Types

Brain Tumors: Grades

Choose a preferred language

Once your doctor knows you have a brain tumor, an important next step is to find out the grade of the tumor. The grade refers to how the cancer cells look under a microscope when compared with normal brain cells. Grade is determined by a pathologist when a tissue sample (biopsy) is sent to the lab.


How grading helps

The grade of your tumor will help your doctor know:

  • How quickly the tumor is likely to grow.

  • How likely it is that the tumor will spread to other parts of the brain.

  • How it might respond to treatment.

  • How likely it is to grow back after treatment. 


Grades of brain tumors

There are many types of brain cancer. The World Health Organization grades tumors based on how abnormal cancer cells look under a microscope. It also considers how quickly a tumor grows and spreads. There are 4 grades used for brain tumors. Grades I and II are also called low-grade tumors. Grades III and IV are also called high-grade or anaplastic tumors. The grades are:

  • Grade I. This kind of tumor is the slowest growing and least likely to spread. 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 grow more slowly than Grade III and IV. They may invade the tissues around them. They tend to start growing faster over time. Even if they are fully removed with surgery, this kind of tumor can sometimes come back.

  • Grade III. This kind of tumor has cells that look more abnormal under the microscope, but there are no dead cells in it. This kind of tumor grows more quickly than Grade I and II tumor cells. They tend to spread into the tissues around it. When a grade III tumor is removed with surgery, it grows back faster than a grade II tumor. After surgery, additional treatment is usually needed using radiation therapy and chemotherapy.

  • Grade IV.  This kind of tumor grows fast. It has blood vessels and areas of dead tissue. Grade IV tumor cells are very abnormal. They grow and spread quickly into other parts of the brain. Surgery can’t take out all of this tumor without harming the brain, so other types of treatment are often needed.

Date Last Reviewed: 04/01/2025

© 2025 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.
doctor icon

Find the right provider to meet your needs

From primary care to specialty services and more.

Find a Doctor
appointment clock icon

Call for an Appointment

Offering personalized care at more than 20 clinics across three cities and two states.

Call Now
Related Articles
Read article
Brain Health
Cluster Headache

A cluster headache is different from a migraine or a tension headache. Learn about symptoms, triggers, and treatments for a cluster headache.

Read article
Hematology
Chronic Myeloid Leukemia (CML): Treatment Questions

Talking with healthcare providers about cancer can be overwhelming. It can be hard to take in all of the information. It helps to be prepared. Make a list of questions that you have and bring them to your appointments.

Read article
Urology
Kidney Cancer: Treatment Discharge Instructions

When you're being treated for kidney cancer, you'll need to take good care of yourself at home after treatment. Read on for helpful tips.

Read article
OB/GYN
Life After Cancer: Pregnancy

If you’re thinking of trying to get pregnant, talk with your healthcare team about what you can expect. Your situation will be unique to you and your cancer journey.