Biopsy Results

This page explains how  prostate biopsy results are assessed.

The samples taken from the prostate will be sent off to a laboratory to be checked for cancer. This is done by scientists called histo-pathologists. They will look at the tissue under a microscope and check for cancerous cells.

Gleason Grading

If prostate cancer is detected, it will be assessed using the Gleason grading system. This is the standard way to classify prostate cancer. The Gleason system gives doctors an accurate picture of how potentially aggressive or problematic the cancer may be. 

Cancerous cells look different to normal cells under a microscope. Normal cells tend to be a similar size and uniform in appearance while cancerous cells may not have a clear shape and are hard to distinguish from each other.

The Gleason grading system uses the appearance of the cells to assign a score between 3 and 5 depending on how abnormal the cells look. For example, Grade 5 cells are more unusual looking than Grade 3 cells. 

The Steps Used to Create a Gleason Score

The histo-pathologist will take the following steps to give your tissue sample an accurate Gleason Score: 

  1. Look for the most common type of cell structure that is present. This will be given a score of between 3 and 5 depending on how cancerous the cells look.  
  2. Identify the next most common type of cancerous cell and grade it in the same way. 
  3. Add the two scores together to give the overall Gleason score out of 10 (for example: 3+3 (6 out of 10). 

The following video explains Gleason Scores: 


Assessing Your Gleason Score

Gleason ScoreType of Cancer
6Slow progression
7 (3+4 or 4+3)Moderate grade
8 (3+5, 4+4, 5+3)More aggressive
9 (4+5 or 5+4) More aggressive
10 (5+5) More aggressive

A Gleason Score of 4+3 is higher than a score of 3+4. 

Gleason Scores and Risk Groups

There is also a newer type of grading system which modifies the Gleason Scores into risk groups, from 1 to 5. 


Gleason ScoreGrade Group NumberRisk Profile
3 + 3Grade Group 1Low Risk
3 + 4Grade Group 2Intermediate Risk
4 + 3 Grade Group 3Intermediate Risk
3 + 5Grade Group 4High/Very High
4 + 4 Grade Group 4High/Very High
5 + 3 Grade Group 4High/Very High
4 + 5 Grade Group 5High/Very High
5 + 4 Grade Group 5High/Very High
5 + 5 Grade Group 5High/Very High

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