Understanding Brain Tumor Grades
Brain tumor grading is a way for doctors to classify how aggressive a tumor is and determine the most effective treatment approach. When a patient is diagnosed with a brain tumor, understanding its grade is crucial to understand treatment planning.
RWJBarnabas Health is New Jersey's largest and most comprehensive academic health care system. Our integrated team of brain cancer specialists works collaboratively to evaluate and treat brain tumors of all grades.
Together with Rutgers Cancer Institute, New Jersey’s only National Cancer Institute-designated Comprehensive Cancer Center, we provide access to the most advanced treatment options including clinical trials. We use sophisticated diagnostic and treatments to create precise, personalized care plans, complemented by comprehensive support services and specialized rehabilitation programs that address the full spectrum of our patients’ needs.
To contact one of New Jersey’s best brain and spine cancer specialists, call 844-CANCERNJ or 844-226-2376.
What Are Brain Tumor Grades?
Brain tumor grading is a standardized system doctors use to classify how aggressive a tumor is by examining its cells under a microscope. The grading system evaluates growth rate, cell appearance, blood vessel formation, and genetic features to assign a grade from I to IV, from the least aggressive tumors, with slow-growing cells that appear almost normal, to the most aggressive, with rapidly growing cells that appear very abnormal and extensively infiltrate surrounding tissue.
How Are Brain Tumors Graded?
There are four grades of brain tumor. Grade I and II are also called low-grade tumors. Grade III and IV are also called high-grade or anaplastic tumors. The grades are:
- Grade I. This kind of tumor is the least malignant. Cells in a grade I tumor look a lot like normal brain cells. Your doctor may remove a grade I tumor with surgery, if it can be done safely. Or your doctor may follow the progress of a grade I tumor with yearly MRI scans.
- Grade II. This kind of tumor has cells that are not normal when looked at under a microscope. They can grow and invade the tissues around them. Even if they are fully removed with surgery, this kind of tumor can sometimes come back at a higher grade. Low-grade diffuse astrocytoma is an example of a grade II tumor.
- Grade III. This kind of tumor has cells that look more abnormal under the microscope. This kind of tumor grows into the tissues around it. When a grade III tumor is removed with surgery, it usually grows back faster than a grade II tumor. A grade III tumor often turns into a grade IV tumor. An example of a grade III tumor is anaplastic astrocytoma.
- Grade IV. This kind of tumor is the most malignant. Grade IV tumor cells are very abnormal. They grow and spread quickly into areas of the brain. Surgery can't reach all these areas without harming the brain, so other types of treatment are often needed. An example of a grade IV tumor is glioblastoma multiforme.
The grading process is particularly important because tumors that look similar on imaging studies can have very different grades. A tumor's grade often influences whether treatment should begin with surgery, radiation therapy, or a combination of treatments. It also helps your care team predict how the tumor might respond to specific therapies and determine how frequently you'll need follow-up imaging studies.
Tests and Procedures for Diagnosing Brain Tumor Grade
Accurate diagnosis requires several specialized tests and procedures, including:
- Imaging. Magnetic resonance imaging (MRI) and computed tomography (CT) scans provide detailed images of the tumor's location and characteristics.
- Biopsy. A biopsy allows expert neuropathologists to examine tumor tissue microscopically and perform molecular testing to determine the specific tumor type and grade.
Determining your brain tumor's grade is a crucial part of the diagnostic process that helps guide your treatment plan. Our expert neuropathologists examine tissue samples from your tumor under a microscope to evaluate several key features that determine its grade. These include how the cells look compared to normal brain cells, how quickly they're growing, and whether there are signs of blood vessel formation or areas of dead tissue within the tumor.
Brain Tumor Treatment by Grade
Treatment approaches vary based on tumor grade.
- Grade I tumors often respond well to surgery alone.
- Grade II tumors typically require surgery and sometimes radiation therapy.
- Grade III tumors usually need combination therapy including surgery, radiation, and chemotherapy.
- Grade IV tumors require aggressive multimodal treatment combining surgery, radiation, chemotherapy, and sometimes experimental therapies through clinical trials.
Clinical Trials
Through our partnership with Rutgers Cancer Institute, we offer access to the latest clinical trials and investigational therapies for brain tumors of all grades.
Expert Brain Tumor Care at RWJBarnabas Health and Rutgers Cancer Institute
At RWJBarnabas Health and Rutgers Cancer Institute, our comprehensive brain tumor program combines expert neuropathologists, advanced diagnostic technologies, and extensive molecular testing capabilities. Through regular multidisciplinary tumor board reviews, we ensure each patient receives optimal care tailored to their specific diagnosis. Care teams can include neurologists, neurosurgeons, oncologists, and nurses who specialize in oncology care.
To contact one of New Jersey’s best brain and spine cancer specialists, call 844-CANCERNJ or 844-226-2376.
