explains the grading of your brain tumour, don’t be afraid to ask questions, and ask them to explain anything that you don’t understand. They should be able to talk through all the recommended treatment options, for example.

Sometimes, certain hospitals or treatment centres run clinical trials of potentially effective new therapies. If this is something that you might be interested in taking part in, ask your doctor if there are any suitable programmes that you could sign up for. In some cases, you may also want to request a second opinion to confirm the diagnosis. 

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