Your Gleason Score is actually the sum of two Gleason grades, the primary grade and the secondary grade. The minimum grade is 1 and the maximum grade is 5. Ergo, the minimum score is 2 and the maximum score is 10. The higher the score, the more advanced or more aggressive the cancer. My score was 3 + 3 = 6. Scores of 2, 3, or 4 are so rare as to be practically unheard of. A score of 5 is more common and the most common scores are 6, 7, & 8.
(This picture shows a drawing of the 5 grades that the pathologist uses in determining your Gleason Score.)Assuming that the biopsy was good and provides an adequate number of mapped cores, (where in the prostate they came from), the pathologist looks at the slides and determines how many include cancer and where the cancer is. She/he then classifies, or "grades", the cell structure in the majority (>50%)of the cancer observed. That becomes the Primary Gleason grade. Then, the pathologist grades the cells in the rest of the cancer and assigns the Secondary Gleason grade.
(Similar picture, but including some pictures of actual pathology slides. You can look at the slide pictures and see how the pathologist does the grading.)The Gleason score is then written as the sum of the two most prominent, or dominant, Gleason grades. (So a Gleason score of 2+3=5 has a primary grade of 2 and a secondary grade of 3). A score of 4+3=7 means that a poorly differentiated component (pattern 4) is dominant. If 95% or more of the tumor is composed of one pattern, the corresponding number is counted twice; thus, a wholly moderately-differentiated tumor would be scored 3+3=6.
In other words, not all scores are equal. A score 7 from 3+4 is better than one from 4+3.
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