A method may include identifying, within an image of a biological sample, a plurality of mitotic figures associated with a tumor tissue present in the biological sample. Each mitotic figure of the plurality of mitotic figures may correspond to a tumor cell that is undergoing mitosis. A mitotic metric quantifying a spatial distribution of the plurality of mitotic figures within the biological sample may be determined based on the plurality of mitotic figures in the biological sample. A tumor grade for the tumor tissue present in the biological sample may be determined based on the mitotic metric. In some cases, at least one of a disease diagnosis, a disease progression, a disease burden, a treatment response, and a survival prognosis for a patient associated with the biological sample may be determined based on the tumor grade. Related systems and computer program products are also provided.