Learn about BRAF – watch our video

Understanding BRAF Gene Mutations in Melanoma

About half (40–50%) of people diagnosed with melanoma have a change in their cancer cells known as a BRAF V600E gene mutation. This mutation causes melanoma cells to produce an altered protein that signals the cells to grow and divide more rapidly.

When you are diagnosed, your doctor may arrange tests to check for gene changes like this. These tests are usually performed on melanoma tissue that has already been removed during surgery, although sometimes an additional sample is needed. Your cancer specialist or clinical nurse specialist can explain the testing process and what the results mean for you.

Why testing matters

The results help your medical team determine which treatments are most likely to be effective. For example:

If your melanoma has spread to the lymph nodes or beyond, testing is especially important.
If a BRAF mutation is found, you may be offered targeted therapy drugs designed to block the signals that make cancer cells grow. These treatments can help shrink tumours or slow their progression.
If no BRAF mutation is present, immunotherapy may be recommended instead.

Melanoma and gene changes

Melanoma is the most serious type of skin cancer and the fifth most common cancer in the United Kingdom, with more than 40 people diagnosed every day. When detected early, it is almost always treatable. However, melanoma is biologically complex, and several gene mutations can influence how it develops.

The three most common genetic mutations linked to melanoma are:

BRAF (most common)
NRAS
c-KIT

Because these mutations can affect how the cancer behaves, identifying them allows doctors to tailor treatment to each individual — an approach known as personalised or precision medicine.

What you should expect

Testing for BRAF status is now standard practice for many melanoma patients. You should be informed of your result and how it influences your treatment options. If anything is unclear, your healthcare team will be able to talk you through it and answer your questions.

The treatment you’re offered can also depend on the stage of your melanoma — you can read more in our guide to melanoma treatment by stage.

Watch: what BRAF is and why it matters

Watch our short animation below to learn what BRAF is and why it matters.

Pierre FABRE provided a restricted grant for this video to be made. This was a restricted grant and Pierre FABRE did not have any input into the content or review of the video.

Treatment By Stage

The treatment your team recommends depends heavily on the stage of your melanoma, from stage 0 through to stage 4. Our stage-by-stage guide explains what each one means and the options usually considered at each.

Targeted Therapies

Targeted therapies work on specific genetic changes inside melanoma cells — most commonly in a gene called BRAF — which is why you may be offered a BRAF test. They're an option for people whose melanoma carries these changes.

Surgery for Melanoma

For most people with melanoma, surgery is the first and main treatment — and often the only one needed when the melanoma is found early. It involves removing the melanoma along with a margin of surrounding skin, and sometimes checking nearby lymph nodes.

Stage IV Melanoma Guide

This booklet is for anyone diagnosed with — or being evaluated for — stage 4 melanoma, the most advanced stage, where the melanoma has spread beyond where it started. It's designed to help you understand and weigh up your treatment options.

Second Opinion

It's completely normal to want reassurance about your diagnosis or treatment plan, and you have every right to ask for a second opinion. It won't offend your medical team — it's a recognised part of your care.

Radiotherapy for Melanoma

Radiotherapy uses carefully targeted radiation to treat melanoma. It isn't used as often as surgery or drug treatments, but it can play a role in certain situations, such as treating melanoma that has spread.

Other Therapies

Some less common treatments, such as isolated limb infusion (ILI) and isolated limb perfusion (ILP), may be recommended when melanoma is confined to one area, such as an arm or leg. These deliver treatment directly to the affected limb.

Learn about BRAF – watch our video

Around half of people diagnosed with melanoma have a change in their cancer cells called a BRAF V600E gene mutation. Watch our short video to understand what BRAF means and why it matters for your treatment options.

Immunotherapy

Immunotherapy works by helping your own immune system recognise and attack melanoma cells. It's often used for melanoma that has spread or has a higher risk of returning, and several immunotherapy treatments are now available on the NHS.

Excision

Local excision is where the abnormal mole or area of skin is removed and sent to a laboratory for testing. It's a relatively simple operation and is often the first step in diagnosing and treating melanoma.

FOLLOW UP APPOINTMENTS

Your follow-up care depends on the stage of the melanoma. Follow-up appointments allow your doctor to monitor for possible recurrence of the melanoma.

MELANOMA AFTER CARE

It’s important to regularly check yourself for any signs of melanoma. As you have already been diagnosed with melanoma, you are at a higher than average risk of having another melanoma in the future.

MELANOMA FURTHER TESTS

If the initial biopsy shows melanoma, you may need further tests. Understanding the extent of the melanoma can help your doctor decide the best treatment option for you.

MELANOMA SKIN BIOPSY

If your doctor does find a suspicious mole, a sample of tissue is removed (a biopsy) for examination under a microscope. The doctor first numbs the skin with an injection of a local anaesthetic

GETTING DIAGNOSED WITH MELANOMA

See your doctor if you develop a new mole or notice a change in an existing mole or area of your skin (including under your nail). Even if you’re worried about what this might be, you shouldn’t delay seeing them. It might not be cancer.